What is the cause of cataracts?
Research suggests that there are many causes for cataracts. These include age, diabetes, sun exposure and cigarette smoking. Certain drugs such as cortisone are also related to cataract formation. Research is being done to find out as much as possible about the cause of cataracts and also how to prevent them. At the moment nothing is available which helps to prevent the vast majority of cataracts. We should know more about this in years to come.
What are the symptoms of a cataract?
In the first stages of the development of a cataract there are often very few symptoms but as the opacities increase in density, the vision slowly becomes effected. The common symptoms of a cataract include blurred, fuzzy or hazy vision, problems with glare, haloes around lights, dulled colours, double or triple vision and frequent changes in spectacle prescriptions. Some people have problems driving at night because headlamps seem too bright. Cataract sufferers find their vision is affected as if they are looking through a cloudy piece of yellowish glass. Cataract means "waterfall", and they get this name because when cataracts are neglected the opaque lens can be seen through the pupil as a white structure which looks like the white water of a waterfall.
How is a cataract detected?
You may think you have a cataract but the only way to be sure that a cataract is the cause of your visual problems is to have an eye examination. Your Ophthalmologist will then make the appropriate diagnosis and advise you about future treatment. You will be asked to read a vision chart to see how sharp your sight is. You may have eyedrops put into your eyes to make the pupils large so that you can be sure you don't have some other problem such as glaucoma or age related macular degeneration causing your visual symptoms.
What is the treatment for a cataract?
There is only one form of treatment which is currently employed when cataracts become a problem and this is surgery. Doctors used to say the cataract was "ripe" but this old term is no longer used. Your eyecare professional will help you to decide when treatment is appropriate. Cataract surgery is painless and takes less than 20 minutes. Overnight hospitalisation is virtually never necessary for a cataract operation. The modern small incisiontechnique employing phacoemulsification means you only need to spend around 2 1/2 hours at the day surgery facility before being ready to return to your own home again. There are no other forms of treatment for cataracts which work. Unfortunately drugs, diets, vitamins etc have not been shown to help to cure cataracts.
When should surgery take place?
Cataract surgery has the potential to greatly improve the quality of life so it is important not to delay having the operation for inappropriate reasons. Nobody should delay surgery because of fear of the operation or because they have heard stories from friends which disturb them. It is appropriate to delay if you do not think the cataract is ready. Your eyecare professional will help you to assess this. The sort of comments people make which lead them to have cataract surgery include: I am afraid of going to unfamiliar places because I worry that I may have a fall. I have stopped driving at night because the lights worry me. My eyesight bothers me a lot. I am having difficulty playing sport (eg bowls). I am having problems reading and sewing.
Do I need to go to hospital?
Over the past fifteen to twenty years there have been a lot of advances in cataract surgery which have made hospitalisation unnecessary. The new instruments in skilled hands have made a complicated procedure into a routine, safe and highly successful one. Since 1985 the US Government has made cataract operations mandatory day surgery procedures. This means that unless there were exceptional circumstances patients could not stay in hospital after cataract operations.
How successful is cataract surgery?
Modern cataract surgery has an overall success rate of around 98%. The wonderful improvements in the operation which have been made over the last 20 years have made it possible for far more people to undergo safe surgery. It is no longer necessary to spend long periods convalescing after the operation and the likelihood of complications is now lower than ever before.
You should however remember that no surgery is risk free but serious complications do not occur frequently. When they do it is possible for the result to be a loss of vision. Your doctor will discuss this with you prior to you deciding on surgery. These are some of the serious complications that can occur. They include elevation of eye pressure, bleeding inside the eye, infection inside the eye, retinal problems such as detachment and swelling, clouding of the cornea and drooping of the upper lid. Blindness can result from some of these and it is possible to lose the eye. It is possible to loose the eye all together but this is very rare at approximately 1 in 5,000 surgeries. The likelihood of a really serious complication leading to major loss of vision is about 3 chances in 1,000. Further information: Risks & Complications
Can cataracts come back?
No, the cataract cannot regrow. However, quite frequently the posterior capsule becomes opaque and needs to be divided with the YAG laser. This also only occurs once, so you will not need to have this done again.
How quickly do cataracts develop?
In some people it can take years before the cataract is bad enough to need an operation, whilst others can go almost completely blind in six months. In patients who are young or have diabetes, cataracts usually progress more quickly. It is difficult to predict how fast the progression will be in a particular person.
How long will I have to wait before I have the other eye done?
There is no set interval between operations. Sometimes the second operation is done a few days later and in other cases it is several years. The only thing that is definite is that two eyes are not done at the same time.
Why did my friend have laser after the cataract operation?
The implant is placed inside the empty capsular bag during the operation. The back or posterior part of the bag is clear at this time. It is called the posterior capsule. In about 30 to 50% of eyes the posterior capsule becomes milky and opaque after a year or two. This opaque membrane is divided using a laser beam. This type of laser is called a YAG laser. The procedure is very simple and completely painless. Complications from it are rare but include floaters and retinal problems.
Will I need to wear glasses after the operation?
When you have the cataract removed an IOL implant or small plastic lens is placed in the eye, this focuses the light and in most cases this will mean that you will not need glasses for distance work. You will need glasses for reading. Years ago thick glasses or contact lenses were necessary after cataract surgery, these are no longer needed because implants afford far superior post-operative correction. |
