Cataract

Understanding Cataracts and Cataract Surgery: A Comprehensive Patient Information Guide

A cataract is the clouding of the eye’s natural lens, leading to blurry or reduced vision. The lens, which is normally clear, becomes opaque over time, causing progressive vision loss. Cataracts develop gradually and are a common condition, especially in older adults. They can affect one or both eyes and, if left untreated, can lead to significant vision impairment and blindness.

Causes and Risk Factors of Cataracts

Cataracts primarily develop due to aging, but several factors can contribute to their formation:

• Aging: The most common cause, leading to the breakdown of proteins in the lens.
• Genetics: Family history can increase the likelihood of developing cataracts.
• UV Exposure: Prolonged exposure to ultraviolet (UV) rays can accelerate cataract formation.
• Diabetes: High blood sugar levels can cause changes in the lens, leading to cataract development.
• Smoking and Alcohol Consumption: Both have been linked to an increased risk of cataracts.
• Nutritional Deficiencies: A diet lacking antioxidants, vitamins (especially Vitamin C and E), and omega-3 fatty acids can contribute to cataract formation.
• Eye Injury or Surgery: Trauma to the eye or previous eye surgeries can lead to cataracts.
• Certain Medications: Long-term use of corticosteroids and certain medications can increase the risk of cataracts.

Types of Cataracts

Cataracts can be classified into different types based on their location and cause:

• Nuclear Cataract: Forms in the center of the lens and is associated with aging.
• Cortical Cataract: Develops on the outer edges of the lens and gradually moves inward.
• Posterior Subcapsular Cataract: Forms at the back of the lens and progresses rapidly, often affecting younger individuals and people with diabetes.
• Congenital Cataract: Present at birth due to genetic disorders or infections during pregnancy.
• Traumatic Cataract: Develops after an eye injury.
• Secondary Cataract: Caused by other medical conditions like diabetes or prolonged use of steroids.

Symptoms of Cataracts

The symptoms of cataracts develop gradually and may include:

• Blurry or cloudy vision
• Increased sensitivity to light and glare
• Difficulty seeing at night
• Faded or yellowed colors
• Seeing halos around lights
• Frequent changes in eyeglass or contact lens prescriptions
• Double vision in one eye

Diagnosing Cataracts

An ophthalmologist can diagnose cataracts through a comprehensive eye examination, which may include:

• Visual Acuity Test: Measures how clearly you can see at various distances.
• Slit-Lamp Examination: Uses a special microscope to examine the lens and other eye structures.
• Retinal Exam: A dilated eye exam to assess the severity of the cataract and check for other eye diseases.
• Tonometry: Measures intraocular pressure to rule out glaucoma.

Treatment Options for Cataracts

Non-Surgical Treatments (Early-Stage Cataracts)

In the early stages, cataract symptoms can be managed with:

• Stronger prescription glasses: Adjusting the prescription can temporarily improve vision.
• Brighter lighting for reading: Increasing light intensity can help improve visibility.
• Anti-glare sunglasses: Reduces discomfort from bright light.
• Magnifying lenses: Helps with reading and other close-up tasks.
• Lifestyle modifications: Eating a diet rich in antioxidants and avoiding smoking or excessive UV exposure may slow cataract progression.

Surgical Treatments (Advanced Cataracts)

When cataracts progress and significantly impair vision, surgery is the only effective treatment.

What is Cataract Surgery?

Cataract surgery is a safe and effective procedure to remove the cloudy lens and replace it with an artificial intraocular lens (IOL). It is one of the most commonly performed surgeries worldwide and has a high success rate. At Samprathi, we do No Injection, No Stich, No Bandage Cataract surgery, also called “Eye Drop Surgery”.

Types of Cataract Surgery

1. Standard Phacoemulsification (Phaco)

• Performed through a 2.8 to 3.2mm incision.
• Uses ultrasound waves to break up the cloudy lens, which is then removed through a small incision.
• A foldable IOL is inserted to replace the natural lens.
• Quick recovery time and minimal complications.

2. Micro Incision Cataract Surgery (MICS)

• Most frequently performed procedure.
• Involves a very small incision of 2 to 2.2mm to remove the cloudy lens
• Since the incision is very small there is no need for anethesia during surgery & also no need for sutures or Bandage
• Faster recovery.

Choosing the Right Intraocular Lens (IOL)

During cataract surgery, the cloudy lens is replaced with an artificial intraocular lens (IOL). Several types of IOLs are available:

• Monofocal IOLs: Provide clear vision at a single distance (near or far); glasses may still be needed.
• Multifocal IOLs: Allow clear vision at multiple distances, reducing dependence on glasses.
• Toric IOLs: Correct astigmatism and provide sharper vision.
• Extended Depth of Focus (EDOF) IOLs: Offer an enhanced range of vision with minimal visual disturbances.

For more details on types of IOLs, please see the section of Types of IOLs & How to choose them.

What to Expect Before, During, and After Surgery

Pre-Operative Instructions for Cataract Surgery

To ensure a successful surgery and smooth recovery, patients should follow these pre-operative instructions:

1. Pre-Surgery Eye Examination

• Your ophthalmologist will conduct a comprehensive eye exam to determine the severity of your cataract and measure your eye for the correct intraocular lens (IOL).
• Discuss any existing medical conditions, medications, or allergies with your doctor.

2. Medication Adjustments

• Some medications, especially blood thinners like aspirin or warfarin, may need to be adjusted before surgery. Consult your doctor for specific instructions. But at Samprathi, we generally don’t stop Blood thinners as we do the Bloodless “Eye drop Surgery”
• Patients with diabetes should monitor their blood sugar levels and inform the surgeon of any changes. Ideally Sugar after food should be less than 200mg%.
• Continue taking prescribed eye drops if recommended by your ophthalmologist.

3. Fasting Guidelines

• Patients are typically advised to have light breakfast before surgery unless specifically mentioned.

4. Hygiene and Personal Care

• Wash your face and eyelids thoroughly before surgery to reduce the risk of infection.
• Do not wear any makeup, lotions, perfumes, or aftershaves on the day of surgery.
• Avoid wearing contact lenses for at least a few days before surgery, as instructed by your doctor.

5. Transportation Arrangements

• Cataract surgery is typically an outpatient procedure, meaning you can go home the same day.
• Arrange for a friend or family member to drive you home, as your vision may be blurry after surgery& you will not be able to drive.

6. Clothing and Accessories

• Wear loose, comfortable clothing on the day of surgery.
• Avoid wearing jewellery, especially around the face and neck.

7. Mental Preparation

• Cataract surgery is a quick and painless procedure, typically lasting about 10 minutes.
• Stay relaxed and follow your doctor’s instructions to ensure a smooth experience.

During Surgery

• The procedure typically takes about 10 minutes per eye.
• Performed under topicalanesthesia, means No injection.
• Your cooperation during the procedure is extremely important
• Patients remain awake but experience no pain.
• If you feel you cannot cooperate or are very anxious, you can ask for Local anaesthesia.
• The cloudy lens is removed, and the IOL is implanted.

After Surgery

• Vision improves within a few days, though some blurriness may persist initially.
• Prescription eye drops are required to prevent infection and reduce inflammation.
• Avoid rubbing the eyes, heavy lifting, and strenuous activities for a few weeks.
• Regular follow-up visits are necessary to monitor healing and ensure the best outcome.

Risks and Complications

Cataract surgery is highly safe, but like any procedure, it carries some risks, including:

• Infection is the most dreaded complication
• Inflammation – Redness of the eyes & watering on & off
• Swelling
• Posterior capsular rupture & inability to implant an IOL
• Retinal detachment (rare)
• Posterior capsule opacification (PCO) – clouding of the lens capsule, which can be treated with laser surgery.

Conclusion

Cataracts are a common age-related condition, but cataract surgery offers a highly effective solution to restore clear vision. Understanding the types of surgery, IOL options, and post-operative care can help patients make informed decisions about their eye health. If you experience symptoms of cataracts, consult an eye specialist to discuss the best treatment plan for you.