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~ Cataracts ~


~ Cataracts ~

What are Cataracts?

A cloudy or opaque area in the lens of the eye.
The lens of the eye is normally clear. If the lens becomes cloudy or is opacified, this is a cataract. Cataracts are rarely present at or shortly after birth if they are they are called congenital cataracts.
Adult cataracts will develop with advancing age and may run in families. Cataracts are accelerated by our environment, such as smoking, pollution or other toxic substances. Cataracts may develop at any time during a persons lifetime following an eye injury. Cataracts may also develop because of metabolic diseases such as diabetes. Certain medications, such as cortisone, may also accelerate cataract formation.

Congenital cataracts are cataracts which are present from birth or shortly after. They may be in the family (autosomal dominant inheritance), or they may be caused by congenital infections such as rubella, or associated with metabolic disorders such as galactosemia. Risk factors include inherited metabolic diseases, a family history of cataract, or maternal viral infection.

Adult cataract is generally associated with aging. It develops slowly and painlessly with a gradual onset of difficulty with vision. Visual problems may include difficulty seeing at night, halos around lights or glare sensitivity, and finally, decreased vision, even in daylight.
Adult cataracts are classified as immature, mature, and hypermature.
A lens that has some clear areas is referred to as an immature cataract.
A mature cataract is completely opaque.
A hypermature cataract has a liquefied surface that leaks through the capsule and may cause inflammation in other parts of the eye.
Most people develop some clouding of the lens after the age of 60. About 50% at ages 65 to 74 to about 70% of those age 75. Most people have similar changes in both eyes, but one eye may be worse than the other. Most do not notices the changes and are not aware of their cataracts. Contributing facts to cataract development are low serum calcium levels, diabetes, long-term use of corticosteroids, and various inflammatory and metabolic disorders. Environmental causes include trauma, radiation exposure, and excessive exposure to ultraviolet light (sunlight). In many cases, the cause of cataract is unknown.
The best prevention involves controlling associated diseases and avoid exposure to the known enviroment that promotes cataract formation.
Wearing sunglasses during the day when outside can reduce the amount of UV light your eyes are exposed to. Make sure your sunglasses filter out the harmful UV. An optician should be able to tell you which sunglasses filter out the most UV. For persons who smoke cigarettes, quitting will decrease the risk of cataracts.
Symptoms are: Cloudy, fuzzy, foggy, or filmy vision
Loss of color intensity
Frequent changes in eyeglass prescription
Impaired vision at night, glare from bright lights while driving
Glare from lamps or the sun or halos around lights
Double vision from an individual eye.
Any change with your eyes is best checked out.
A standard ophthalmic exam, including slit lamp examination, an ultrasonography of the eye when preparing for cataract surgery.
Other tests that may be done are:
A glare test
Contrast sensitivity test
Potential vision test
Specular microscopy of the cornea in preparation for cataract surgery

The only treatment for cataract is surgical removal. This is done when a person cannot see well enough with glasses to perform their normal activities. For some people changing their glasses, getting stronger bifocals, or using a magnifying lens is helpful enough. Others choose to have cataract surgery.
If a cataract is not bothersome, then surgery is usually not necessary. At times occasionally, there may be other eye problems that cannot be treated without first proceeding with cataract surgery.
Cataract surgery includes removing the lens of the eye and replacing it with an artificial plastic lens. A cataract surgeon will discuss the options with the patient and together they will decide which type of removal and lens replacement is best for the individual.
There are 2 different types of surgery that can be used to remove lenses that have a cataract.
Extracapsular surgery consists of surgically removing the lens, but leaving the back half of the capsule (the outer covering of the lens) intact. High frequency sound waves (phacoemulsification) may be used to soften the lens to facilitate removal through a smaller incision.
Intracapsular surgery involves surgically removing the entire lens, including the capsule. This procedure is very rare.
Usually an artificial lens is inserted at the same time of surgery. This artificial lens is a plastic disc called an intraocular lens. It is usually placed in the lens capsule inside the eye.
Other options are contact lenses and cataract glasses.
Surgery can be done as an outpatient at a center or hospital. Most do not stay overnight in a hospital. The patient will need a friend or family member to help with travel home and also home care after outpatient surgery. Following the surgeons instructions are important for a full recovery.
For most, cataract surgery has a low risk of complications. With implanted artificial lenses, some no longer need corrective lenses for distance vision. Glasses are usually necessary for reading.
Vision may not improve to 20/20 after surgery especially if other eye diseases such as macular degeneration are present. Ophthalmologists usually, but not always, can determine this in advance.
This is quite different with infants, amblyopia and decreased visual development may occur as a result of cataract. Early diagnosis and treatment is essential.
If you have the symptoms of cataract, such as progressive deterioration of vision, decreased night vision, or problems with glare call for an appointment with your health care provider. Or if you have a family history of congenital cataracts or if your child has symptoms or signs suggestive of a cataract.
This way the necessary steps can be followed to improve your vision.

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