What Are Cataracts And How Are They Removed?

In healthy eyes, light enters through the cornea and passes through the pupil and the lens. The lens helps by focusing light rays on to light-sensitive cells within the retina at the back of your eye. Cataracts become increasingly prevalent after the age of 60 and the word cataract comes from the Latin cataracta meaning 'waterfall or floodgate.' When cataract forms, the otherwise clear lens start to develop semi-opaque or full opaque areas. This results in the lens becoming less transparent. Over time, cataracts become worse and start to affect the vision of the sufferer. Eventually, laser eye surgery will be required to remove and replace the lens as glasses will not correct the problem.

Types of Cataracts

These are the three most common types of cataracts;

1. Nuclear Cataract

Nuclear cataracts form within the nucleus of the eyes' lens and are most frequently connected with the effects of ageing.

2. Subcapsular Cataract

Subcapsular cataracts form towards the rear of the lens. If you suffer from diabetes or have been prescribed a large dose of steroid medication, you may run a higher risk of developing a subcapsular cataract.

3. Cortical Cataract

A cortical cataract occurs in the lens cortex which is the area surrounding the central nucleus. Cortical cataracts start to form toward the outer ridge with small streaks, referred to as cortical spokes, developing towards the centre of the lens. In some cases, it's possible to be born with cataracts present in the lenses and this is referred to as a congenital cataract. This form of cataracts can affect one or both eyes and severely hampers the visual development of newborns.

What are the Risk Factors?

Throughout our lifetime, proteins found within the eye may start to cluster together, causing a cataract. As we continue to get older, the cloudy cataract portion may spread throughout the lens which will obstruct more of your vision. Genetic defects may play a key part in your chances of developing cataracts. Additionally, suffering an injury may affect the eye's lens. Several risk factors have been identified that contribute to the development of cataracts;

• Old age
• Being overweight
• Long term use of cholesterol medication
• Being very short-sighted
• Use of tobacco
• HRT
• Damage caused by excessive UV ray exposure
• Family history of the condition

What Are the Symptoms of Cataracts?

There will likely be little to no effect on your vision during the early onset of cataracts. As the condition worsens, you'll find your vision becoming foggy or blurred. You may experience an increased level of photosensitivity with indoor lighting and you may notice that the sun seems brighter than usual. However, the symptoms you experience may vary on the type of cataract that you're developing. During the early stages of nuclear cataracts, it's likely that you'll experience 'second-sight', which improves the level of near-sighted vision and is caused by the hardening of the lens. If you're experiencing any of the following symptoms, it's highly recommendable that you schedule an appointment for an eye exam;

• Halos around light sources
• Vision at night becoming increasingly worse
• Double vision within a single eye
• Photosensitivity from light sources
• Blurred or dim vision

Are Cataracts Treatable?

Regular eye examinations can help to detect cataracts before they become a problem. If you're over the age of 45, you should have an eye test every two years or yearly if you have close family members with refractive error. Wearing sunglasses that block 100% of UV rays as the radiation from the sun could contribute to the development of cataracts. Additionally, a healthy diet that includes antioxidant and Vitamin E rich fresh fruit and vegetables can help to maintain the health of your eyes. Laser eye surgery is one of the surgeries that are quite effective in the treatment of cataracts. It enables the surgeon to make precise incisions in your cornea. However, not everyone qualifies for this type of surgery. That's why one has to prior consultation with their doctor. Cataract surgery is great for restoring vision and most patients who undergo the procedure return to having good sight. Cataract surgery involves removing the cloudy lens through a small incision in the eye and replacing it with a clear, plastic one known as an intraocular lens (IOL). In most cases, cataract surgery is carried out under local anesthetic and you can usually go home the next day. Almost everyone who has cataract surgery experiences an improvement in their vision, but it can take a few days or weeks for your sight to settle.

What Happens During Cataract Removal Surgery?

Although there are various types of cataract, the surgical approach is the same and it involves 3 main steps.

Step 1 After anaesthetising the eye, the first step is to remove the cloudy cataract lens from behind the iris. Very small entrance points are made at the edge of the cornea to provide access to the inside of the front part of the eye. The natural lens is dissolved and sucked into a small tool called a phaco top. The surgeon will make sure that no lens cortex remains as this can lead to inflammation surgery.

Step 2 Once the lens material has been removed, the opened capsular bag will remain in place. The empty bag will be the new home for an artificial plastic intraocular lens. Modern lenses are flexible which allows them to be folded and inserted using a lens injector, through a small keyhole opening in the eye. The benefits of keyhole cataract surgery are that the eye heals rapidly, and the keyhole incisions are self-sealing.

Step 3 Once the lens has been injected into the capsular bag, the surgeon will manipulate and rotate the IOL so that it's seated in the right position. This provides the best possible vision after cataract surgery is complete. Antibiotics are injected into the fluid in front of the iris, which protects against bacterial infection after surgery.

Summary

Choosing an expert surgeon is the most important step in your journey to living without cataracts. For the best comfort and vision possible, speak to your optician about glasses with an anti-reflective coating. If your cataracts are giving minimal symptoms, stronger glasses and better illumination when reading should help. However, don't ignore the symptoms as they steadily progress. To date, surgery for cataract is the only proven solution. The timing of the procedure is dependent on your loss of vision and much of an that has on your daily life.