What is cataract?
Our eyes consist of lens which helps us to see. As we grow old the natural crystalline lens becomes harder and loses its natural flexibility to focus on things at varying distances and creates vision problems. Gradually, the lens turns cloudy and your natural lens becomes like a window that is frosted or yellowed.
Cataract is a cloudy area in the lens inside the eye which is normally clear. Cataract can develop in one or both eyes.
Cataracts are most often caused by our body's natural aging process, although they can also be the result of heredity or accidents.
What are the symptoms of cataract?
A painless blurring of vision
Cataract leads to blurred, fuzzy and hazy vision while normal vision ensures crisp, clear well-defined images.
Cataract leads to reduced light sensitivity resulting in glare and undefined images.
Double vision in one eye
Cataract may lead to double vision in one eye, resulting in difficulty while driving and doing other day to day activities.
Some other symptoms of cataract are:
- Poor night vision
- Changes in the way you see colors
- Glare in front of eyes while driving
- Difficulty in identifying faces from distance
What treatment options are available?
Developing a cataract does not mean a permanent loss of vision quality, or having to give up the things you love, because cataract surgery is a safe and effective way to improve your vision.
Fortunately, there is a commonly performed surgery to treat a cataract. This involves removing the natural lens from the eye and replacing it with a new artificial lens.
What is involved in surgery?
Cataract surgery involves removing the cataract and replacing with an artificial lens implant.
When you visit our OPD, our doctor will test your eyes to check how well you can see. The doctor will dilate your pupil in order to examine the condition of the lens and other parts of the eye and suggest the treatment accordingly. While you can bring your glasses or lenses along, it is advisable not to come for the surgery with your contact lens on.
The counseling department will then brief you about the surgery and run fitness & safety tests to ensure you are fit for the operation. You will be given a surgery date by the healthcare team.
The healthcare team at NIO will carry out a number of checks to make sure you have the operation you came in for and on the correct side. You can help by confirming to your surgeon and the healthcare team your name and the operation you are having.
Types of Surgery
Currently, the two most frequently used techniques to remove a cataract are
- Phacoemulsification (PKE)
- Micro Incision Cataract Surgery (MICS)
What is Micro Incision Cataract Surgery (MICS)
Recent advances in the conventional phacoemulsification cataract surgery procedures have gradually reduced the size of the incisions needed for the surgery from 12 mm to 2.8 mm, making it safer and less invasive.
MICS is the advanced, state-of-the-art technique for treating cataracts. In this type of surgery, the cataract is emulsified using sound waves through a micro incision.
In MICS, incision of 1.8 mm to 2.2 mm is required to perform the entire cataract surgery procedure. The micro incision heals fast, enabling you to recover quickly.
- Benefits of MICS
- Safe and reliable surgery
- Improved patient comfort as the surgery is gentler and less invasive
- Prevents unwanted interferences to vision known as astigmatism
- Faster healing and recovery time
What is intraocular lens (IOL)? What are the various types of intraocular lens?
Once the natural lens from the eye is removed, it is replaced with an artificial lens know as intraocular lens (IOL). This lens focuses light on the retina and restores clarity of vision. Aspheric lens and non- aspheric lens are two main types of intraocular lens (IOL).
Traditional IOLs are spherical and have their front surface uniformly curved. Aspheric IOLs are slightly flatter in the periphery and are designed to provide better contrast sensitivity.
Let’s take a look at some of the types of aspheric lens-
- Accommodative lenses / Multifocal
The lenses with multifocal or accommodative designs provide vision at multiple distances and help the patient reduce dependency on glasses. Studies have shown that majority of patients (8 out of 10) can achieve this
- Toric lenses
These are a special variety of lenses designed with an aim to reduce dependency on glasses, and reduce high cylindrical number (astigmatism)
Non-aspheric (traditional) lens
Non-aspheric lenses are lenses whose surfaces are parts of a plane or parts of a sphere. Compared to aspheric lens, non aspheric lens are simple and relatively cheaper.
How is the IOL power calculated before surgery?
IOL power calculations at NIO are done by trained personnel and every endeavor is made to minimize errors. This is done using Ziess IOLMaster and or ultrasound biometry.
What is the life span of an IOL?
Once implanted in the eye, it remains in place for the remainder of one's lifetime.
What will happen if you decide not to go for operation?
Cataract usually gets worse day by day. Leaving a Cataract untreated will not threaten your vision immediately; however, it can slowly disable your eyes until you have little vision left. In worst case scenario, untreated Cataract can also damage the optic nerve of your eye due to raised intraocular pressure which can damage the nerve.
What type of anesthesia is used during surgery?
The surgery usually takes about 20 minutes. The operation is usually performed under a local anesthesia in the form of injection or eye drops. Rarely, a general anesthesia is used. Your anesthetist or surgeon will discuss the options with you and recommend the best form of anesthesia for you.
Which surgery equipments are used in NIO?
NIO has several technically advanced Phacoemulsification machines like-
- The Stellaris Vision Enhancement Microphaco system
Stellaris Vision Enhancement System is one of the world's most trusted platforms for advanced lens surgery. It is designed to complement the doctor's surgical technique and exceed the patient's expectations. It enables sub-2 mm lens surgery through a flexible, hybrid approach to fluidics and advanced, ultra-efficient cutting dynamics. It offers increased wound sealability, reduction in endothelial cell loss and surgically induced astigmatism while resulting in a more rapid visual recovery.
Eye Care Learning
What is Congenital Cataract?
Congenital cataract is, clouding of the lens of the eye, that is present at birth. The white opacity seen in a childís eye may be due to several reasons; however the most common reason is cataract. If such opacity is seen in a childís eye since birth, it is called congenital cataract.
What causes Congenital Cataracts?
Most common reason for a new born baby to have cataract is maternal infections acquired during pregnancy called TORCH group of infections. Out of these, rubella, also known as German measles is an important cause for congenital cataracts in India.
Other causes are:
- Heredity: Approximately one eighth of bilateral cataracts are inherited. Families with history of congenital cataracts should seek genetic counseling.
- Metabolic disorders and syndromes: Cataracts are also seen in children with abnormalities of other systems of the body and eye.
- Injury to the eye: A blunt or penetrating injury to the eye can lead to this condition.
- Steroids: When used for a long time, either systemically or through eye drops, steroids can cause cataract in one or both eyes in young children. Children often are steroid responders and are more prone to various side effects of steroids taken for a long time.
What are the symptoms of Congenital Cataract?
- Gray or white cloudiness of the pupil (which is normally black)
- Infant may not be able to see (if cataracts are in both eyes)
- No ìRed eyeî glow of the pupil in photos
- Unusual rapid eye movements (nystagmus)
What are the implications of congenital cataract?
Cataract surgery involves removing the cataract and replacing with an artificial lens implant.
Cataracts in infants or children are not uncommon and can lead to moderate to severe visual impairment. Infants with complete cataracts in both eyes often show very little ëvisual interestí and have delayed development. Lazy eye can develop in some cases, called ìStimulus deprivation amblyopiaî, because due to the presence of cataract, the brain receives no visual information thereby making the eye ëlazyí. Such lazy eyes are difficult to treat due to the severity of amblyopia. Unsteady gaze or nystagmus also develops which indicates poor vision.
What are the treatment options for congenital cataract?
Moderate to severe cataracts that affect vision, or a cataract that is in only one eye, will need to be treated with surgery. Significant cataracts whether present in one eye or both eyes, should be removed urgently if the baby is too young. In slightly older children, timing of surgery depends on the duration of visually significant opacity.
Babies who are younger than 2 years of age are given glasses or contact lenses after surgery, till they attain 2 years of age, after which intraocular lenses can be implanted in the eye. Parents are first taught how to insert and remove contact lenses and also how to maintain hygiene, which is of utmost importance. Once they master the insertion and removal process, the lenses are handed over to them with clear instructions to consult the doctor if they face any difficulties in handling the lens or if the baby does not seem comfortable with lenses on.
Finally, once the child crosses 2 years of age, lens implantation is performed as a second stage procedure. If the cataract is seen in a younger child but only in one eye, usually intraocular lens is inserted inside the eye irrespective of the age of the child, after which the child will require glasses.
Patching of the normal eye, to force the child to use the weaker eye, is often needed to prevent amblyopia. The infant may also need to be treated for the inherited disorder that is causing the cataracts.
What care should I follow after the surgery?
- Your baby will be given a short course of steroid eye drops. Please use them only as advised and for the stipulated time period. Children tend to have steroid-inflammatory reaction hence these eye drops are very important.
- Keep the eyes clean and do not miss out on the timings of eye drops.
- Use of glasses or contact lenses is mandatory and should be followed meticulously.
- Patching of the good eye as prescribed should be followed.
- Children are often uncooperative for all these post-operative necessities. Parents must cajole them and coax them into following all the above instructions.
- If there is discharge from the childís eye, the child is rubbing the operated eye all the time, or the eye is looking reddish, please consult your pediatric ophthalmologist immediately.
- One must remember that even though there are newer techniques of cataract removal and good quality intraocular lenses, management of this condition does not end with surgery only. Proper postoperative care, use of glasses, and therapy for lazy eye, is extremely important for actual rehabilitation of the affected children. They must be followed years after surgery as some complications may arise and early detection and treatment is the key to tackling theses complications.NIO is one of the best eye care hospitals in Pune for cataract surgery, where experienced doctors provide patients with quality health care services and new technological advancements.
You can call our Healthcare team on 02025536369 / 41460100 if you have any queries regarding your childís eye.
Eye Care Learning
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