CataractIntroduction: Cataracts
(see image) are opacities in the lens of the eye. As we age there
is a normal degeneration of the lens of the eye, which starts in a very subtle
way in the 50's or 60's and gradually deteriorates with further aging. At the
time when the cataract is getting so dense that prescription eye glasses or contact
lenses will not correct the loss of vision that is associated with this. The
eye specialist will recommend cataract surgery where the cataract is removed and
replaced with a plastic lens or silicone lens. Signs and symptoms:
There is a progressive loss of vision without pain. Light sensitivity
often is a problem, particularly very bright lights. Night vision is unreliable
with complaints of being blinded by oncoming traffic. There will be a need
for more changes in prescription glasses or contact lenses. In some cases where
there is swelling of the lens there can be an associated glaucoma, in which case
there would be pain in the affected eye. Diagnostic tests:
Before the eye specialist dilates the pupil the intraoccular pressure is
measured. An eye examination is also done to rule out a narrow angle in the anterior
eye chamber, which could increase the intraoccular pressure and would be a sign
of associated glaucoma. A cataract can be seen as a gray or brown/yellow opacity
in the lens using slit lamp examination. There are also inborn (congenital) forms
of cataracts
in children. Here are more findings
for various patients with cataracts (see images). Treatment: Before
cataract surgery is contemplated, the eye specialist has to exclude conditions
such as macular degeneration, glaucoma and some other conditions that would not
respond to surgery. With a prescreened population like this the success rate
for cataract surgery with lens implantation is about 95%, one of medicine's most
rewarding success stories. The procedure
is done on an outpatient basis under local anesthetic. Here is a website that
describes cataract
surgery in more detail. Cataract surgery is done using a local
anesthetic in combination with intravenous sedation. Cataract removal (called
"cataract extraction") is usually always combined with an intraoccular
lens implant where the old lens is replaced with an artificial lens (made of plastic
or silicone material). Following the surgery the patient is put on prophylactic
antibiotic drops and corticosteroid drops for a period of about 4 weeks after
the surgery. This keeps the swelling following the surgery to a minimum and prevents
infection. Quite often the patient will not need glasses after the surgery. A
minority of patients will need very weak prescription glasses or contact lenses
following this surgery to achieve perfect vision. |
