Any patient who needs to undergo cataract surgery must be evaluated in a thorough manner so as to establish the requirement, appropriateness, expected surgical problems, expected benefits and co-morbid conditions having an influence on cataract surgery.
The preoperative assessment consists of-
A test for your existing glasses prescription:
It is useful for your cataract surgeon to know your existing glasses prescription in cases where there is a high refractive error (people who are very short or long sighted), in order to plan to correct this error after cataract surgery.
A full ocular examination: This includes looking at-
The eyelid anatomy and inflammation.
The state of the tear film, dry eye changes could make surgery difficult
The presence of abnormalities in the cornea that could make visualisation of the cataract difficult during surgery.
The amount of dilation the iris undergoes with dilating drops.
The type of cataract. Soft cataracts can be aspirated. Hard cataracts need more ultra-sound energy and surgical time to break up and remove. White cataracts may need trypan blue staining to visualize the capsule
The measurement of intra-ocular pressure. With this test, we aim to exclude glaucoma and ensure optimal control of immediate pre-operative and intra-operative eye pressures often with extra eye drops that temporarily lower eye pressure.
This is a simple pre-operative measurement. It calculates the correct power of artificial intra-ocular lens. They will be implanted into your eye once your cataract is removed.
This is a test to map out the corneal curvature in greater detail. It is used prior to premium IOL Implantation like Toric IOLS either monofocal or multifocal, to ensure avoid postoperative refractive errors. This extra test is only required if the biometry readings show larger than normal differences in keratometry readings.
Optical Coherence Tomography (OCT)
This test allows detailed visualisation of the macula (the central sensitive part of the retina used for fine vision). If the ophthalmologist suspects any macula changes that may prevent a patient from visual improvement after cataract surgery, he always suggest optical coherence tomography.
Blood Pressure Measurements
It is very important to know your blood pressure measurements before your cataract operation. The risk of having a bleed at the back of your eye during cataract surgery (supra-choroidal haemorrhage) is very small (1 in 10000). But is higher if you have uncontrolled blood pressure.
Blood Sugar Measurements in Diabetic Patients
Cataract surgery itself does not affect your blood sugar measurements if you are diabetic. A routine checkup of blood sugars in diabetics before cataract surgery is done and the surgery if often delayed if the levels were greater than 20mmol/L as the risk of post-operative infection is higher.
One of the most common ailments that affect elders the most is a cataract. Cataract develops gradually and can occur in one or both eyes and if not treated in time can cause blindness. Most cataracts are not visible to the naked eye, but in some cases, a dense cataract can make the pupil appear white. A cataract can be defined as a dense, cloudy build-up of protein masses on the eye lens. This obstructs the light falling on the retina and does not allow the retina to form a clear image.
Advancing in age is one of the most common causes of cataracts. Along with this, there are several other factors that play a role in the development of cataracts as well. These include smoking, exposure to ultraviolet radiation, long term use of steroids, trauma, radiation therapy and diabetes. Anything that triggers an overproduction of chemically altered oxygen molecules in the body can increase your risk of suffering from this condition. Hypertension and a family history of cataracts can also put you at a higher risk of developing cataracts. Poor nutrition or a diet that is deficient in antioxidants can also put you at high risk of suffering from this condition.
Cataracts can be categorized on the basis of where and how they develop in the eye. This categorization is based on location:
Categorization based on how they develop:
A cataract is a clouding of the normally clear lens of your eye. For people who have cataracts, seeing through cloudy lenses is a bit like looking through a frosty or fogged-up window.
Clouded vision caused by cataracts can make it more difficult to read, drive a car (especially at night) or see the expression on a friend's face.
Most cataracts develop slowly and don't disturb your eyesight early on. But with time, cataracts will eventually interfere with your vision.
At first, stronger lighting and eyeglasses can help you deal with cataracts. But if impaired vision interferes with your usual activities, you might need cataract surgery. Fortunately, cataract surgery is generally a safe, effective procedure.
Causes of Cataracts-
Cataracts happen when protein builds up in the lens of your eye, making it cloudy. This prevents light from passing clearly through the lens, causing some loss of vision. New lens cells form on the outside of the lens, and the older cells are compacted into the center of the lens, forming the cataract.
Types of cataracts include:
Age-related cataracts: These cataracts form because of aging.
Congenital Cataracts: Babies are sometimes born with cataracts as a result of an infection, injury, or poor development before they were born, or they may develop during childhood.
Secondary Cataracts: These develop as a result of other medical conditions, like diabetes, or exposure to toxic substances, certain drugs (such as corticosteroids or diuretics), ultraviolet light, or radiation.
Traumatic cataracts: These form after an injury to the eye.
Other things that can raise your risk of getting cataracts include cigarette smoke, air pollution, and heavy drinking.
Symptoms of Cataracts-
-Clouded, blurred or dim vision
-Increasing difficulty with vision at night
-Sensitivity to light and glare
-Seeing "halos" around lights
-Frequent changes in eyeglass or contact lens prescription
-Fading or yellowing of colours
-Double vision in a single eye
- Surgery: Surgical removal of a cataract is the first and foremost way of dealing with it. The clouded lens is usually removed and then replaced with a new, artificial lens that will give you improved vision.
- Visual Aids: These aids include lens and eyeglasses that will help you see better after the surgery. Cataract glasses usually come in thick and heavy structure. Also, intraocular lens and contact lens can be used by adults who have undergone the surgery. The constant need to remove, clean and reapply makes it inappropriate for young children. Low vision aids can be used before surgery as well, to ensure that the best use of the remaining vision is made with the help of video enlargement software and other adaptive means.
- Medication: The use of eye drops and other medication can also help in improving vision without the actual surgery for cataract removal. This is a short term solution that can be prescribed by the ophthalmologist whom you visit. The doctor will usually study the extent of the damage and prescribe this kind of medication for cases that are mild. But finally, surgery will have to be carried out as the progression of the cataract is guaranteed in all cases.
- Soft Lighting: At home and at work, you can make use of soft lighting so that there is less pressure on the eye lens. Also, soft lighting will help you see better without the glare blocking your vision in case of the presence of a cataract.
- Avoiding Intricate Work: One must avoid hobbies and work that require unblinking attention or many hours as this can put a strain on the eyes and even lead to severe headaches. This includes painting, embroidery and carving related activities.
Dealing with a cataract is a matter of going in for surgery and making certain lifestyle changes to avoid injuries due to impaired vision.
Cataract surgery is performed to remove the lens of the eye and replace it with an artificial one. The surgery is undertaken to cure cataract, which makes the lens of the eyes cloudy, making it difficult to see. The surgery is not considered to be a major one and is performed on an outpatient basis, meaning that the patient can go home the very same day without having to spend the night at the hospital. The procedure is very normal and is undertaken when cataract starts to affect the day-to-day life of the patient.
Know the risks involved
Complications after cataract surgery are rare but not unheard of. The surgery in itself is a simple one but there is a risk of complications if the patient is suffering from another eye disease or is suffering from an underlying health condition. As a precaution, always get yourself tested for other eye diseases before deciding to go for the surgery. Some of the other risks involved include:
What to do before cataract surgery?
Before the surgery takes place, your ophthalmologist will ask you to do certain preparations so that the surgery goes as planned. Make sure that you follow his/her advice diligently for a successful surgery and recovery. Some of these things include:
A simple, uncomplicated cataract surgery should not take more than 10 minutes to perform. The best part about a cataract surgery is that most people see almost immediate results and improved vision. However, full recovery can take awhile. Each person heals at a different speed but ideally, your eyes should heal completely in a month.
Here are a few tips to help speed up this process and avoid infections and eye injuries :
Take it easy
Just because the surgery takes a short time is no reason to underestimate its importance. Do not drive on the first day and as far as possible avoid driving for the next few days as well. Do not put any extra pressure on your eyes by bending, lifting weights etc. This will ensure that your stitches do not tear open. Try to avoid excessive sneezing and coughing as this can jerk the lens out of place.
Protect your eyes
Wearing sunglasses is a good idea after a cataract surgery. This will protect your delicate eyes against dust, wind etc. Avoid using community swimming pools and hot tubs immediately after such a surgery to lower the risk of infections. Avoid rubbing your eyes aggressively. For the first week, keep your face out of the shower so as to avoid feeling the need to press or rub your eyes as well as to protect them from bacteria in the water.
Your eyes may feel dry and scratchy after a cataract surgery. This is normal and not something to worry about. Your doctor will prescribe eye drops to be taken after the surgery. Use these regularly. Once this is over you may need additional artificial tears or lubricating eye drops. However, do not take these drops without first consulting your doctor. If your eyes are sensitive to the preservatives in bottled eye drops, look for single use ampoules. Ensure that you always wash your hands well before administering the eye drops.
Keep the eye clean
Though washing your face is avoidable, you must still keep the eye clean. Use cotton and a sterile saline wash for the first few days. You can later replace the saline with cool boiled water.
If you feel any deterioration in your vision, pain or excessive discharge in the operated eye, you must immediately consult your doctor. Seeing sudden flashes of light or floaters in your vision should also not be ignored.
Your eyes are one of the most significant of all the sense organs since it allows you to see things around you. It is essential to take good care of your eyes. But, many lack awareness of ocular care. Read on to know a few lifestyle habits that will help in maintaining good ocular hygiene thus ensuring normal vision.
Ensure your ocular hygiene with these healthy lifestyle habits
Most of these tips may sound simple, but they are highly effective and can help avoid eye problems completely. And don’t forget to get your routine eye check-up done as well. All that is required is to incorporate these basic lifestyle changes to protect the amazing part of your body, your eyes.