About  Cataract Surgery

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Cataract is caused due to clouding of the lens in one’s eye. This leads to vision loss and cannot be rectified with regular power glass. But with the help of a Cataract surgery we can restore a person’s vision. It is a very simple procedure and does not require long duration to come to normal state after surgery. Cataracts can be found mostly in older people.Thankfully, modern cataract surgery is one of the safest and most effective surgical procedures performed today.

FAQS ON CATARACT SURGERY

What is Cataract Surgery?

Cataract surgery is a day care procedure, wherein the natural lens inside our eye, that has become cloudy is removed and replaced with an artificial lens called intraocular lens to restorelloe clear vision

How do cataracts affect your vision?

When the natural lens become cloudy, due to protein clumping eye and falling on to the retina resulting in blurred vision

What are the cataract symptoms?

Blurred vision, glare-reading to difficulty in driving at night, double vision, frequent change of glass prescription, improvement in near vision (second sight) that can get worse later on.

What causes cataract?

Cataract develops in the following conditions:

  • When the protein builds up in the natural lens of the eye due to-Aging.
  • During pregnancy infections such as chickenpox, rubella, toxoplasma, and poor development in the womb
  • Secondary – Due to diabetes, exposure to u-v light or radiation, taking drugs like steroids or diuretics
  • Other causes – smoking, drinking, air pollution

When do I need a cataract surgery?

If the vision can be corrected with glass, then you can wait for the cataract surgery. if vision cannot be corrected with glasses and performing routine activities in daily life is becoming difficult, then you may need cataract surgery.

Is cataract surgery safe?

Nowadays, cataract surgeries are a simple, safe and   day care procedure, done to restore vision loss due to cataract in a very effective way. Besides, the intra operative and post operative period is mostly uneventful.

How long does it take to recover after surgery?

Most of the cataract surgeries are uncomplicated and takes no longer than 10-15 minutes to perform. After the surgery, you can take rest for half an hour to an hour in the recovery room or ward and then leave. Once the eye shield is removed, you will be asked to apply antibiotic and anti- inflammatory eye drops for a month or so, to help prevent infection & control inflammation some patients see very well the day after cataract surgery. Others see well a few days after surgery &still others may need a full month to reach their maximum vision improvement.

What is involved in a cataract operation?

Cataract surgery is a procedure done to remove the cataract our lens that is cloudy, and replace it with the artificial intra-ocular lens, to restore normal vision.

What is Laser Cataract Surgery?

Laser cataract surgery used an advanced femtosecond laser to replace the manual. Hand help surgical steps like corneal incision. Anterior capsulotomy (capsulorhexis) and lens fragmentation in a more precise way.

Is cataract surgery necessary?

Yes if the vision loss due to cataract cannot be corrected with glasses and performing everyday activities especially driving vehicles becomes difficult, then it is advisable to undergo cataract surgery as early as possible.

Can I shower after cataract surgery?

Nowadays, due to the advanced surgery techniques, the recovery time post-operatively is very quick and uneventful mostly; you can have your regular bath below neck and have a towel bath for your face the first 1 week. after that you can have your shower, avoiding direct contact of water in to the eye.

What are the side effects of cataract surgery?

Cataract surgery is generally a very safe day care procedure. However, while the risks are minimal, patients should anticipate the development of some side effects after treatment they include

  1. Blurry vision-for the first few days after surgery which will improve as the eye heals with the application of post operative medications
  2. Red eye/blood shot eye-which will settle down within few days.
  3. Black eye-Due to injection of anesthesia below the lower eyelid prior to surgery.
  4. Discomfort-Minor pain can be experienced by few patients that can be treated with analgesics (pain killers).
  5. Dry,it by eyes-can occur because of the corneal incisions made during cataract surgery lubricant eye drops will help these patients.

How do you prepare for cataract surgery?

Before cataract surgery, the ophthalmologist performs a comprehensive eye examination of both your eyes including refraction to check your power. Additional tests to determine your corneal curvature and axial length of the eye will also be done to determine your intra-ocular lens power. A series of blood tests and ECG will also be done to assess the general condition of the patient prior to the surgery. After all these assessments, if the patient is medically & ophthalmological fit for cataract surgery, then he/she will be given a set of pre-operative medications a day or two before surgery.

Before going for a cataract surgery, it is important to know the various things related to it.

Ultrasound test: Usually before the cataract surgeries say a week before your eye surgeon will do an ultrasound test to your eyes to check the size and shape of the eye. Based on this test the doctors will plan the right type of lens to implant.

Eye drops: Doctors will prescribe special eye drops two or three days before the surgery to avoid infection risk.

Medicines: Apart from the eye drops you may be taking few more medicines. It is always advisable to ask the doctor whether you can take the regular medicines. In most cases, doctors may ask you to stop the regular medicines to avoid the risk of bleeding.

Fasting: You may be advised not to drink or eat 12 hours before the cataract surgery. Again this is a precautionary measure to avoid future complications.

Post treatment instructions: After the surgery, doctors will give you specific instructions on the dos and don’ts. You will have to strictly follow that. Even though the cataract surgery is a one day procedure, you need someone’s help to go back home. So you will have to arrange someone to be with you to help you. You may be restricted from doing certain activities at least for a week. Apart from whatever the doctor says, if you have any questions on your mind, please do not hesitate and get it clarified from the doctor.

Is laser surgery safer?

Use of femto second laser for cataract surgery, can improve the precision & accuracy of various steps in cataract surgery, potentially reducing the risks and improving the visual outcomes.

How do you remove a cataract?

Cataracts, nowadays are removed by a procedure called phaco-emulsification, wherein a high frequency ultrasound device breaks the cloudy lens into small pieces, which are then gently removed by suction. After this, a clear intraocular lens is placed in the same location where the natural lens was occupying earlier.

How long do you have to use eye drops after cataract surgery?

The postoperative eye drops, which are given to prevent infection & control inflammation, may have to be applied for a month or so.

Can I have my cataract surgery redone?

Cataract surgery is done only once, unless & until there is some complication, wherin the patient is taken again to the OT for any reparative procedure

Can a cataract come back?

No. A cataract cannot come back after cataract surgery. But after cataract surgery, the posterior lens capsule holding the intra-ocular lens can become cloudy & give rise to blurry vision similar to that of a cataract. This is called posterior capsular opacification which is treated with Yag Laser, that creates an opening in the center of the opacified capsule to allow the light to enter the eye.

Why Cataract Surgery is done?

Cataract Surgery is performed on people who have a difficulty in doing their normal activities due to blur vision then the doctor may prescribe for a surgery. Cataract Surgery need not be done on an emergency basis unless the doctors say so. In most cases, the patient may have another eye problem along with cataract. If doctors have difficulty in treating the other problem because of cataract then a cataract surgery may be suggested.

Another important thing to be noted about cataract is, the surgery as such is not mandatory. If the affected person has good vision in spite of having cataract, then the surgery is not a must. It can be postponed to a later date. Before going for a cataract surgery you need to ask yourself some of the basic questions given below:

  • Do I have difficulty seeing in bright lights?
  • Do I have a problem in vision while driving?
  • Do I have problems watching television or reading?
  • Do I have problem in vision while cooking?

If you find that you experience some of the above, it is advisable to consult your doctor. Cataract Surgery generally will not have any complications and the success rate is also on the higher side. So you need not fear, if doctors suggest for a Cataract Surgery.

What are the risks involved with Cataract Surgery?

Cataract Surgery involves the following risks:

  • Bleeding
  • Glaucoma
  • Inflammation
  • Detachment of Retina
  • Swelling
  • Artificial lens dislocation
  • Infection in eye
  • Drooping eyelid
  • Vision loss
  • Secondary cataract

As mentioned earlier cataract surgery is one of the safest surgery. In spite of that, there is chance of complication to occur when the patient has a serious eye problem along with cataract. In some cases cataract surgery had to be performed before treating the other eye problem. In some cases it is the other way. Wherever possible it is always good to get the other eye problem treated before a cataract surgery is done.

What you can expect before cataract surgery?

Before the cataract surgery is performed, you need to decide on what type of lens you want to implant. In general, an artificial lens called as intraocular lens (IOL) will be prescribed by doctors to be paced in your eyes. Once fixed, it will be part of your eye permanently.

Intraocular lens are of various types. The lens will change based on your usage and pricing. However, your doctor will advise which type of lens will be useful for you. When selecting the lens also be aware of things like insurance. Sometimes this may not be covered in insurance.

Intraocular lens is usually made of silicone, plastic or acrylic. There are flexible and rigid intraocular lens available. This will change based on the condition of the patient. In some cases the intraocular lens needs to be placed in the eye by incision. There are many types of lenses available namely multifocal, toric lens, accommodating-focus monofocal and fixed-focus monofocal. Each of it is used for different purposes. Your eye surgeon will guide you on which lens will suit your purpose best.

What you can expect during cataract surgery?

If you have gone for an eye check-up, they generally place eye drops to your eye. In the same way, before the surgery, eye drops will be given to your eyes to dilate the pupil. After that local anaesthetics will be given and in some cases sedative will also be given. During the surgery, your blurred natural lens will be replaced with artificial lens. There are also instances where the cataract will be removed without placing an artificial lens. The entire surgery will not take more than an hour. In most of the cases, the patient can be discharged the same day.

Now let us see how the cataract is removed by surgery. During a cataract surgery, the eye surgeon follows a procedure called phacoemulsification. The surgeon will use ultrasound waves to remove cataract by breaking the formation in the eye. Another way of doing the cataract surgery is, by using the laser technique where the cataract is softened and then removed. This is a painless procedure and will hardly take 30 minutes to be completed. This is the most commonly used procedure performed by majority of the surgeons. There is also one more way of removing the cataract which is known as extra capsular cataract extraction. This is prescribed only if there are too many complications in the eye.

What you can expect after cataract surgery?

Though cataract surgery is a day care procedure, the post-operative care is very important .you will be given a pair of sunglasses to wear or the operated eye can be patched, depending on the surgeon’s discretion. A set of post-operative medications particularly eye drops will be given. which has to be applied diligently.

As soon as the eye shield or patch is removed on the first post-operative day, your vision can be blurry, your eyes can be red or you can have a black eye(due to injection of anesthesia)and you can have mild pain or irritation. All this will settle down within few days, so you need not be worried.

After the cataract surgery gets over you are definitely going to witness better eye sight. You will be able to see things a little brighter than you saw earlier. This clarity in vision is due to the new lens fixed in your eyes. Generally after surgery your vision will be little blurry, but it will soon become normal as your eye heals.

You may feel itching and little discomfort for the first 2-3 days. If it is very severe, please check with your doctor. You may have to visit your doctor on regular intervals say weekly and monthly to understand whether everything is fine after surgery. You may also be prescribed with some eye drops and medication after surgery. Kindly follow all this regularly to recover fast.

Introduction to Cataract Surgery

A Cataract is the formation of a cloud like layer on the lens of the eye which eventually leads to decrease or disturbance in the sight of the victim. Cataracts usually occur in people due to aging and most frequently diagnosed in people over the age of 40. Other possible reasons for the occurrence of this disease can also be trauma and radiation exposure. Radiation exposure can be inflicted in a person either from birth or can also be the side effects of an eye surgery done earlier.

When a person is affected by cataract, what it actually means is that clumps of protein or yellow-brown pigment might get deposited on the lens. This condition of pigment deposition leads to lesser amount of light transmission into the retina at the back of the eye. Cataracts are not predictable in nature and differ typically from one case to another, thus making it mandatory for the victim to have a regular diagnosis by an expert. Cataracts can occur on either both the eyes or one depending upon the case.

Consequences of Cataract

Cataract is a time taking disease and is not usually diagnosed or detected in a short period. The gradual growth of the yellow-brown pigment blurs the vision slowly, thus making the victim realise that something is not right with his vision. Although there are quite a few potential symptoms that causes cataract like having trouble seeing bright light, blurred or dimmed vision, halos around colours, trouble seeing things at night and faded colours.

The before mentioned symptoms indicate the existence of the disease, which leads the victim to having difficulty in driving and reading. Cataracts can become lethal diseases on a small scale by causing severe vision problems to the victim that he/she might be led to an extent where they have problems identifying their kith and kin or faces of people close to them whom they have known for a long time. Statistics available with www.wikipedia.com throw light on very alarming data regarding cataracts. Reduced or poor vision as a result of cataract constitutes up to around half of the blindness in the world and forms 33% of visual impairment diseases globally. (Statistics from www.wikipedia.com).

Symptoms and Signs of Cataract

The basic signs of cataract are that it makes you, the victim uncomfortable while looking at the sunlight or as simple as the light emitting from a candle or lamp. Cataracts make the light from the sun or the lamp look too shiny or bright, thus making it difficult for them even faces the direction. It seems like they are glaring right into the eyes of the person.

There are two extreme conditions to this disease in this context. There are high chances of the person facing too much brightness than before from light like the headlights of the oncoming vehicles. On the contrary, there are also equal chances of the victim noticing that the lights are not as bright as before. This disease might increase or decrease the sensitivity of the victim’s eye depending on the case.

Cataract is a silent killer and a very one at it. This deadly condition begins slowly without your attention, grows itself gradually until a certain extent where in you realise that there is blurriness in your vision and disturbance in your sight. This very slow and inattentive growth of this disease makes you ignore the condition in its initial stages and start taking care of it after diagnosis at a later stage. The later stages are when it is mostly diagnosed as the victims start realising that their vision has gotten decreased and that they feel like looking through a cloud.

            There are other signs and symptoms.

  • Disturbed/blurred vision.
  • Having trouble seeing at night.
  • Will require more light then usual when reading.
  • Appearance of bright colours as dull or yellow or faded.
  • Appearance of split image (seeing two images instead of one).
  • Extra sensitive to light.

Things to do (After Cataract surgery)

  • Consume high dietary intakes of Vitamin E like spinach, sunflower seeds and almonds. The carotenoids lutein and zeaxanthin from your food supplements like kale and other green vegetables decrease the risks of cataract.
  • High consumption of multi vitamins keeps your eye safe and reduces the chances of you getting cataract.
  • Few studies have shown that antioxidant vitamins like Vitamin A and Vitamin C and all food containing omega-3 fatty acids may reduce the risk of cataract. Both the vitamins protect the eye from free radicals and keep the eye distant from diseases like cataract.
  • Keep up the time and use your eye drops and medication, if any, as prescribed by your ophthalmologist.
  • Reduce activities that exert stress or burden on the eye such as reading, watching TV, writing or walking. Although you are allowed to do these activities, it is recommended that you ‘reduce’ the time doing it. It is also advised that you reduce physical activity in general.
  • It is very essential for you to wear you protective eye wear while you are awake and you are asleep. The eye wear should be worn at all times until the doctor diagnoses your eye and seems it fit to go without the protective wear.
  • Try not to sleep on that side of the eye which has been operated. This way, you reduce the burden on the operated eye.
  • Make sure you take a shower or bath with your eyes closed, restricting the water from entering your eyes.
  • Proper rest is essential on the day of surgery and the day after that. This promotes better healing and reduces recovery time.

Eye drops are usually prescribed for a month and it should be followed properly. The eye drops will prevent your eye from side effects like inflammation or getting an infection.

Things not to do (After Cataract Surgery)

  • Avoid alcohol, smoking tobacco and exposure to sunlight for a long time. These reasons are to be avoided before hand to prevent the occurrence of cataract.
  • Do not make physical contact directly or indirectly with the eye. Stay in a dust-free environment to protect your eyes. Even water can increase the chances of an infection.
  • Swimming or using a hot tub should be strictly prohibited for at least 2 weeks. Letting water have contact with your eye might open the window for an infection to grow.
  • You should not drive for 24 hours after the surgery. The head lights of the oncoming vehicles are too intense for the eyes to take. This makes the eye take a lot of stress, thus delaying the recovery time.
  • Avoid burdening yourself with physical work like bending and lifting something, a little over 15 pounds. There is a certain amount of pressure put on the eye when you bend and hence it is to be avoided.
  • Distance yourself from any kind of eye make-up or cosmetics until your doctor gives you permission to do so. Cosmetics or eye make-up have considerable amount of chemicals in them which might cause damage to the operated eye.
  • It is also advised not to vomit or sneeze after the surgery to avoid any kind of pressure on the eye.

Wearing a sun glasses all the time can restrict the sunlight from entering your eyes. This may, at times be meaningful, as the glasses protect your eyes from too much Ultra Violet rays but it also blocks the flow of wavelength which nourishes your eye and is important for overall good health.

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