Choose the content to read
- What is a cataract?
- What causes cataracts?
- How many stages of cataracts?
- How is cataract treated?
- What is the preparation for cataract surgery?
- Cataracts, Blurred Vision, Cloudy Eyes, The Treatable Eyes Conditions
Cataract
Cataract is an opacity of the ocular lens caused by degeneration of the lens matrix proteins, resulting in cloudy vision and impaired vision clarity. Typically, healthy lenses are transparent, allowing light to pass to the retina, whose light-sensitive photoreceptor cells convert light to nerve impulse signals that reach the brain via the optic nerve. The brain integrates and interprets these signals, creating the images we see. Cloudy white cataracts prevent light from focusing on the retina, resulting in a decline in vision quality that significantly impacts daily life.
What is a cataract?
Cataract is an ocular lens that becomes cloudy, like seeing through a fogged-up window that constantly obscures visibility, causing the vision to be blurry, unable to see sharp pictures, seeing light with a halo, and colors becoming faded with a yellowish tint. In some cases, they may experience glare or scattered or blocked light even in well-lit areas, impairing their vision even during the daytime.
Cataracts can affect both men and women and can affect one or both eyes, but they neither hurt nor irritate the eyes. As cataracts slowly form and develop, the vision will gradually deteriorate, resulting in dim, hazy images and blurred vision that is challenging for daily activities.
What causes cataracts?
Cataracts develop due to the denaturation of the proteins in the lens. As we age, proteins degenerate, resulting in a cluster of dense protein clumps forming cataracts, with the lenses becoming opaque. Cataracts are more prevalent in those aged over 60. In addition, cataracts can also result from tissue injuries around the lens or in the eye, an infectious eye disease, and congenital rubella infection in the womb.
Causes of Cataracts
- Aging
- Prenatal infections, such as maternal rubella during pregnancy
- Congenital diseases such as galactosemia, prematurity, and hereditary cataract
- Certain diseases, such as arthritis, lupus, and Wilson's disease
- Prolonged use of steroids to treat conditions such as arthritis or lupus
- Phenothiazine medications to treat specific types of schizophrenia, such as bipolar disorder
- Some medications, such as mydriatic eye drops, heart rhythm drugs, lipid-lowering drugs, tamoxifen for breast cancer, etc.
- Ocular diseases such as eye inflammation, uveitis, eyeball infection, exfoliation syndrome, anterior segment ischemia, and retinitis pigmentosa (RP) raise the risk of cataract development.
- Excessive exposure to high levels of ultraviolet (UV) radiation without sunglasses or other protective equipment
- An accident or contusion around the eye, such as metal or stone fragments thrown into the eye or torn tissues within the eyeball, increases the risk of developing cataracts.
- Radiation therapy to the upper body or the head
- Previous retinal or vitreous surgery
- Exposure to chemicals
- Electric shock
- Exposure to secondhand smoke
- Excessive alcohol consumption
What are the early symptoms of cataracts?
Early-stage cataract symptoms include nearsightedness and astigmatism; the eyes will gradually blur due to the level and location of increased opacity of the lens as if a white coating or mist were obscuring vision until it reaches the advanced hypermature stage, which could lead to glaucoma and eventual blindness. Cataract symptoms are as follows:
- Blurred vision, unclear vision, seeing objects appear as if in the dark even in well-lit environments.
- Seeing the color of objects distort, seeing images as a yellow tint or fading.
- Difficulty seeing at night, focusing more than usual, needing lighter to see.
- Photophobia: sensitivity to light; see glare or halos around lights.
- Marked unequal visual acuity of the eyes.
- Change glasses more often due to the expanding of cataracts, altering visual acuity.
- When cataracts advance to the hypermature stage, the white lens is noticeable in the middle of the pupil. If left untreated, it can lead to complications and eventually blindness.
How many stages of cataracts?
Cataract symptoms are classified into 4 stages, including:
- Stage I (Incipient) The lens of the eye begins cloudy, blurry vision, seeing light reflecting into the eye, which obstructs vision and causes tired eyes. Early-stage cataracts are classified into 2 types: 1.) Cloudy around the eye's lens but clear in the center; 2.) Clear around the eye's lens but cloudy in the center. Cataracts at this stage have no significant effect on vision until they become cloudier.
- Stage II (Intumescent) The cataract becomes cloudier. The cloudy lens area expands, and the swollen eye lens impairs vision.
- Stage III (Mature) The cataract is very cloudy. The opacity spreads to all areas of the lens, blurring vision. Light cannot pass through to the retina, which has a significant impact on vision and daily activities.
- Stage IV (Hypermature) The cataract advances to the hypermature cataracts. Cataracts are densely opaque, hardened, and may shrink and dislocate, causing numerous vision issues. Cataracts at this stage are dangerous and should be treated as soon as possible. If left untreated, cataracts will advance to glaucoma, which will eventually end in blindness.
How is a cataract diagnosed and assessed?
Diagnosis of early-stage cataracts can be difficult due to cataracts not causing any pain or noticeable changes in the eye until they reach more advanced stages, at which point a white spot appears in the pupil. Those who are at risk should regularly check their eyes in the mirror. If you notice an abnormality or are unsure whether it is an abnormality, seek an ophthalmologist to make a thorough diagnosis. Cataracts can be diagnosed as follows:
- Visual acuity test: Measures sharpness of vision to assess the ability to see.
- Tonometry test: Determines intraocular pressure if any abnormalities are found.
- Slit-lamp examination: Examines the eyes using a narrow-beam microscope with a high-intensity light to examine the internal ocular structures, including the cornea, pupil, lens, and retina, to find abnormalities.
- Retinal eye exam: Examines the retina by instilling eye drops into the eye to dilate the pupil. The ophthalmologist uses a magnifying lens to detect abnormalities in the retina and optic nerve. Dilating eye drops will temporarily blur your vision.
How is cataract treated?
At an early stage, where the symptoms do not significantly interfere with daily life. The ophthalmologists will schedule regular eye exams. They may prescribe eyeglass adjustments and advise to avoid stimuli such as bright sunlight to delay cataract progression. When the cataract symptoms worsen, impairing vision and interfering with daily life, the ophthalmologist will determine cataract surgery to remove and replace the cloudy white lens with an artificial lens. Recognized cataract surgery methods are as follows:
- Phacoemulsification is cataract surgery utilizing high-frequency sound waves to break up the cataract and replace it with an artificial lens, using the gold standard, a minimally invasive cataract surgery extensively used worldwide, offering a tiny incision, less pain, and quick recovery, integrating the use of Digital Marking Systems and Wavefront Technology, enables precise intraocular lens replacement for optimal post-operative vision.
- Femtosecond Laser-Assisted Cataract Surgery is cataract surgery using high-performance femtosecond laser technology to aid in softening and fragmenting the cataract quickly, accurately, and safely, making it simple to break up the cataract with less ultrasound energy.
- Extracapsular cataract extraction (ECCE) is a surgical procedure to remove the cloudy central lens nucleus in one piece, then suctioning out the softer outer layer of the lens, leaving the posterior lens capsule intact to hold the implanted lens. This surgery requires a bigger corneal incision for lens extraction. The ophthalmologist reserves this procedure for a hypermature cataract, which is hard to break up.
What is the preparation for cataract surgery?
The ophthalmologist will perform a thorough preoperative eye examination and send you for a comprehensive refractive eye exam, including measuring intraocular pressure and retina, intraocular lens size and vision acuity, measuring corneal curvature topology, and eyeball length before determining the lens type and size most suitable for the patient. Cataract surgery typically takes 20-45 minutes, and patients can return home without an overnight stay in the hospital. Preparation for cataract surgery is as follows:
- Those with congenital diseases or taking underlying medications should notify the ophthalmologist in advance before the surgery.
- Those who take anticoagulants should discontinue them at least 7 days before the surgery.
- Before the surgery, practice lying flat on your back, covering your face with a cloth without a supporting pillow, for at least 30 minutes.
- Those undergoing general anesthesia should stop eating at least 12 hours before the procedure.
- Cleanse your body, shower, wash your face and hair thoroughly, and avoid wearing makeup.
- All kinds of dentures must be removed, including all kinds of jewelry.
- There should be relatives waiting during the surgery; patients should not drive back and forth alone.
Self-care after cataract surgery
After cataract surgery, the ophthalmologist will cover the operated eye with a blindfold and will remove it the next day. The ophthalmologist will schedule an appointment to assess the symptoms the following day. Self-care after cataract surgery is as follows:
- Instill eye drops at the time specified by the ophthalmologist.
- If there is pain, take an analgesic drug prescribed by an ophthalmologist to alleviate the pain.
- Be careful not to let the water enter the eyes until the wound heals.
- Do not rub your eyes, and be careful not to injure them.
- Before going to bed, put on an eye shield to prevent rubbing.
- Avoid sleeping on the side of the cataract surgery site.
- Refrain from exercising or lifting heavy objects.
- Refrain from eating spicy food to avoid sweating.
- Be careful not to cough or sneeze vigorously, and do not lower your head.
- Attend all scheduled appointments to monitor the treatment outcomes.
Is cataracts dangerous?
Untreated mature cataracts will lead to a white opaque lens in the center of the pupil, causing complications that worsen symptoms and disrupt visions, affecting daily activities and overall quality of life in a variety of ways, including difficulty with driving, reading, working, hobbies, facial recognition, sports, and the risk of falling. In addition, hypermature cataracts will stimulate intraocular inflammation, eye pain, red eye, and glaucoma, which impair vision and can lead to blindness.
How to prevent cataracts?
Because cataracts are age-related lens degeneration, currently, there is no foolproof preventative measure. Despite being less common, cataracts can still develop in young people persistently exposed to risk factors. Lifestyle modifications can slow the progression of cataracts through the following practices:
- Avoid direct sunlight and wear sunglasses to protect against UVA/UVB exposure.
- Refrain from smoking, inhaling cigarette smoke, and consuming alcohol.
- Avoid staring at a screen for too long; take frequent breaks to rest your eyes.
- Create a workspace with adequate brightness.
- Always wear eye protection when working in an accident-prone area to avoid being hit by projectiles.
- Never use over-the-counter eye drops without a doctor's prescription.
- Those aged 40 and up should have annual eye exams.
- Those with underlying diseases such as diabetes or high blood pressure should see an ophthalmologist for an eye examination.
Cataracts, Blurred Vision, Cloudy Eyes, The Treatable Eyes Conditions
Eyes are vital organs we cherish and want to preserve to maintain lifelong sharp visual acuity. Nowadays, cataract surgery utilizes advanced medical technology for better precision, speed, and safety, as well as to increase surgery efficacy, prevent complications, and assist patients in regaining healthy vision. Therefore, regular eye exams and early treatment are crucial for managing cataracts and preserving our vision.
