Cataract

The lens is a transparent structure behind the brown coloured visible part of the eye called Iris. It makes a clear image of the objects on the retina of the eye . Cataract is an opacity in the clear Lens. In patient with cataract formation vision becomes Blurred or Hazy, which is one of the most common and early symptom, Multiple Images and increased Glare can also be main complaint. Night driving becomesdifficult because of Glare from

Bright lights. other complaints include altered colour perception, frequent change of the number/ glasses, reduced contrast etc.

• It usually develops from birth to any age (depends upon the cause), in old age it also called senile cataract which may occur in patients after the age of 50 years and others which may be associated with heredity, local causes (Uveitis, Trauma, Drugs) or systemic diseases like diabetes, infections etc. If retina of the eye and other structures are normal except cataract then almost full visual recovery is expected after uneventful cataract operation.

  How is Cataract treated?
  As cataract is an ageing process, cannot be stopped but can be delayed. No medicines have yet been discovered to treat cataract. Cataract can only be Surgically removed and artificial intraocular lens (IOL) is implanted after removal of cataract by various techniques at the same time. The latest procedures are Phaco-emulsification and Phaconit. Other popular techniques are ECCE with IOL which is conventional surgery and ICCE (done earlier), PPL (Pars plana lensectomy).

  
• What is Phaco-emulsification Technique?
  In this method the cataract is emulsified by an Ultrasonic Phaco probe and removed with suction through a very small entry of 2.5mm. The foldable intraocular lens (IOL) is also put through the same entry. This heals up quickly and the patient can resume normal lifestyle very soon. Different brands of IOLs are available in the market which are commonly made of a soft polymers i.e. silicone , acrylic, ( Bausch & Lomb, Allergan, Pharmacia, Alcon etc.) Multifocal IOL,s are also available in the market which eliminate the need of reading glasses after cataract surgery but proper patient selection is a must as adjustment with multifocal IOLs is bit difficult as compared to unifocal IOL,s .
  
  Patients suitable for Multifocal IOL
• Best corrected visual acuity 6/12 or better
• Younger may be better
• Astigmatism 1.5D or less
  
  
  Patients not suitable for Multifocal IOL,s;
• Patients with best corrected visual acuity worse than 6/24
• Patients with high astigmatism
• Patients complaining of glare at night.
• Patients with pupil smaller than 2.5 mm.
• Patients with abnormally long or short eyes.
  
  When should the cataract be operated ?
  In the past, Eye Surgeons often waited until the cataract become mature because of various reasons. If visual impairment interferes with your daily routine work, one should consider for early cataract surgery. Do not wait for the cataract to mature because it can cause lens-induced glaucoma, which is sight threatening emergency, and technically becomes difficult.
  
  Phaco-emulsification is a Simple Surgical Technique with no Pain, no Injection, no Stitch, no Bandage.
  The procedure requires 15- 25mts. Patients can go home even immediately after the surgery. After Phaco-emulsification surgery vision generally recovers early than the other surgical procedures. .
  
  What Precautions are required after Operation?
  
• Do not rub the operated eye.
• Do not lift heavy weights, Exercises and Swimming.
• Use protective dark glasses to prevent eyes from dust.
• Water should not enter the eye for 1 to 2 weeks.
• Avoid driving until your surgeon tells you it is safe.
• New powered glasses are generally prescribed 2-3 weeks after surgery.
• How long you are off work will depend on your job. Ask your eye specialist about this.
  
  With the advent of Phaco Surgery all the above precautions can be relaxed to a greater extent as the wound is Self Sealing and heals up very quickly.