Cataract is a condition we all have heard from our parents and friends. But do we know all we should about it? Lets find out some answers to the common questions about it

What is cataract?

Our eyes have a lens, which helps us focus on what we see. It brings the rays of light entering our eyes to come to focus at the retina. This lens is made of protein like material. When there is an opacification, which develops in the lens, it is called cataract. This would mean that the rays of light cannot reach the retina properly and we can’t see very clearly.
This opacification can be due to various reasons the commonest being age related.

If I have cataract in one eye can it spread to the other eye?

No, cataract does not spread from one eye to the other.

Can a child have cataract?

Yes it is possible that the child has cataract when he is born and may develop it after birth too depending on certain other abnormalities in his body

What causes cataract?

Usually cataracts are age related, but they can occur secondary to other eye diseases, trauma, and steroid use.

How can cataract affect my vision?

Cataract can reduce the sharpness of the image reaching the retina. The clear lens slowly changes to yellowish / brownish color, adding a brownish tint to the vision.

Am I at risk of developing cataract?

The risk of cataract increases, as you get older. The other risk factors are certain diseases like diabetes, personal behavior such as smoking and alcohol use. Excessive exposure to sunlight can also be a risk factor.
Prolonged use of medication containing steroids can lead to development of cataract.

How would I know if I have cataract?

Initially you are not be able to know and during and eye examination you may be told about it.
When the cataract advances you may have difficulty in distance viewing, which may be more when you are out in the sun or in very bright light.
Driving at night may become difficult. The colors may appear dull.
It may be difficult to climb down stairs and your daily activities may also become difficult to perform depending upon the density of cataract.

What is the treatment?

The only treatment for cataract is surgery.

What examination is to be done before?

Your doctor would like to evaluate your eye for all parameters like the visual acuity, intraocular pressure and dilated funds examination.

What are the different types of surgeries for cataract?

The purpose of surgery is to remove the lens, which has become opaque and replace it with an intraocular implant, which would serve the purpose of bringing the light rays to focus on the retina.
Making a large incision and removing the lens and then putting the IOL can achieve this. This is called extra capsular cataract extraction. This requires application of sutures to seal the incision made.
Another way is to enter the eye with a guarded tunnel incision which is small and self sealing and then a special probe is used to emulsify the cataractous lens in the eye itself and the IOL is placed in the bag of the original lens.
The incision does not require sutures.
This method is called phacoemulsification.

What are the different types of IOLs?

Broadly IOLs can be divided into two types- foldable and non-foldable
The difference between the two is that to put in a foldable lens the incision size required is smaller then the nonfoldable lens.

How is that better?

Foldable lenses give better and predictable results and the healing is also faster.

Would I have to wear glasses after surgery?

In monofocal lenses the vision is corrected for distance and you would be able to see far without glasses but for near you would have to wear spectacles.
This is not so in multifocals.

What are multifocal lenses?

These lenses are designed such that after the implantation you would not require to wear glasses for distance or for near.

Would I feel pain during surgery?

Prior to surgery anesthesia will be administered. This is usually an injection given near the eye to make the eye immobile and also curtail the pain sensations.
This can be achieved by putting drops in the eye; which would requires good patient cooperation during surgery.
In children general anesthesia is preferred.

What happens after the surgery?

A bandage is applied after the completion of the surgery. This is then removed after some time and the eye is examined and then you are allowed to go home.

What are the precautions I have to take after surgery?

With the advent of sutureless surgery the time of healing has decreased and so the precautions also. But as being cautious never hurts you are advised to be careful that postoperatively your eyes are not exposed to dust and dirt. And protect your eyes from trauma.
You would be advised to avoid putting water in your eyes for a week or so; this is to prevent any infection.

If you have any question, which has been left unanswered, please write to the undersigned and you will get a reply soon.

Dr Monica Gandhi
Consultant Ophthalmologist
Dr Shroff’s Charity Eye Hospital
Email : monica@sceh.net
            monicagandhi@yahoo.com