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Cataracts

cataract

For us to see clearly and sharply, the lens of the eye has to be clear( transparent).A cataract is when the lens of an eye becomes cloudy(opaque)  and affects vision. Cataracts most commonly occur in older people and develop gradually.

Who gets cataracts and how common are they?

There are different types of cataracts:

Age-related cataract (senile cataract)

This is by far the most common type and affects older people. It becomes more common with increasing age. People over the age of 65 are commonly effected. Men and women are equally affected. Often both eyes are affected, but one eye may be worse than the other.Typically, an age-related cataract forms gradually thus vision becomes gradually worse over the years.

Congenital cataracts (present at birth)

These are uncommon but important to diagnose early. This is because vision and seeing have to be learnt very early in infancy. A cataract that is present at birth stops the eye from learning to see and can cause blindness which may persist even if the cataract is removed later in life. A congenital cataract must be removed as early as possible after birth.

Other types of cataract

There are some uncommon causes of cataracts. A cataract may develop after an injury to an eye, or as a result of radiation exposure. Cataracts sometimes develop as a secondary problem if you have another condition. For example, as a complication of some other eye conditions, and some people with diabetes develop cataracts.

What causes age-related cataracts?

The cause is not entirely clear. There seems to be a change to the structure of the proteins in the lens. Most affected people develop a cataract for no apparent reason. Factors that may increase the chance of developing cataracts include:

  • Having a poor diet.
  • Smoking.
  • Being exposed to a lot of ultraviolet light.
  • Diabetes.
  • Steroid medicines.
  • Having a family history of cataracts.

What are the symptoms of age-related cataracts?

At first you may notice your vision becoming a bit blurred. With time, you may notice some of the following:

  • Having spots in your vision.
  • Seeing halos around bright lights - for example, street lights.
  • Not being able to see as well in brightly lit rooms or in sunshine.
  • Becoming easily dazzled by bright lights such as the headlights of an oncoming car.
  • Your colour vision may become washed out or faded.
  • Over the years your vision may gradually become worse and is unable to be corrected by glasses.
  • Depending on the severity of the cataract, the effect on your sight can range from vision being slightly blurred to complete blindness in the affected eye.

How is an age-related cataract diagnosed?

A cataract can usually be seen easily by a doctor or optometrist (optician) when they examine your eyes.

Sometimes an early cataract is detected during a routine eye check, before you have noticed a problem with vision.

Do I need treatment for age-related cataracts?

An early cataract may not cause any noticeable problem with your vision. The rate of decline in vision varies considerably from person to person. It is now common for people to have their cataract treated at an early stage when the cataract is affecting ability to function normally. For example, if you are having problems reading the paper, watching TV, driving, cooking. Treatment is usually successful.

What is the treatment for age-related cataracts?

There are no medicines, eye drops or lasers that can treat cataracts. The only way of treating cataracts is with an operation. The operation involves removing the cloudy lens and replacing it with an artificial plastic lens (an intraocular implant). It is a routine operation that usually takes 10-20 minutes. It is often done as a day case.

What happens during a cataract operation?

Usually one eye is operated on at a time. In most people the operation is done under local anaesthetic. This means that you are awake during the operation but it is not painful because local anaesthetic eye drops are used to numb your eye. (Occasionally, local anaesthetic injections are used around the eye.)

The operation is performed, using a microscope, through a very small opening in the eye.The contents of the lens are then removed and a clear plastic lens is placed within the lens capsule through the hole made in the front part of the lens capsule. Usually no stitches are needed. You may have to wear a pad over your eye after the operation.

What are the possible complications of cataract surgery?

In the vast majority of cases, the operation is successful and vision improves immediately. In a small number of cases, complications occur. For example, bleeding into the eye, infection, inflammation of the eye and damage to the cornea or to other parts of the eye. These are all uncommon, can often be treated, but are very occasionally serious enough to cause permanent visual problems.

Posterior capsule opacification (cloudiness)

This is a complication that can occur following a cataract operation. Sometimes the back part of the lens capsule thickens several months after surgery, becomes cloudy (opacifies) and affects your vision. If this occurs it can usually be easily treated with a painless procedure using a laser. The laser can burn a hole in the middle part of the capsule which then allows light through and restores vision.


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