Cataract

What is a cataract?

A cataract is one of the most common eye conditions, which causes blurry vision as a result of clouding of the natural lens in the eye. The human lens is located behind the iris (the coloured portion of the eye), and it is mostly made up of water and proteins. These specific proteins provide the lens its transparent structure.

What are the causes of cataracts?

Any structural change in the lens proteins can alter its clarity and negatively impact vision. The lens becomes more and more cloudy with time when a cataract occurs, and may be seen as white patches in the centre of the pupil.

Types of Cataracts

Cataracts may be classified based on their location within the eye, which include:

Nuclear Cataract:

Cloudiness is present in the centre of the lens.

Cortical Cataract:

Cloudiness is seen as white spokes in the outer periphery of the lens.

Posterior Subcapsular Cataract:

This occurs at the back of the lens capsule, which is like a shell of the lens. It may develop quicker than the other types of cataracts and it is more commonly seen in patients with diabetes or on long term steroid treatment.

Who are at risk of developing cataracts?

The development of a cataract is a natural aging process of an individual.

Cataracts can also be inherited or can develop in infants as a result of infections in the mother during pregnancy.

They can form as a complication of other diseases such as glaucoma and diabetes, or can develop after certain injuries.

Prolonged use of corticosteroid inhalers and eye drops, and excessive exposure to UV rays, X-rays and other radiation during radiotherapy, can increase the risk of cataract formation.

How is cataract diagnosed?

To assess the impact of the cataract on your vision, your ophthalmologist will test your visual acuity. This test involves reading an eye chart from a certain distance with one eye at a time. A comprehensive eye examination will then be performed in order to assess the severity of the cataract.

What is the best treatment for cataract?

Surgery is the only treatment option for cataracts, which is recommended based on the severity of the disease and the impact it will have on the daily activities of the patient.

The latest cataract surgery comprises of advanced Phacoemulsification combined with Micro-incision or Femtosecond Laser-Assisted Cataract Surgery.

Cataract Surgery is performed in five stages, these are:

1. The operated eye will be completely anaesthetised by an anaesthetic specialist
2. A small incision will then be created manually or with laser to allow access to the cataract
3. The cataract will be broken down into small pieces with an ultrasound probe (Phacoemulsification)
4. After the cataract is removed, an artificial lens implant will be inserted into the eye for focussing light
5. Finally, the eye will be patched and you may return home

What are the different types of intraocular lens implants available?

There are many different types of lens implants available:

Monofocal Intraocular Lens

The traditional lens implant is a monofocal intraocular lens, which can only be used to correct a certain range of vision (usually the distance vision for driving).

Trifocal or Extended Depth of Vision Intraocular Lens

The latest lens implants may correct different portions of your vision, which include:

• Distance
• Intermediate (computer)
• Near (reading) vision

These implants may help to reduce the need of spectacles after cataract surgery, however they are not suitable for all individuals.

Toric Intraocular Lens

• Also, there are toric lens implants, which can be used to correct astigmatism and decrease the dependence of spectacles.
• Your ophthalmologist will help you to choose the most suitable lens implant based on your needs and lifestyle.
• It is essential to appreciate that spectacles may still be required to provide the sharpest focus in certain conditions despite the most suitable implants are chosen.

Recovery After Cataract Surgery

• Your ophthalmologist will check your eye on the following day after surgery.
• You will need to use eye drops for one month, and you should not allow tap water enter into your operated eye for at least one week.
• Depending on the severity of your cataract, your vision will clear in a couple of days, or may take a few weeks.
• It is essential to understand that even if visual recovery is slower, the final visual outcome will still be the same.