What are cataracts?
Cataracts are a very common eye condition that occurs as we age. Cataracts are formed when the lens in our eyes become cloudy. When this occurs, light cannot pass directly through your lens and vision is decreased. A cataract is neither a growth nor a film growing over the eye; it is simply the lens becoming foggy.
What causes cataracts?
There are several causes of cataracts, but the most common reason is aging.
Other causes of cataracts include diabetes, trauma, eye conditions, medications such as steroids, eye surgery for other eye conditions, lifelong exposure to sunlight, tobacco smoking, poor diet lacking antioxidant vitamins.
Symptoms
Cataract development is usually slow.
When a cataract starts to develop, you may feel that your vision is not quite right (as though you are wearing glasses and the lenses are dirty).
Gradually, sight becomes cloudy making it difficult to see.
You may feel as though you need a lot more light for reading.
Another common symptom is a problem with bright lights. The lights cause glare or dazzle you more than they normally would.
Some people can also experience a slight change in colour vision: things may appear a bit yellow. This mostly happens if one eye develops a cataract first and colours look different when compared to the other eye.
Treatment
The only effective treatment for cataracts is surgery. During this procedure your Ophthalmologist will remove the cloudy lens and replace it with an artificial lens implant which eventually becomes a permanent part of your eye. There is no evidence suggesting that vitamins, diet changes or use of eye drops can cure cataracts.
Removal
Cataracts can be removed at any time. Due to modern equipment, there is no reason to wait for the cataract to become ‘ripe’ before removal. Most people choose to remove their cataracts when it starts to affect their vision and cause difficulties in everyday life. This varies from person to person and should be discussed with your eye specialist who will provide further advice.
What to expect before surgery?
Before removing the cataract, you will be required to have a pre-operative eye examination to decide the details of surgery. Your vision will be checked and the eye measured to decide the strength of the lens that is to be implanted when the surgery is performed. If you have had previous eye surgery / laser procedures, you must inform your Ophthalmologist.
What to expect during surgery?
Cataract surgery usually lasts about 10-12 minutes. It is usually done with a local anaesthetic, which means you will be awake throughout the procedure but will feel no pain. However, it can be done under general anaesthetic, meaning you will be completely uncoinscious during the surgery.
You will be given dilating drops to the eye to be operated on. Your face will be covered by a sheet in order to keep the area around your eye clean during the surgery.
The most common way to remove cataracts is phacoemulsification. This involves using high frequency sound energy to breakup the natural lens with the cataract. Only small incisions are used, eliminating the need for stitches. The eye surgeon generally uses a microscope to get the best view of your eye. During the operation, the surgeon cuts through the lens capsule and removes the clouded lens using suction. The lens capsule is left in place and an artificial lens is implanted in place.
If you are awake for the surgery, it is important that you keep as still as you can.
What to expect after surgery?
After surgery, your eye will be covered with an eye shield and dressing. As the anaesthetic begins to wear off, it is normal for the eye to feel a bit sore. This pain is usually not too bad and painkillers such as paracetamol can be used to help.
If your cataract was relatively mild, you may not detect a big change in vision but if your cataract was quite bad you may notice quite an enhancement in your vision.
Nonetheless, your sight may not be as good as you expect for the first week after surgery as the eye may still be recovering.
You will be given eye drops to reduce inflammation and it is important that you use it as advised. Most people have no problems and are up and about as normal the next day.
You may however find certain lighting too bright for a couple weeks and wearing sunglasses can assist with this. If any problems arise, please inform your doctor.
OTHER RESOURCES
Animation: Cataract
Source: National Eye Institute, NIH
Phacoemulsification Cataract Surgery
Source: Eye Smart- American Academy of Ophthalmology
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