Cataract, It’s causes, treatment and Cataract Surgery

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Mature Cataract Photo

What is Cataract?

When it becomes Cataract is when the clear lens inside the eye becomes cloudy. cloudy you cannot see well, like looking through a very dirty window. It is simply known as Opacification of the crystalline lens.

What causes cataract?

There are many causes but here are the main ones.

1. Ageing: 
From about 40 years up there are many changes in the body and the eye.  For example, in some people, the hair may become grey.  In some people, the lens of the eye may become cloudy and this reduces vision.

2. Trauma:
Injuries to the eye may cause the cataract to form.

3. Congenital or developmental
it is possible to be born with cataract or to develop it as a young child.  This may be due to inheritance from the family or from illness in mother or child. 

4. Ultraviolet radiation: 
More exposure to UV irradiation from sunlight can also lead to cataract.

5. Diabetes
People with diabetes are likely to develop a cataract.

6. Smoking
Cigarettes smoking cause cataract.  

MAture Cataract
Mature Cataract

 How do you know if someone has a cataract?

The vision gradually decreases, as the cataract gets more and more cloudy. Cataract can occur in one eye or in both eyes.  Anyone with decreasing vision should be examined by a doctor or health worker trained to detect the cataract. Sometimes the cloudiness becomes so great that the black part in the centre of the eye actually looks white.  In these cases, the vision is very reduced.

Treatment of Cataract

The good news is that modern surgery can cure cataract. There is no medical and optical cure for cataract until now. Nowadays, eye surgeons can remove the cataract and replace the cloudy lens with a small artificial lens called Intraocular Lens (IOL). Surgery is done in hospitals with modern techniques. There are two techniques commonly performed in an eye hospital, that are ECCE or Small Incision Cataract surgery (SICS) and Phacoemulsification surgery. Before surgery, a patient is given a local anaesthetic so there is no pain during the operation. 

The operation takes 15-20 minutes. After the operation, a patient must rest for a day with a bandage/Eye Pad or only with eye shield in the hospital or go home and came next day morning on follow up. After one day, the doctor examines the eye, and medicines are instilled. After post-operative examination patient is discharged to go home with medicines.  If he/she has any further problems she may need to stay in the hospital. Before discharge from the hospital, the patient will be taught how to put in medicine at home and must use the medicine for a few weeks. 

 Procedure of catarct surgery

After 2-3 weeks the patient should get another examination, either at the hospital or another site with eye care professionals as directed by surgeons.  If a patient has severe pain or sudden loss of vision in the eye before the examination he should come right away. Many patients do not need glasses after surgery for distance, but some like to use glasses for reading or doing close work.

Intraocular Lens placed in Posterior chamber after cataract surgery.

Follow up

It is important to be assessed after surgery.  This can be done in the eye hospital or nearest eye care professionals clinics/eye centres. 
Before and After Cataract Surgery
Before and After Cataract Surgery with IOL Implant

Frequently asked questions:

1. Do cataract surgery also correct preoperative astigmatisms? 

Yes, there are many techniques of Cataract surgery with astigmatism corrections (Pre Operative) some of it by using Toric Intraocular Lenses which are best Intraocular lens for astigmatism correction. Depends upon Keratometry reading (Reading of curvature of Cornea) your surgeon will explain to you about the best lenses. 

2. Can blurred vision after cataract surgery may occurs? 

Not at all but sometimes there is opacification on Intraocular lens may occur, which is called Posterior capsular opacification (PCO) which need special LASER called Nd: Yag Laser to clear it so your vision will be clear again it’s not a big thing, and another cause of blurred vision after cataract surgery is your retina may be affected by your old age, hypertension, diabetes and other systemic cause. So if you feel blurred vision after surgery you have to consult immediately with your cataract surgeon. 

3. What is Femto laser surgery for cataract?

Femto Laser-Assisted Cataract Surgery, or FLACS, is a surgical procedure which uses Femto Laser to replaces some of the steps during cataract surgery that requires a blade and softens the cataract, allowing for easier and smoother removal of Cataract lens, after that cataract will remove using the small probe and Foldable intraocular lens is implanted. 

Femto Laser-Assisted Cataract Surgery in Nepal.
Tilganga Institute of Ophthalmology provides Femto laser cataract surgery services, you can ask about it to the Surgery counsellor or ophthalmologist who examines you there. Prof Dr Sanduk Ruit, Dr Reeta Gurung, Dr Shyam Vyas and many of surgeons of Tilganga Institute of Ophthalmology perform these surgeries nowadays. 

4. Which cataract surgery is best Phaco or SICS?

Phacoemulsification cataract surgery is the best procedure compared to SICS, you can view this video by Dr Prachand Gautam to know it on brief. 

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