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Cataract

The eye has a natural crystalline lens which helps focus light on to the retina. This is a transparent clear biconvex lens. When this structure turns hazy, it is called a cataract.

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Frequently asked questions about cataracts

What are the symptoms of Cataract?
In the early stages (Immature Cataract) the hazy lens scatters light as it passé through .So one sees a hazy image. Driving, especially in the night may become difficult. In a central cataract, daytime vision and reading will be blurred. In advanced cataract, no light can enter the eye as the lens is completely opaque (Mature Cataract). Then vision is very much impaired.

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How is cataract treated?
An early cataract which is not causing difficulty in your activities need not be treated. Sometimes only a change of spectacle may suffice.

If the cataract is causing difficulty in vision, it has to be treated. Treatment of cataract is always surgical. There are no tablets or eye drops that can reverse a cataract. Cataract surgery is one of the most successful surgeries performed with a very high percentage of patient satisfaction. It is a painless procedure done as a day care surgery. Most patients are up and about on the day od surgery and recovery time is minimal.

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One needs to undergo a detailed evaluation of the eye prior to surgery. This includes ruling out other diseases such as glaucoma, retinal pathology etc., the eyes will be measured (Biometry) to calculate the power if the lens that needs to be inserted into the eye.

Modern cataract surgery is done with a sophisticated ultrasound technology (Phaco-emulsification). The cataract is removed through a very small incision (1.8 to 2.8mm) and a lens is injected into the eye thro the same site. The lens unfolds and rests in the natural position of the crystalline lens.

Are there different types of intraocular lenses?

Based on the material with which they are made, lenses may be hydrophilic or hydrophobic.

Until recently, patients were offered only a single focus lens for implantation. This necessitated the use of glasses for reading. Now we can offer multifocal lenses with which you can have good distance, near and intermediate vision reducing the dependence on spectacles.

How long does the surgery take?

Cataract surgery is done as a day care procedure. You will need to come to the hospital an hour before the scheduled time. The surgery will take about 30mins to perform. You can go back home an hour after the procedure. A bandage or eye shield will be applied for a short period of time and can be removed before you go home.

What can I expect after cataract surgery?

On the day of the surgery –
Your eye will be patched for a few hours. After the patch is removed, you can resume all normal activities wearing a pair of protective glasses. Vision will be blurry for a few hours. There may be some watering from the eye and mild discomfort.

In the first month after surgery
You will need to instill antibiotic drops and steroid drops into the operated eye for a few weeks after surgery. After a few days, glasses will be prescribed if needed. You will need to be reviewed periodically during the month after surgery to ensure proper healing and to prevent complications

Will I need to wear glasses after cataract surgery?

If you have opted for a single vision lens, the aim will usually be to make you see well in the distance. However variations do occur due to several factors and 25% of patients may need to wear a spectacle to see very well in the distance. Almost everyone will need to wear glasses.

If you have opted for a multifocal lens to be implanted, the aim will be to make you see well for both distance and near. This successful outcome is seen in nearly 90 % of patients, 10 % may still need glasses for some activities.

You can discuss your daily routine and activities at the time of your final consultation and we can then plan the appropriate lens to be implanted so that you can have comfortable vision with and without glasses.

What must I avoid after surgery?

You must avoid rubbing the eye and touching it unnecessarily. Do not splash water into the eye and avoid swimming for one month after surgery.

If you have any of the following symptoms in the first few weeks after surgery, you should contact the hospital immediately and one of the doctors will attend to you right away.

1. Excessive pain
2. Decrease in vision
3. Inability to face bright light
4. Swelling of the eyelids.
5. Increasing redness of the eyes.
6. White or yellow discharge from the eyes.

What are the possible complications of cataract surgery?

During surgery:

The capsule that supports the lens may be partially or completely torn and disturb the vitreous jelly in the eye. This needs a different type of lens to be implanted in the eye and there may be some reduction in vision.
1. Loss of a part or whole of the cataract into the eye may require a separate surgery to be done by a retina specialist.
2. Bleeding into the eye.

After surgery:
1. Rise in pressure inside the eye.
2. Clouding of the cornea – front portion of the eye.
3. Incorrect power of lens implanted.
4. Swelling of the central retina – macular edema.
5. Increased awareness of floaters.
6. Glare, especially during night driving.
7. Detachment of the retina.
8. Infection in the eye – endophthalmitis

All these complications can be treated effectively and do not result in significant loss of vision. But they do mean extra medications, sometimes additional surgery and delay in full visual recovery.

We hope that this information is sufficient for you to take an informed decision about your cataract surgery. You may feel free to contact any of our consultants for further information and clarifications.