Eye cataract is a blurring of the eye lens that causes blur (to loss) of vision in the affected eye. It can occur in one eye (unilateralis) or both eyes (bilateralis).
It usually develops as a consequence of aging (senile cataract).
By aging, natural lens in our eye, also known as “crystal lens,” becomes blurred, and gets a milky appearance.
In some cases, genetic predisposition may cause cataracts in younger persons. It is a normal progressing process through which each of us will sooner or later have to go through in our lifetime.
The types of cataract:
Cataract associated with aging (senile cataract)
It is also called old man’s cataracts or cataracta senilis. This is the most common type of cataract, makes up about 90% of all cataracts. It usually occurs after the 60th year. The cause is still unknown. It is believed that it occurs due to disorder of lens metabolism. Degrees of senile cataract development are: initial cataract, immature, mature and ripe. With ripe cataract the crust of a cataract lens becomes watery like milk, and its core falls to the bottom. Milk part can come out so the capsule shrivels.
Traumatic cataract may occur as a result of mechanical injury:
– Contusion, for example when hitting with fist in the eye when the anterior capsule stretches, cracks occur, aqueous humor enters the lens and blurs it
– Perforation – creates an opening in the lens, aqueous humor enters and blurs it
or as a result of natural causes:
– A consequence of electric shock
– The effect of radiation
– Cataracts due to the heat (exposure to infrared radiation)
These metabolic cataracts most often occur due to:
– Drug toxicity, most commonly due to prolonged use of corticosteroids
The most important morphological forms are cortical and nuclear cataract.
In cortical cataract blurs look like spokes of a wheel or a wedge with a base on the equator and the tip toward the center of the lens.
Nuclear cataract affects the central part of the lens.
Treatment: Regardless of the morphology, the only treatment of any form of cataract which interferes with vision is surgery. Drops to slow the development of cataract are unreliable.
Blurred vision, problems with running light, pale colors, bad night vision, double or multiple visions, frequent need to change lenses or glasses.
All these symptoms may be due to some other eye diseases so it is necessary to have an examination at the medical specialist: ophthalmologist.
There is no drug therapy.
Treatment of initial stages is the stronger lighting and eyeglasses or contact lenses.
Later, surgery is required. Three types of procedures are used:
– Intracapsular surgery
– Extracapsular surgery
In all these procedures a blurred lens is removed and in most cases another lens in built in. After intracapsular surgery, the artificial lens cannot be installed because there is no support for it.
In case a part of the patient’s lens remains in the eye after surgery, it can get blurred later and this condition can be treated by laser, with a technique called YAG laser capsulotomy.
There are two main surgical ways for the removal of cataract:
1) Phacoemulsification – the operator makes a small incision on the side of the cornea, inserts a thin probe through which ultrasound waves are emitted which soften and break blurred center of the lens that is later removed with a probe. Phacoemulsification is in an advantage over extracapsular surgery because it allows for faster recovery – patient is within a few days capable of working. Vision after this surgery is also better.
2) Extracapsular surgery – a long incision on the side of the cornea is made and the hard part of the lens is removed. The rest of the lens is removed by suction.
In most surgical procedures the removed blurred lens is lens is replaced by an artificial lens. The artificial lens is transparent, requires no care and becomes a permanent part of the eye. The new lens allows the arrival of light on the retina and creating of images. The artificial lens cannot be felt or seen. Some people cannot have artificial lens because of problems during surgery or other eye diseases. For them there is the option of wearing soft contact lenses or glasses with high magnification.
Phacoemulsification (ultrasonic surgery) is very effective and successful in most cases and gives good results.
After surgery, common feelings are itching and mild discomfort in the operated eye. There may be leakage and eye sensitivity to light and touch. For stronger pain the doctor may prescribe you painkillers. After 1-2 days the pain should stop. In most cases, healing is achieved in the period of 6 weeks. After surgery it is necessary to perform regular medical examinations in order to control healing. The doctor may prescribe eye drops or medications that control intraocular pressure. For eye protection it is required to wear eye protection or sunglasses. Rubbing and pressing the eye should certainly be avoided.
Problems after surgery are rare, but possible. They include infection, bleeding, loss of vision or flashes of light. With quick reaction by the medical staff, these problems are quickly fixed.
During recovery after surgery the patient should not bend or carry heavy objects.
After surgery the patient can quickly return to normal activities, but at first his sight may be blurred. Operated eye needs some time to adapt, especially if the other eye has cataract too. After placing an artificial lens in the eye, colors can be stronger or have a blue tint. Also, after a stay in bright sunlight everything can seem red during the next few hours. After several months these changes in experience of color disappear.