CATARACT


When the lens in your eye becomes cloudy, the light reaching the retina is blurred and distorted and your vision is affected then this clouded lens is called a cataract which must be removed for vision to be restored. A clouded lens can be compared to a window that is frosted or "fogged" with steam. Cataracts are treated as a surgical procedure that has become a fairly common practice in India. The two most common types of cataracts are: cortical cataract and a posterior sub capsular cataract. Depending on the type of cataract, a patient will experience different visual problems, but the most common cataract symptoms include:

  • ❖ Blurring vision
  • ❖ Sensitivity to light or glare
  • ❖ Double vision in one eye
  • ❖ Poor night vision
  • ❖ Needing brighter light to read
  • ❖ Experiencing fading or yellowing of colors
  • ❖ If the cloudiness is not near the center of the lens, you may not be aware that you have a cataract

Age-Related Cataracts:

Many cataracts take years to develop to the point where vision is seriously affected. Most occur as a result of the normal aging process. The types of age-related cataracts are usually described by their location in the lens. They are: nuclear cataracts, cortical cataracts and sub capsular cataracts. Nuclear Cataracts occur in the center of the lens and may induce other eye problems, such as Myopia. Cortical Cataracts tend to occur in persons with diabetes, beginning from the outer portion of the lens and slowly moving inward.Sub Capsular Cataracts develop under the capsule, often at the back of the lens. This type of cataract also occurs more in patients suffering from diabetes, but is also found in persons with high myopia, adults with Retinitis Pigmentosa and in patients who take steroids.

Other Types of Cataracts:

There are other kinds of cataracts not related to the aging process.Traumatic Cataracts develop as a result of eye injuries. Others can develop from metabolic blood disorders, eye infections and inflammations and certain types of medications. Another type, called Congenital Cataract, occurs at birth, particularly if the mother has had Rubella (German measles) during pregnancy. Research continues to look for ways to prevent cataracts. Until then, good vision can be restored in 98 percent of all patients who have normal, healthy eyes after surgery.

Investigations:

  • ❖ Precise Measuring: exact measurement of the eye is possible even in cases of high ametropia, pupil size as well as state of accommodation.
  • ❖ Non contact Technique: no requirement of local anesthesia, no risk of infection from patient to patient.
  • ❖ Saves time: axial length, corneal curvature and anterior chamber depth of the patient's eye are measured on he same instrument saving valuable time.
  • ❖ PAM: Gives an estimate of potential vision following cataract surgery. The Potential Acuity Meter (PAM) is a device that is designed to project an eye chart directly onto the retina, in essence bypassing the cloudy lens. For patients with retinal disease, such as age related macular degeneration, the PAM may improve the reliability of anticipated vision following cataract surgery.
  • ❖ The Super Pinhole device works on a different principle, but may deliver the same result. The patient views a specialized eye chart through a pinhole in an attempt to discover a clearer region in the cataract. Both of these potential acuity measurements may overestimate or underestimate the vision achieved after cataract surgery.
  • ❖ Experiencing fading or yellowing of colors
  • ❖ If the cloudiness is not near the center of the lens, you may not be aware that you have a cataract

Treatments

  • ❖ Cataracts can be removed at any age. You no longer have to wait until the cataract "ripens" or until you lose your sight before surgery can be performed. In fact the placement of an intraocular lens (IOL) implant to restore vision is best done in when the cataract starts interfering with your daily activities or causes a decrease in vision.The clouded lens (cataract) must be removed surgically. Common type of Extra Capsular Cataract Extraction is called Phacoemulsification (often just called "phaco") which the general public understands as Laser cataract surgery.

About Phacocmulsification:

Dr. Charles Kelmen conceived and developed phacoemulsification, a method of cataract removal by ultrasonic fragmentation and aspiration of the cataractous lens through a small wound. Phacoemulsification is advantageous for both patients and surgeon.

  • ❖ Greater intra operative control.
  • ❖ Patients are able to resume normal activity much sooner and with fewer restrictions than the traditional cataract surgery. Phacoemulsification with sophisticated instrumentation provides options of pulse and burst mode.