Cataract is a disease of the eye or the lens of the eye. It is most often caused by advanced age, but it can also be congenital. The exact causes of its occurrence are not yet fully understood, but today it can already be successfully treated with surgery. In the article, you will read about the types of cataracts, their causes, symptoms and current treatment options.
Contents: Cataracts – causes, symptoms and treatment
What is a cataract?
Causes of cataract formation
Symptoms of cataracts
Cataract treatment
Cataract surgery
Cataract surgery and recovery
Postoperative complications
Is there prevention of cataracts?
With cataracts, vision deteriorates due to clouding of the lens, when the sufferer sees blurred , as if looking through fogged glass.
What is a cataract?
The lens has the ability of accommodation (adaptation), which enables the tracking of near and distant objects. It also serves as a natural protection against UV radiation. Cataracts cause clouding of the lens of the eye .
With cataracts, vision deteriorates due to clouding of the lens, when the sufferer sees blurred , as if looking through fogged glass. There are changes in the proteins that make up the lens, when the tissue of the normally transparent lens begins to become opaque (cloud). The problem increases in intensity over time and in the worst cases can lead to complete blindness , explains MUDr. Vadim Fridman, MBA, FEBO, Chief Physician of Ophthalmology at Canadian Medical.
Nowadays, however, it is usually surgically removed much earlier than it could cause blindness. An extensive cataract is visible to the eye as whitening or graying of the pupil area . Some patients then suffer from secondary cataracts , which is clouding of the lens capsule . In general, cataracts are divided into the following types:
- Subcapsular cataract– usually occurs on the back surface of the lens. Patients with diabetes and patients taking higher doses of corticosteroids are most at risk.
- Nuclear cataract– occurs in the central zone of the eye lens. It is often associated with aging and can significantly affect the number of diopters.
- Cortical cataract– occurs in the cortex of the lens (around the central nucleus). Here are the typical white, wedge-shaped vitreous opacities that start at the periphery of the lens and progress to the center of the lens.
Photo: Freepik.com
Causes of cataract formation
Cataracts appear mainly in connection with advancing age – it is a natural aging process of the human eye and the eye lens (senile cataract). It most often begins to manifest around the age of over 65 , but it can also appear later. Surveys point to the fact that cataracts affect over 75% of the population over the age of 70 .
However, the actual cause of cataracts is still not fully known . Although the above-mentioned senile cataract is most often diagnosed, in addition to age, the following factors can contribute to the development of the disease:
- hereditary predispositions,
- gender – cataracts more often affect women,
- race – the incidence is higher in African-Americans,
- systemic and metabolic diseases (e.g. diabetes),
- other eye diseases (inflammation of the eye or iris, eye tumor, glaucoma…),
- accidents or more serious eye injuries (traumatic cataract),
- use of certain drugs (corticoids, cytostatics, etc.),
- long-term use of certain eye drops,
- stronger dioptric defects or intraocular operations – can accelerate the development of the disease,
- inappropriate diet composition,
- smoking and drug use,
- excessive exposure to infrared and ultraviolet radiation,
- air pollution level,
- radiation exposure.
Some patients are born with cataracts – so-called congenital cataracts . Heredity plays an important role in such cases . If cataracts develop in a newborn , an infection the mother suffered during pregnancy may also be to blame . Generally, cataracts developed at a young age are referred to as juvenile cataracts .
Photo: Freepik.com
Symptoms of cataracts
How does cataract manifest itself? Initially, the disease may not affect vision in any way, but the cloudiness gradually increases and vision deteriorates. As already mentioned, the normally clear lens of the eye becomes cloudy, which prevents the passage of light rays on the retina and reduces its transparency.
At the same time, the patient does not suffer from eye irritation or pain or other problems. However, he experiences unpleasant changes, which include:
- blurred vision
- blurred image,
- higher sensitivity to light,
- different color perception,
- double vision,
- increasing myopia,
- increasing astigmatism,
- limiting the field of vision,
- if left untreated, complete blindness.
Cataracts more often affect both eyes. The clouding of the lens gradually intensifies, and only extensive clouding is visible from the outside of the eye. The speed of development of the disease is individual – it lasts months, even years and can lead to complete blindness. In our country, however, cataracts are surgically removed in time . The appropriate timing of the operation is governed by the specific difficulties of the patient, the extent of impaired vision or findings during the examination.
In the case of symptoms indicating a cataract, it is necessary to visit an ophthalmologist immediately .
Cataract treatment
In the case of symptoms indicating a cataract, it is necessary to visit an ophthalmologist immediately . He will examine the patient’s family history and specific visual complications. This is followed by an eye examination to confirm or refute the diagnosis.
The doctor will measure the visual acuity and refraction of the eye . The examination will then focus on the vitreous and the front of the eye, but the center of attention will be the lens, fundus and peripheral retina . Devices such as a slit lamp or an ophthalmoscope are used during the examination. Here at Canadian Medical, we also examine clients with an OCT device (optical coherence tomography). The pupillary reflex, eye movements, intraocular pressure and usually also the patient’s field of vision are also examined, explains MUDr. Friedman.
Cataract surgery
Cataracts cannot be removed with medication or glasses. However, in some patients, at least for a certain period of time, it is possible to correct the deterioration of vision with the help of glasses or contact lenses. Therefore, the only treatment option is surgery, during which the clouded eye lens is removed and replaced with an artificial one.
The artificial intraocular lens remains in the eye permanently . It perfectly compensates the dioptric power of the original lens, so by choosing the appropriate type of artificial lens, both myopia and hyperopia can be eliminated. The patient can also choose a multifocal lens , which improves vision at all distances. The operation is always indicated by an ophthalmologist, is performed on an outpatient basis, is gentle and painless.
The types of surgery include ultrasound phacoemulsification or turbidity removal using a femtosecond laser . And the price? Cataract surgery, including a basic intraocular lens, is fully covered by all health insurance companies.
The main reason for surgery is a decrease in visual acuity. However, the indication is very individual and the needs and wishes of the patient must always be taken into account. Early surgery is suitable for patients who also suffer from glaucoma.
Photo: Freepik.com
Cataract surgery and recovery
Since the procedure is performed on an outpatient basis under local anesthesia , the patient should be able to go home immediately after cataract surgery, of course with an escort. The subsequent restoration of vision is quite fast – complete stabilization of vision occurs within 2 to 4 weeks .
In the first days after the operation, the patient may feel a slight cutting or watering of the eyes. However, if the pain is severe and the eyes are red, if there is photophobia or a sudden deterioration of vision, an immediate visit to the doctor is in order. Cataract drops or so-called artificial tears are then used to prevent the inflammatory reaction.
As part of the postoperative regime, it is advisable to limit activities that tire the eyes. Wear sunglasses, avoid visits to the sauna or swimming pool, dusty environments and protect the eye from damage. It is also necessary to monitor intraocular pressure, e.g. deep bending forward, sleeping on the stomach, lifting heavy objects, rubbing the eye or applying make-up is not recommended.
Postoperative complications
The risk of postoperative complications is relatively low. In the early period after surgery, however, inflammation or bleeding may occur , and there is also a risk of a change in intraocular pressure . Later on, for example, detachment of the retina, clouding of the rear case of the eye lens, or a change in the position of the new lens may occur.
Is there prevention of cataracts?
The real possibility of prevention is questionable, while the early onset of cataracts cannot be completely prevented. However, studies show that it is possible to at least partially prevent it – protect the eyes from UV radiation and take care of a balanced diet rich in antioxidants. The menu should therefore contain vitamins A , C and E, carotenoids and foods containing omega-3 fatty acids.
TIP: Good sources of vitamin E are sunflower seeds, almonds and spinach. The source of carotenoids (lutein and zeaxanthin) is e.g. spinach, cabbage and other green leafy vegetables.
The problems associated with cataracts increase in intensity over time and in neglected cases can lead to complete blindness. So, if you experience symptoms, see an eye doctor without hesitation. You can also turn to experts from the EUC clinic.