Did you know that untreated cataracts are the leading cause of blindness in India? Read on to learn about the causes, risk factors, symptoms, and treatment of cataracts.
What is a cataract?
When the normally clear lens of the eye becomes clouded and opaque, it is called a cataract. Your eye loses its ability to concentrate light and focus it on the retina, which leads to blurring or loss of vision.
What are the types of cataracts?
There are various types of cataracts. Based on where and how they manifest in your eye, they are categorised as follows:
- Nucleus cataracts are those in which the nucleus or the centre of the lens turns yellow or brown
- Cortical cataracts are wedge-shaped and develop around the borders of the nucleus
- Posterior capsular cataracts affect the back of the lens, which develops more quickly than the other two forms
- Congenital cataracts are formed at birth or develop throughout a baby’s first year.
- Secondary cataracts are caused by disease or drug side effects. Diabetes and glaucoma are two conditions connected to the development of cataracts. Prednisone usage and other drugs can occasionally result in cataracts.
- Traumatic cataracts form after an eye injury, although it may take a while for them to develop.
- Radiation cataracts occur after receiving radiation therapy for cancer.
What are the causes of cataracts?
Around a third of cataracts occur due to unknown reasons. In others, causes include:
- Genetics (they can be hereditary or due to disorders such as Down syndrome, and Lowe’s syndrome)
- Excess production of free radicals (oxygen molecules that have undergone chemical change as a result of normal activities)
- Smoking
- UV radiation
- The prolonged use of steroids and other drugs (e.g., thalidomide)
- Some conditions like diabetes
- Trauma
- Radiation therapy
- Infections during pregnancy
What are the risk factors for cataracts?
As you age, your chance of developing cataracts increases. In addition, you face a larger risk if you
- Have health issues such as diabetes
- Smoke
- Have heavy alcohol consumption
- Have a positive family history
- you undergone radiation therapy or eye surgery
- Had a lot of sun exposure
- Take steroids for prolonged periods which are medications used to treat conditions like allergies, and asthma.
What are the symptoms of cataracts?
Cataracts can lead to:
- Cloudy, blurry, or hazy vision
- Sensitivity to bright lights like bulbs and car headlights
- Getting glares (like halos around the lights) while driving at night with incoming headlights
- Alterations in eyewear prescriptions, such as sudden nearsightedness
- Double vision
- Reading difficulties in normal or low light
- Poor night vision
- Changes in how you perceive colour
Do cataracts cause eye pain and irritation?
Cataracts rarely cause pain, with the except for occasional light sensitivity and glare. but as it progresses, you may experience additional symptoms including irritation and headaches.
How is a cataract diagnosed?
A detailed eye examination will be performed by your doctor to analyse your vision and look for opacities. Tests include:
- Visual acuity test: To measure the vision of the eye at different distances (using eye charts)
- Tonometry: This is done to check the eye pressure
- Retinal exam: It is used to visualise damage in the retina and optic nerve
Other tests include:
- Sensitivity to glare
- Perception of colours
- Slit lamp examination: This involves using a microscope with a bright light to examine your eyes
How is a cataract treated?
If the symptoms are mild, a new prescription for glasses or contacts might help. But cataracts usually get worse with time, which leads to surgery. Surgery is usually recommended when a cataract interferes with your daily activities.
What happens during cataract surgery?
Cataract surgery involves:
- The process of 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 where your natural lens is present
What are the types of cataract surgery?
The two types of cataract surgery include:
Phacoemulsification cataract surgery:
- The most popular cataract treatment
- In this process, your ophthalmologist makes a small incision in the eye to access the opacified lens
- They separate the lens using a laser or high-frequency sound waves (ultrasound)
- After removing the lens fragments from your eye, the doctor inserts a new plastic lens
Extracapsular cataract surgery:
- This involves the removal of the cloudy part of the lens with a long incision in the cornea
- After the procedure, an artificial intraocular lens is placed where the natural lens was present
What can I expect immediately after cataract surgery?
After the procedure,
- Your eye may be itchy or sore for the first couple of days
- You might also have some tearing at this time, and
- You might find it difficult to see clearly in bright light
What is the recovery period for cataract surgery?
Within a few hours of surgery, you can sense the feeling has returned, but it can take a few days for your eyesight to fully recover. It is common to have:
- Grittiness
- Eye-watering
- Double vision
- Red or bloodshot eyes
- Although these side effects typically subside within a few days, full recovery can take anywhere between 4 and 6 weeks.
Are there any complications to cataract surgery?
The risk of cataract surgery involves:
- Inflammation and infections
- Bleeding
- Eyelid droops and swellings
- Misalignment of the artificial lens
- Retinal detachment
- Glaucoma
- Loss of vision
- Posterior capsular opacification or secondary cataract
What is a secondary cataract (posterior capsular opacification)?
This is one of the most common complications of cataract surgery. The artificial lens surface becomes cloudy after weeks, months, or even years post-surgery. A short laser procedure termed a posterior capsulotomy is used to correct this condition.
Can cataracts recur after surgery?
After surgery, cataracts cannot recur as there can be no cataract growth with an artificial intraocular lens. However, in some patients, the lens capsule could become cloudy post-surgery and may result in blurred vision and symptoms resembling cataracts.
Is cataract preventable?
There is no scientific evidence to support any methods for cataract prevention or progression. According to medical experts, certain strategies might help including:
- Regular eye checkups
- Keeping your blood sugar levels under control, especially if you are diabetic or prediabetic
- Following a healthy diet
- Using sunglasses when you are out in the sun
- Avoiding unhealthy habits like smoking and alcohol
