Cataract Surgery: Restoring Your Vision
i. What are cataracts?: Cataracts are a clouding of the natural lens of the eye. This lens focuses light onto the retina, the light-sensitive layer at the back of the eye. A healthy lens is clear, but as cataracts develop, the lens becomes cloudy, affecting your vision.
ii. Signs and symptoms of cataracts: Cataracts often develop gradually, and symptoms may include:
- Blurry or cloudy vision
- Increased sensitivity to glare
- Faded colours
- Difficulty seeing at night
- Frequent changes in eyeglass prescription
iii. Impact of cataracts on vision: Cataracts can significantly impair your vision, making it difficult to perform everyday tasks like driving, reading, or recognising faces. Left untreated, cataracts can eventually lead to severe vision loss.
What causes cataracts?
Several factors can contribute to cataract formation:
- Age: Age-related changes are the most common cause. As we age, the proteins in the lens can break down and clump together, causing the clouding.
- Injury: Eye injuries can increase your risk of cataracts.
- Medical conditions: Certain conditions, such as diabetes and a history of uveitis (eye inflammation), can increase your risk.
- Medications: Long-term use of certain medications, like corticosteroids, can also be a risk factor.
- Family history: A family history of cataracts increases your likelihood of developing them.
Types of cataracts
Cataracts can be categorised based on their location within the lens:
- Nuclear cataracts affect the lens's centre, causing vision to become cloudy or blurry.
- Cortical cataracts: These develop in the outer cortex of the lens and may appear as spoke-like white streaks.
- Posterior subcapsular cataracts: These form on the back capsule of the lens and can cause glare and difficulty seeing near objects.
How cataracts affect vision
The clouding caused by cataracts disrupts the light passing through the lens, leading to blurry or distorted vision. It may also affect your ability to distinguish colours, making them appear faded.
When to Consider Cataract Surgery
i. When the benefits outweigh the risks: Cataract surgery is safe and effective. However, it's not always necessary in the early stages. The decision for surgery depends on how cataracts are impacting your daily life.
ii. How cataracts impact your daily life: Consider surgery if cataracts are affecting your ability to:
- Drive safely
- Read comfortably
- Perform daily tasks with ease.
- Maintain your quality of life.
Cataract Surgery Procedure
Pre-operative consultation and preparation: Before surgery, your doctor will discuss your medical history, perform a comprehensive eye exam, and measure the size and shape of your eye. This information is crucial for choosing the correct intraocular lens (IOL) to implant during surgery.
Types of cataract surgery
Several types exist, but phacoemulsification is the most common. In this minimally invasive procedure:
- Anaesthesia: You will receive local anaesthesia to numb the area around the eye, and you may also be given medication to help you relax.
- Making an incision: A tiny incision is made in the cornea, the clear front of your eye.
- Breaking up the cataract: Using ultrasound waves, a probe is inserted through the incision to break the cloudy lens into smaller pieces.
- Removing the fragments: The fragmented lens pieces are suctioned out of the eye.
- Implanting the IOL: A foldable artificial lens is inserted through the incision and placed behind the remaining lens capsule. The lens unfolds and takes the place of the cloudy natural lens.
- Closing the incision: The incision usually self-seals and does not require stitches.
What to expect during surgery: Cataract surgery is typically outpatient, meaning you won't need to stay overnight in the hospital. The surgery itself is relatively quick, usually lasting about 30 minutes.
Post-operative care and recovery: After surgery, you will likely experience temporary blurry vision. Your doctor will prescribe eye drops to prevent infection and inflammation. You must wear an eye shield while sleeping for a few days. Most people recover quickly from cataract surgery and experience significant improvement in their vision within a few weeks.
Benefits and Risks of Cataract Surgery
Cataract surgery is a highly successful procedure with numerous benefits:
- Improved vision: The primary benefit is a significant improvement in vision. After surgery, most patients experience clearer, sharper vision and a brighter perception of colours. This can significantly enhance your quality of life and allow you to resume activities you may have had to limit due to cataracts.
- Reduced dependence on glasses: In some cases, cataract surgery may reduce your dependence on eyeglasses or contact lenses. The implanted intraocular lens (IOL) can be chosen to correct any existing nearsightedness, farsightedness, or astigmatism you may have.
Risks and complications
While considered a safe procedure, cataract surgery, like any surgery, carries some potential risks and complications. These are rare but important to discuss with your doctor. They include:
- Infection
- Bleeding
- Swelling
- Drooping eyelid
- Posterior capsule opacification (clouding of the lens capsule behind the IOL - usually treatable with a laser procedure)
- Retinal detachment (a serious complication that requires immediate medical attention)
Life After Cataract Surgery
i. Expectations for vision improvement: Most people experience significant improvement in vision after cataract surgery. However, it's important to have realistic expectations. Depending on the type of IOL implanted, you may still need reading glasses for close-up work.
ii. Follow-up care and medication use: You must attend follow-up appointments with your doctor following surgery to monitor your healing and vision. Your doctor will likely prescribe eye drops to reduce inflammation and prevent infection.
iii. Maintaining good eye health: Following cataract surgery, it's important to maintain good eye health habits to protect your vision. This includes:
- Regular eye exams with your ophthalmologist
- A healthy diet rich in fruits and vegetables
- Wearing sunglasses that block UVA and UVB rays
- Protecting your eyes from injury
