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Cataract

What is a cataract?

A cataract is a progressive clouding of the human lens inside the eye. The lens is a small oval like structure and consists of a thin capsule (like a very fine plastic sheet) enveloping a bag of protein. The protein is crystal clear and colourless at birth but discolours and clouds with age: first yellow, then brown, and finally cloudy.

When the lens becomes cloudy and interferes with vision, it is called a cataract. A cataract is not a growth, a "skin", or a disease. It is usually not a sign of eye or systemic disease, though it could be the result of one. When a cataract develops, the lens no longer transmits or focuses light clearly.

How does a cataract affect vision?

Initially the cataract changes the focusing power of the eye, and a change of glasses can satisfactorily improve vision. Gradually, clarity drops so that visual tasks become increasingly difficult, despite the best possible glasses.

A person with cataract views the world as if through a dirty window or a dusty windshield that needs cleaning. Glare becomes a serious problem. Colour perception becomes muted. Reading, driving, computer work, hobbies, and athletics become less easy and eventually impossible due to diminished vision.

Can cataract occur at earlier age or in childhood also?

Yes. Sometimes the child may be born with cataract or may develop cataract in early childhood. The management of these cataracts is different from that in adult patients. Cataract may also occur at an earlier age because of trauma, inflammation of eye, use of medicines like steroids, general medical conditions like diabetes, radiation etc.

What precautions should I take to prevent a cataract from developing?

Avoid smoking for it accelerates cataract development. Routine eye exams are important in watching for cataract formation that may be the result of medicines or general illnesses.

Could I just change my glasses to make me see better?

A cataract is a clouding of the human lens, impairing the transmission and clarity (not focus) of light entering the eye. Glasses function by helping the eye focus light, they do not improve the transmission of light. If a window has dirt on it, even with binoculars we cannot see clearly through it.

Are there other non-surgical treatments besides using spectacles?

There is no nonsurgical treatment for a cataract. Preventative measures include wearing good ultraviolet (UV) blocking sunglasses to protect the eyes from the sun. Anti-oxidant vitamins may slow cataract changes.

When should I have the cataract removed?

Each person's need is different. First obtain the best possible glasses and decide if the vision is provided is sufficient for your needs. Your job, hobby, driving needs, and personality will determine how satisfied you are with your vision.

Is it a good idea to wait until the cataract is ripe?

This concept is now outdated.

How long will the surgery take?

The vast majority of cataract surgeries are done on an Outpatient basis either in a hospital or doctor run surgery center. You are not admitted to the surgery. Surgery lasts from 10 to 30 minutes, and you go right home. Anesthesia use is varied but usually light sedation and local. General anesthesia is rarely needed. Pain is very rare. No surgery is completely predictable but the vast majority of operations are successful.

How fast will my vision return?

Some people will see quite well within a few hours or by the next morning. Even with no problems some people will need several weeks of healing for their vision to return to normal.

Will I need glasses?

The process of cataract removal and lens implantation is intended to restore your focus to normal, minimizing your dependence on glasses. Most people need some form of glasses, if only to read.

Who benefits from a lens implant?

When the cataract is removed the lens itself is removed except for the
thin capsule. While the cloud is gone, the focus is also gone. The lens implant restores the focusing power to the eye, and being artificial cannot cloud over. The power of the lens is calculated to minimize your dependence on glasses after surgery. The implant is permanent and it is extremely rare that one needs to be removed or repositioned.

Can lasers be used to remove a cataract?

Despite some public misconception, laser is not an option for removing cataracts at this time. Even the experimental devices are quite different from what one might imagine for use in a laser cataract surgery.

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