Cataract

What is cataract?

When the naturally occurring lens in the eye becomes cloudy, it is called cataract. Normally the lens is clear but due to ageing, systemic health issues, dehydration, diabetes, injury to the eye, there is break-down of proteins inside the lens that causes it to become opaque either slowly or immediately depending on condition.

What are the symptoms of cataract?

Mostly age-related cataracts occur slowly and will not affect vision to begin it, but with time when cataract becomes denser, the vision is affected. Initial stages can be rectified with glass prescription to improve vision. As the cataract matures, surgery is the only definite treatment. Cataract surgery is a procedure to remove the cloudy lens and replaced with artificial lens called an intraocular lens(IOL) that corrects the vision lost due to cataracts but it can also correct other refractive errors like nearsightedness, farsightedness, astigmatism and presbyopia.

There are different types of cataract surgery

Extracapsular cataract extraction(ECCE)-– The lens is removed from a capsular bag and manually extracted out of the eye( either in toto/ by splitting it into 2 halves) through a large incision about 10-12mm long that needs sutures to assist in healing. Its variation that is commonly practised is manual small incision cataract surgery(MSICS) which needs a smaller incision about 5-6mm (compared to its older version) which usually doesn’t need sutures.

Phacoemulsification– It is the most commonly used technique that uses 2mm incision. It utilises the ultrasound energy from a machine to break the cataract inside the capsular bag and removed with the help of suction.

Femtosecond laser-assisted cataract surgery(FLACS)– This is a recent development in cataract surgery. A femtosecond laser is utilised to make an incision of the wound, opening in the capsular bag and fragmentation of the cataract. It is assisted with the help of real-time imaging during surgery which makes it more precise. Rest of the procedure continues like phacoemulsification.

Different varieties of IOLs are chosen to suit the person's eye condition and lifestyle requirements.

Monofocal IOL- These are lenses best suited to correction for one – at a distance. Near-vision glasses are needed for those who are implanted with this type of lens.
Multifocal IOL- These are specially sculpted lenses that have different zones to help see for distance and near. Some help in intermediate distance too.
Extended depth of focus (EDOF)IOL- These are lenses with an expanded corrective zone that restores vision for distance and intermediate working distance.
Toric IOL- These are lenses that have built-in correction for astigmatism.Available with mono-focal and other presbyopia-correcting IOLs.
Accommodative lens- These lens correct for all distances. They use the natural movement of internal eye muscles to focus objects at different focal length.
Light-adjusted lens(LAL)- These are special mono-focal lenses that can be customised after the cataract surgery wound has healed.Adjustments are done in OPD through series of light based procedures to customise the power of IOL that can be set for distance and near without need of glasses.

Ability to carry out reading and daily activities depends on person’s ability. Mutifocal, EDOF, Toric, and other IOLs are called premium IOLs that may not suit everyone. Your ophthalmologist may do a comprehensive eye check up and suggest the best possible IOL for your eye according to your eye and systemic condition. Meet your doctor once you have the above symptoms or if you have/had suffered any of the above conditions mentioned above like diabetes/ injury to the eye/ steroid use in any form.

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Meet the doctor once you have the above symptoms or if you have/had suffered any of the above conditions mentioned above like diabetes/ injury to the eye/ steroid use in any form.

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