Cataract Surgery
A cataract is a cloudy or opaque area in the normally clear lens of the eye. Depending upon its size and location, it can interfere with normal vision. Most cataracts develop in people over age 55, but they occasionally occur in infants and young children. Usually cataracts develop in both eyes, but one may be worse than the other.
The lens is located inside the eye behind the iris, the colored part of the eye. The lens focuses light on the back of the eye, the retina. The lens is made of mostly proteins and water. Clouding of the lens occurs due to changes in the proteins and lens fibers.
The lens is composed of layers like an onion. The outermost is the capsule. The layer inside the capsule is the cortex, and the innermost layer is the nucleus. A cataract may develop in any of these areas and is described based on its location in the lens:
- A nuclear cataract is located in the center of the lens. The nucleus tends to darken changing from clear to yellow and sometimes brown.
- A cortical cataract affects the layer of the lens surrounding the nucleus. It is identified by its unique wedge or spoke appearance.
- A posterior capsular cataract is found in the back outer layer of the lens. This type often develops more rapidly.
Normally, the lens focuses light on the retina, which sends the image through the optic nerve to the brain. However, if the lens is clouded by a cataract, light is scattered so the lens can no longer focus it properly, causing vision problems.
Cataracts generally form very slowly. Signs and symptoms of a cataract may include:
- Blurred, hazy vision
- Reduced intensity of colors
- Increased sensitivity to glare from lights, particularly when driving at night
- Increased difficulty seeing at night
- Change in the eye's refractive error
While the process of cataract formation is becoming more clearly understood, there is no clinically established treatment to prevent or slow their progression. In age-related cataracts, changes in vision can be very gradual. Some people may not initially recognize the visual changes. However, as cataracts worsen vision symptoms tend to increase in severity.
What causes a cataracts?
Most cataracts are due to age-related changes in the lens of the eye. However, other factors can contribute to their development including:
- Diabetes mellitus - Persons with diabetes are at higher risk for cataracts.
- Drugs - Certain medications have been found to be associated with the development of a cataract. These include:
- Corticosteroids
- Chlorpromazine and other phenothiazine related medications
- Ultraviolet radiation - Studies have shown that there is an increased chance of cataract formation with unprotected exposure to ultraviolet (UV) radiation.
Smoking - An association between smoking and increased nuclear opacities has been reported.
- Alcohol - Several studies have shown increased cataract formation in patients with higher alcohol consumption compared with people who have lower or no alcohol consumption.
- Nutritional deficiency - Although the results are inconclusive, studies have suggested an association between cataract formation and low levels of antioxidants (e.g. vitamin C, vitamin E, carotenoids). Further studies may show that antioxidants have a significant effect on decreasing cataract development.
Rarely, cataracts can be present at birth or develop shortly after. They may be inherited or develop due to an infection, i.e. rubella, in the mother during pregnancy. A cataract may also develop following an injury to the eye or surgery for another eye problem, such as glaucoma.
'While there are no clinically proven approaches to preventing cataracts, simple preventive strategies include reducing exposure to sunlight through UV blocking lenses, decreasing or discontinuing smoking and increasing antioxidant vitamin intake through consumption of leafy green vegetables and nutritional supplements.
Cataract Surgery
When a cataract progresses to the point that it affects a person's ability to do normal everyday tasks, surgery may be needed. Cataract surgery involves removing the lens of the eye and replacing it with an artificial lens. The artificial lens requires no care and can significantly improve vision. New artificial lens options include those that simulate the natural focusing ability of a young healthy lens.
At vivid laser centre Dr. Baldassare performs Small incision cataract surgery. This involves making an incision in the side of the cornea, the clear outer covering of the eye, and inserting a tiny probe into the eye. The probe emits ultrasound waves that soften and break-up the lens so it can be removed by suction. This process is called phacoemulsification.
Once the natural lens has been removed, it is replaced by a clear plastic lens called an intraocular lens (IOL). For situations where implanting an IOL is not possible because of other eye problems, contact lenses and in some cases eyeglasses may be an option to provide needed vision correction.
As with any surgery, cataract surgery has risks from infection. Cataract surgery also slightly increases the risk of retinal detachment. All risks and benefits will be thoroughly discussed with you prior to your surgery and you can be assured that we will minimize any risks through excellence in training, a state of the art surgical centre, and through surgeon experience.
Cataract surgery is one of the safest and most effective types of surgery performed in the North America today.
To read more about cataracts and commonly asked questions: www.cataractsurgery.com
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