cataracts

According to the American Academy of Ophthamology the definition of "a cataract is a clouding of the normally clear lens of the eye. It can be compared to a window that is frosted or yellowed. The amount and pattern of cloudiness within the lens can vary. If the cloudiness is not near the center of the lens, you may not be aware that a cataract is present." A full copy of the AAO Cataract Brochure can be downloaded by going to their website at www.aao.org.

 

Many misconceptions exist about cataracts including a cataract is not a film over the eye, caused by overusing the eyes, spread from one eye to the other or is a cause of irreversible blindness. However, early in the development stages of an age-related cataract the power of the lens may be increased, causing near-sightedness or myopia, and the gradual yellowing and opacification of the lens may reduce the perception of blue colors. Cataracts typically progress slowly to cause vision loss and can lead to blindness of not treated. Senile cataracts, commonly occurring in the elderly, are "characterized by an initial opacity in the lens, subsequent swelling of the lens and final shrinkage with a complete loss of transparency." As time passes, the cataract cortex liquefies to create a milky white fluid in a Morgagnian cataract, which can cause severe inflammation if the lens capsule fractures and leaks. If untreated, the cataract can cause phacomorphic glaucoma. Very advanced cataracts with weak zonules are liable to dislocation anteriorly or posteriorly.

 

Some common symptoms of cataracts can include painless blurring of vision, veiling glare, or light sensitivity, poor night vision, double vision in one eye, requirements for brighter lights to read and fading or yellowing of colors. As a cataract becomes more opaque, deterioration of clear vision occurs. According to the World Health Organization, (WHO), age-related cataract is responsible for 48% of world blindness, which represents about 18 million people.

 

The causes of cataracts are varied and can potentially develop from a variety of reasons. These include long-term exposure to ultraviolet light, high exposure to radiation, secondary effects of diseases such as diabetes, hypertension and advanced age, or trauma; they are normally a result of denaturation of lens protein. Genetic factors can potentially play a role in the cause of congenital cataracts and potentially predispose individuals at earlier ages. Cataracts can also be caused by an eye injury or physical trauma. Work that exposes individuals to excessive amounts of radiation can cause cataracts. Atopic or allergic conditions are also known to quicken the progression of cataracts, especially in children. Cataracts can be complete or partial, progressive or stationary and hard or soft. There are various types of cataracts, including nuclear, cortical, mature, and hypermature. Some drugs have been found to encourage cataract development, such as Corticosteroids, Ezetimibe and Seroquel.

 

Unfortunately, there is no scientifically proven prevention for cataracts. It is stated that wearing ultraviolet protective eyewear can reduce the development of cataracts and regularly taking antioxidants may be helpful. When a cataract is highly developed, surgery can be performed to remove it. The most common procedure is to make an incision, capsulotomy, into the capsule of the cloudy lens in order to surgically remove the lens. There are two types of eye surgery that can be performed to remove cataracts: extra-capsular (extracapsular cataract extraction, or ECCE) and intra-capsular (intracapsular cataract extraction, or ICCE). Extra-capsular (ECCE) surgery involves removing the lens but leaving the majority of the lens capsule in place. High frequency sound waves (phacoemulsification) are sometimes used to break up the lens before extraction.

 

Intra-capsular (ICCE) surgery involves removing the entire lens of the eye, including the lens capsule, but this procedure is not commonly used in modern practices.

 

In both extra-capsular surgery and intra-capsular surgery, the cataractous lens is removed and replaced with a plastic lens (an intraocular lens implant) which stays in the eye permanently.

 

Cataract operations are usually performed using a local anaesthetic and the patient is allowed to go home the same day. Complications can occur after the surgery, including endophthalmitis, posterior capsular opacification and retinal detachment.

 

It is imperative to consult with an Optometric Physician or Optometrist to assess the stages of cataracts to advise the most suitable solutions moving forward.

 

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