Cataract Surgery
Most cataracts develop when aging or injury changes the tissue that makes up the eye’s lens. Proteins and fibers in the lens begin to break down, causing vision to become hazy or cloudy. Some inherited genetic disorders that cause other health problems can increase your risk of cataracts.
Cataract surgery involves removing the clouded lens and replacing it with a clear artificial lens. The artificial lens, called an intraocular lens, is positioned in the same place as your natural lens. It remains a permanent part of your eye. For some people, other eye problems prohibit the use of an artificial lens.
Diagnosis
To determine whether you have a cataract, your doctor will review your medical history and symptoms, and perform an eye examination. Your doctor may conduct several tests, including:
- Visual acuity test.A visual acuity test uses an eye chart to measure how well you can read a series of letters. Your eyes are tested one at a time, while the other eye is covered. The decrease in visual acquity is the commonest complaint a cataract patient will present with.
- Slit-lamp examination.A slit lamp allows your eye doctor to see the structures at the front of your eye under magnification. The microscope is called a slit lamp because it uses an intense line of light, a slit, to illuminate your cornea, iris, lens, and the space between your iris and cornea. The slit allows your doctor to view these structures in small sections, which makes it easier to detect any tiny abnormalities.This machine helps doctor to identify the type of cataract and associated abnormalities of lens apparatus and plan your surgery accordingly.
- Retinal exam.To prepare for a retinal exam, your eye doctor puts drops in your eyes to open your pupils wide (dilate). This makes it easier to examine the back of your eyes (retina). Using a slit lamp and 90D lens or a special device called an ophthalmoscope, your eye doctor can examine your retina to assess the expected visual outcome after cataract surgery.
- Applanation tonometry/NCT.This test measures fluid pressure in your eye. There are multiple different devices available to do this.High pressure might indicate at times to postpone one’s cataract surgery
Treatment
When your prescription glasses can’t clear your vision, the only effective treatment for cataracts is surgery.
Concerned about pain during cataract surgery? Get a clear understanding of the procedure and recovery here.
When to consider cataract surgery
Talk with your eye doctor about whether surgery is right for you. Most eye doctors suggest considering cataract surgery when your cataracts begin to affect your quality of life or interfere with your ability to perform normal daily activities, such as reading or driving at night.
It’s up to you and your doctor to decide when cataract surgery is right for you. For most people, there is no rush to remove cataracts because they usually don’t harm the eyes. But cataracts can worsen faster in people with certain conditions, including diabetes, high blood pressure or obesity or already mature cataracts.
Delaying the procedure generally won’t affect how well your vision recovers if you later decide to have cataract surgery,unless already delayed. Take time to consider the benefits and risks of cataract surgery with your doctor.
If you choose not to undergo cataract surgery now, your eye doctor may recommend periodic follow-up exams to see if your cataracts are progressing. How often you’ll see your eye doctor depends on your situation.
What happens during cataract surgery
Cataract surgery Open pop-up dialog box
Cataract surgery involves removing the clouded lens and replacing it with a clear artificial lens. The artificial lens, called an intraocular lens, is positioned in the same place as your natural lens. It remains a permanent part of your eye.
For some people, other eye problems prohibit the use of an artificial lens. In these situations, once the cataract is removed, vision may be corrected with eyeglasses or contact lenses.
Cataract surgery is generally done on an outpatient basis, which means you won’t need to stay in a hospital after the surgery. During cataract surgery, your eye doctor uses a local anesthetic to numb the area around your eye, but you usually stay awake during the procedure and can communicate freely with the doctor during surgery.
These days all cataract procedures are done by phacoemulsification (MICS) only unless indicated otherwise,where a small keyhole incision of 2.2 mm is given through which your cataractous lens can be dissolved by ultrasonic vibrations and foldable IOL of your choice can be implanted through same incision .
Cataract surgery is generally safe, but like any other procedure in body it carries a risk of infection. Cataract surgery increases the risk of retinal detachment in some patients.
After the procedure, you’ll have some discomfort ,mild redness or foreign body sensation for a few days. Healing generally occurs within a few days to weeks.
If you need cataract surgery in both eyes, your doctor will schedule surgery to remove the cataract in the second eye after you’ve healed from the first surgery in most of cases.
Intraocular lenses
These days with advent of newer lenses and machines the treatment is tailored to one’s specific needs and eye datails, it’s not one shoe fits all type ,that used to be normal previously Master machine calculates certain parameters of your eye and helps doctor to decide which type of lens would be most suitable to your eyes taking into account your specific requirements.
Monofocal IOL’s-
Earlier these were the only lenses available for all types of pts,making pt dependent on near vision glasses for their near work and needed slight power for distance also in many cases.
TORIC IOL’S-
Needed in some patients with high astigmatism to minimize dependence on distance glasses,doctor will guide you about this if these are required.
Multifocal IOL’S-
Will give you good vision for near and far but intermediate vision is not that clear
TRIFOCAL IOL’S-
With today’s life style where one spends lot of his time on system,no surprise this is the most preferred IOL chosen by patients these days,where you can see all distances clear with this iol and one will almost be independent of glasses for all their routine work.
Lifestyle and home remedies
To deal with symptoms of cataracts until you decide to have surgery, try to:
- Make sure your eyeglasses or contact lenses are the most accurate prescription possible
- Use a magnifying glass to read if you need additional help reading
- Improve the lighting in your home with more or brighter lamps
- When you go outside during the day, wear sunglasses or a broad-brimmed hat to reduce glare
- Limit your night driving
Self-care measures may help for a while, but as the cataract progresses, your vision may deteriorate further. When vision loss starts to interfere with your everyday activities, consider cataract surgery.Considering the range of lenses available in market these days one should not unnecessarily postpone cataract surgery.
Preparing for your appointment
Make an appointment with your usual eye care provider if you notice changes in your vision. If your doctor determines that you have cataracts, then you may be asked to undergo certain eye investigations to assess suitability of type of iol for youir eye .
Because there’s often a lot to talk about, it’s a good idea to be well prepared for your appointment so that you can make the most of your time with your doctor. Here’s some information to help you get ready.
What you can do
- List any symptoms you’re experiencing,including any that may seem unrelated to the reason for which you scheduled the appointment.
- Make a list of all medications,vitamins or supplements that you’re taking.
- Take a family member or friend along.Sometimes it can be difficult to absorb all the information provided during an appointment. Someone who accompanies you may remember something that you missed or forgot,also if your eyes need dilated retina examination,it helps to have someone drive you back home as your vision might be slightly blurry for few hours after dilatation drops.
- List questions to askyour doctor.
For cataracts, some basic questions to ask your doctor include:
- Are cataracts causing my vision problems?
- What kinds of tests do I need?
- Will cataract surgery correct my vision problems and which type of lens will be most suitable for my eyes?
- What are the potential risks of cataract surgery? Are there risks in delaying surgery?
- What will cataract surgery cost, and will my insurance cover it?
- How much time will I need to recover from cataract surgery?
- Will any usual activities be restricted after cataract surgery? For how long?
- After cataract surgery, how long should I wait before getting new glasses if any?
- If I don’t want surgery right now, what else can I do to cope with my vision changes?
- How will I know if my cataracts are getting worse?
- I have these other health conditions. How can I best manage these conditions together?
- Are there any brochures or other printed material that I can take with me?
In addition to the questions that you’ve prepared to ask your doctor, don’t hesitate to ask questions at any time that you don’t understand something.
For more details or to book a consultation, visit our Contact Us page.
What to expect from your doctor
Your doctor or his assistant is likely to ask you a number of questions. Being ready to answer them may allow more time later to cover other points you want to address. Your doctor may ask:
- When did you begin experiencing symptoms?
- Do you have your symptoms all the time or do they come and go?
- Do you experience vision problems in bright light?
- Have your symptoms gotten worse?
- Do your vision problems make it difficult for you to drive?
- Do your vision problems make it difficult to read?
- Do your vision problems make it difficult to do your job?
- Have you ever had an eye injury or eye surgery?
- Have you ever been diagnosed with an eye problem, such as inflammation of your iris (iritis)?
- Have you ever received radiation therapy to your head or neck?
- Any significant systemic disease such as disbetes ,hypertension,or any medication history for long?
FREQUENTLY ASKED QUESTIONS
Our natural lens is like a camera lens crystal clear in most of us .The way smudgy lenses causes blurrying of vision same way our natural lens looses it’s transparency over a period of time and becomes opaque,the more opaque the lens is the blurrier the images becomes, that we see.
Loss of transparency can start in any portion of our lens ,depending upon which we classify cataracts as nuclear/cortical/subcapsular/posterior polar/mature and so on.
We can have opacification of posterior capsule (PCO) after many years of cataract surgery, which can be cleaned sitting on a YAG laser beam in few seconds.But cataracts once removed completely can’t occur again.
Large number of indian population is now diabetic or hypertensive,if with medication you are keeping healthy, then you can undergo cataract surgery like in normal patients without much additional risk
We can have normal diet from the day of surgery,shaving ,morning walk and head bath and driving 3 days after surgery,kitchen work 7 days after surgery; yoga and gyms 2-3 weeks after surgery;computer/screen work/TV 1- 2 weeks after surgery.
We do almost all cases using anaesthetic eye drops,which means no pain of injection and no bandage afterwards, enabling us to start seeing 2-3 hours after surgery.
With the vast experience of close to one lakh cataract surgeries by our doctor,the chances of complication during surgery are negligible,also post operatively there are mininmum chaces of problems,but despite all this risk of infection always stays as in any other procedure on our body and thus the importance of cleanliness post-surgery