What is a cataract?

It is an opacified area in the eye’s crystalline lens. A normal lens, as its name indicates, is clear and allows light to reach the retina. The crystalline lens is also the eye’s focusing mechanism.

A cataract prevents free passage of light through the eye and as the lens opacifies, it is increasingly difficult to see.

Cataracts are a normal part of aging. Approximately 50% of all people between 65 and 75 years of age, and 70% of people over 75 have cataracts.

It usually develops in both eyes at the same time, although one eye may have poorer vision because cataract densities may differ.

What are cataract symptoms like?

• Blurred, snowy, hazy vision
• Changes in color vision
• Difficulty driving at night because of glare
• Increased glare in the sunlight
• Frequent changes in prescriptions for glasses
• Double-image vision
• Improved near vision

What is the treatment for cataract?

Initially, a change of glasses, better lighting conditions or the use of magnifying lenses may be enough.

The presence of a cataract does not necessarily imply immediate surgery. With some exceptions, it may be operated when the patient is unhappy with the lower vision.

The surgical treatment consists of the removal of the opacified crystalline lens and replacement with an artificial lens.

Your ophthalmologist will tell you when surgery is needed. Only a small number of people require this surgery. There are exceptions such as vitreous or retinal diseases that require cataract surgery for their treatment.

How can I decide whether I should go to surgery or not?

Your doctor cannot decide for you, but a discussion with him or her may help you make your decision. Most people have plenty of time to decide about this surgery. Consider your visual difficulties and discuss them- with your physician.

• I need to drive my car but I get a lot of glare from the sun or from the lights of other cars.
• I cannot see very well when doing normal every-day life activities.
• I cannot see well when doing the things I like – playing cards, watching TV, sewing, going out with friends.
• I am afraid of falling or hurting myself when walking.
• I have lost my independence because of my cataract.
• I cannot see well with my spectacles.
• I am very bothered by my vision.

What do I need to know about cataract surgery?

Most people do not need to say overnight at the Clinic after cataract surgery. You will be able to go home when the doctor tells you it is all right to do so. However, you will need assistance from a family member of a friend to drive you home or to stay with you at least for one or two days in order to help you with the instructions for post-operative care.

The full recovery of your eye will take a few months. Your ophthalmologist will need to follow your recovery until it is complete.

There are three ways or techniques to perform this surgery:

Phaco-emulsification surgery where the surgeon breaks or softens the cataract inside the eye with the help of ultrasound and then removes it with suction, leaving the lens capsule behind. This technique allows for the fastest visual recovery.

Extra-capsular surgery where the surgeon removes the whole cataract, leaving the posterior capsule behind. Cataract extraction requires a broad incision.

Intra-capsular surgery where the surgeon removes the entire cataract, i.e., capsule and nucleus. This technique requires a broad incision and is very rarely performed.

Lens replacement?

When cataract surgery is performed, the crystalline lens is usually replaced with an artificial lens place inside the capsule. Other options to help the eye focus are contact lenses and spectacles.

Your doctor will be able to explain and recommend the most suitable modality for you.

Do cataracts relapse?

No. Cataracts cannot relapse. However, in 50% of people in whom the posterior capsule is left behind after extra-capsular or phaco-emulsification techniques, the capsule may eventually opacify. When it happens, posterior capsule opacity may be observed approximately six months after surgery or later, and it also contributes to reduced vision.

The treatment for this condition is a procedure known as “Yag capsulotomy” consisting of a small hole made in the capsule with the help of a light beam (Laser) in order to allow the free passage of light into the eye. It does not require admission to hospital.

Most people enjoy improved vision after the capsulotomy, but there may be complications associated with it.

What complications can occur during or after cataract surgery?

• Increased intraocular pressure
• Hemorrhage inside the eye
• Infection
• Artificial lens damage or displacement
• Drooping of the lid
• Retinal detachment
• Corneal edema and haziness
• Blindness
• Loss of the eyeball