General Health ArticlesLooking clearly at ‘cataracts’

Looking clearly at ‘cataracts’

Looking clearly at ‘cataracts’

Cataracts are a condition in which the eye's lens becomes cloudy, causing blurry vision. This can be caused by various factors, which can be divided into two main types:

1. Congenital cataracts:

Cloudiness of the eye's lens that occurs from birth up to 3 months of age. If the cloudiness is mild, it may not cause any decrease in vision. However, it can remain stable or gradually worsen over time, leading to decreased vision in adulthood.

Causes: may be due to infections during pregnancy, exposure to X-rays while pregnant, malnutrition, maternal diabetes, and genetic factors.

2. Acquired cataracts:

These are cataracts that occur in people who previously had clear lenses. They are more common and can occur at any age.

Causes: aging, exposure to UV radiation, smoking, certain medications, and medical conditions such as diabetes.

Senile cataract is a natural change that occurs with age, causing a gradual, slow blurring of vision over the years. Traumatic cataract, on the other hand, occurs as a result of injury to the eye, whether it be from impact, foreign objects entering the eye, a history of previous eye surgery, exposure to high-voltage electricity or radiation to the head and face. Cataracts caused by metabolic diseases such as diabetes can occur earlier in life. Cataracts caused by certain medications used to treat other diseases such as corticosteroids can also occur. Other eye conditions such as previous eye injuries, inflammation of the iris or retinal detachment can also lead to cataracts.

Symptoms of cataracts include gradual, painless blurring of vision and a reduction in contrast sensitivity in dim lighting, darkness or at night. Some individuals may experience monocular diplopia, or double vision in one eye, due to the scattering of light by the cloudy lens. Initially, vision may be blurred, especially for distant objects, similar to nearsightedness. Some patients may experience sudden eye pain, redness, and rapid worsening of vision due to complications from the cataract, such as acute angle-closure glaucoma, which requires urgent medical attention.

Treatment:

In the early stages, blurred vision can often be corrected with the use of eyeglasses. However, at a certain point, when the cataract becomes more pronounced, eyeglasses are no longer effective.

There are reports that certain types of eye drops can delay the progression of cataracts, but they cannot make existing cataracts disappear. The results of this treatment are not yet fully confirmed and may not be effective for some people.

Currently, there are two main types of surgical procedures that are commonly performed for cataract removal:

1. Extracapsular cataract extraction (ECCE) involves using a scalpel to make an incision in the eye, puncturing the lens capsule, removing the cloudy lens, leaving the lens capsule intact, and inserting a new artificial lens. The incision is then sutured closed. This procedure is usually performed on people with mature or advanced cataracts.

2. Phacoemulsification is a highly popular method nowadays because it involves a smaller incision. A 3mm blade is used to puncture the eye and open the lens capsule, then a phaco head releases high-frequency sound waves (similar to ultrasound) to break the cataract into small pieces which are then suctioned out. Unlike ECCE which removes the entire lens, phacoemulsification only removes the cataract, leaving the natural lens intact. An artificial lens is then inserted. The incision is small, and it may not be necessary to suture the wound, making it a relatively safe procedure.

The choice of surgical method may vary depending on the individual patient. There is a small risk of complications, such as infection, glaucoma, or swelling of the eye nerves, which can occur in a small percentage of cases. However, these risks can be minimized with careful preoperative evaluation and postoperative care.