Cataracts- Symptoms, Diagnosis, Surgery and Types of cataracts
The healthy eye’s natural lens is clear allowing the penetration of light. The lens together with
the cornea are responsible for focusing light projected onto a thin tissue found inside the eye
ball (the retina), which transmits the picture to the brain.
The term cataract describes a condition in which the natural eye lens is cloudy. This cloudiness
or opacity may appear in different areas of the lens and in different levels of severity.
Slight opacity on the front and peripheral area of the lens won’t affect the vision and will be
discovered only with an eye examination; central opacity may cause deterioration in visual
acuity; and opacity on the back area of the lens mainly causes reading difficulties and blinding
from light.
Common Cataract Symptoms
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Slow deterioration in your eyesight without any pain.
Blinding or sensitivity to the light.
Reduced quality of night vision.
Seeing double in one eye.
When you need a stronger reading light.
Changes in color vision- seeing yellower or duller colors.
A change in your glasses’ prescription number.
Causes for cataracts
Aging is the most common cause for cataracts, as part of the natural aging of the eye.
Other causes which may contribute to the development of a cataract are:
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Family history.
A medical condition, such as diabetes.
Taking medication, especially steroids.
Prior eye surgeries.
Exposure to radiation.
Long term exposure to sunlight without appropriate protection.
Cataract Diagnosis
A cataract can be diagnosed by an ophthalmologist after a comprehensive eye examination. The
purpose of this comprehensive examination, including pupil dilation, is to rule out other
conditions which could cause blurred vision.
If you feel your eyesight isn’t as it used to be, it is advisable to go for an eye examination to
determine the source of your vision problem. When the vision problem is minor, appropriate
glasses may provide a temporary solution. Currently there are no medications, eye drops,
exercises or glasses which can cure or prevent cataracts. If the diagnosis is in fact a cataract, the
only effective treatment is a simple eye surgery in which the cloudy lens is replaced with an
artificial lens.
If you suffer from impaired quality of vision, which interferes with your ability to carry on with
your daily activities, it is time to consider undergoing cataract surgery.
Cataract Surgery
In cataract surgery the opaque lens is removed and replaced with an artificial intraocular lens.
This surgery preserves the delicate capsule which had contained the natural lens, by implanting
the artificial lens in its place.
Modern cataract surgery uses the Phaco-emulsification method. An instrument crushes and
vacuums the opaque lens to remove it from the eye capsule. This method allows for the removal
of the lens through a very tiny incision (of 1.8-3 mm width) which will heal on its own, usually
without the need for sutures.
Implantation of the artificial lens is performed by inserting the folded artificial lens through the
same tiny incision; it will then unfold and settle inside the eye capsule.
Cataract Surgery using a Laser
A recent medical breakthrough is the utilization of laser technology in cataract removal surgery.
However the research is still in progress and it’s too soon to predict when and how laser
technology will be implemented in future cataract surgeries.
Anesthesia used for Cataract Surgery
Most cataract surgeries are performed with local anesthesia, using eye drops or gel, without the
need for anesthesia injections. In most cases this type of anesthesia is sufficient to prevent any
pain throughout the surgery. The patient will feel the instruments touching his eye and may
even see them or see light in front of his operated eye. The eye muscles are not affected by the
anesthesia and the patient can move his eye freely. In addition to this local anesthesia,
additional anesthesia may be injected into the eye cavity during the operation.
A deeper local anesthesia can be achieved by injection of anesthesia under the external layers of
the eyeball. This type of anesthesia is required in cases of complex cataract surgeries. Regional
anesthesia of the eye can be attained by injection of anesthesia behind the eyeball. This type of
anesthesia is required in cases in which the eye muscles need to be paralyzed; for example in
patients with Nystagmus (involuntary eye movements).
General anesthesia is required in cases presenting lack of patient cooperation during the
operation; for example with children.
Types of cataracts
Innate Cataract
A cataract may appear at birth or can develop during childhood. The cataract can appear in one
or both eyes. In one third of the cases the cataract is hereditary, and is found in other family
members.
Cataracts appear as a white shade covering the pupil, which normally would be black. The innate
state is usually discovered in the red reflex examination performed on all newborns in the
hospital nursery. Without treatment the cataract may cause strabismus (cross-eye) and
impaired vision in the affected eye.
Treatment for childhood cataract includes surgery for the removal of the opaque lens and
implanting an artificial lens. In the case of innate cataract the lens isn’t replaced with an artificial
lens rather contact lenses are used, since the eyes at this age continue to grow. The contact
lenses can be changed as needed as opposed to the intraocular artificial lens which is
permanent. At a later date an artificial lens is implanted in an additional surgery.
Secondary Cataract
After the cataract surgery, eyesight may become blurry, as it was before surgery. This condition
isn’t a new cataract. This condition, called posterior capsule opacification is when the delicate
capsule containing the intraocular artificial lens becomes opaque, which may cause blurry
vision. This condition is a secondary cataract and can develop months or even years after
surgery.
Unlike treatment for cataract, this condition can be treated with laser in a procedure called Yag
laser capsulotomy. With the laser, the doctor creates a very tiny opening in the capsule allowing
the penetration of light. This short procedure is performed in less than 5 minutes, doesn’t
require hospitalization and is pain free.
Cataract after Laser Vision Correction Surgery
To implant the correct intraocular artificial lens a calculation using complex equations takes into
consideration the natural shape of the cornea. Laser vision correction surgery alters the
curvature of the cornea and using these complex equations may lead to unexpected refraction.
In order to achieve more accurate results after cataract surgery and to reduce the risk for
unpredicted results, Ein Tal has the most modern medical equipment currently available and a
medical team experienced in treating these complex conditions.