Cataracts: Causes, Symptoms and Treatment

A cataract is a clouding of the eye’s natural lens, which lies behind the iris and the pupil.

Cataracts are the most common reason for vision loss in individuals over age 40 and is the primary reason for loss of sight on the planet. In fact, there are more cases of cataracts worldwide than there are of glaucoma, macular degeneration and diabetic retinopathy combined, according to Prevent Loss of sight America (PBA).

What Is Cataracts

Today, cataracts impact more than 22 million Americans age 40 and older. And as the U.S. population ages, more than 30 million Americans are anticipated to have cataracts by the year 2020, PBA states.

Types of cataracts include:

A subcapsular cataract occurs at the back of the lens. People with diabetes or those taking high dosages of steroid medications have a greater risk of developing a subcapsular cataract.

A nuclear cataract types deep in the central zone (nucleus) of the lens. Nuclear cataracts generally are related to aging.
A cortical cataract is identified by white, wedge-like opacities that begin in the periphery of the lens and work their way to the center in a spoke-like fashion. This type of cataract takes place in the lens cortex, which is the part of the lens that surrounds the main nucleus.

Many cataracts establish gradually and do not disrupt your eyesight early on. However with time, cataracts will ultimately interfere with your vision.

Cataract Symptoms and Signs

A cataract starts out small and in the beginning has little result on your vision. You may notice that your vision is blurred a little bit, like checking out a cloudy piece of glass or seeing an impressionist painting.

A cataract might make light from the sun or a lamp appear too brilliant or glaring. Or you may observe when you own at night that the oncoming headlights cause more glare than previously. Colors may not look like bright as they once did.

The kind of cataract you have will impact precisely which symptoms you experience and how soon they will occur. When a nuclear cataract first develops, it can produce a temporary enhancement in your near vision, called “2nd sight.”

Regrettably, the improved vision is brief and will vanish as the cataract intensifies. On the other hand, a subcapsular cataract might not produce any symptoms till it’s strong.

If you think you have a cataract, see an optometrist for an exam to find out for sure.

Cataracts Definition, Causes, Symptoms and Treatment

What Causes Cataracts?

The lens inside the eye works much like a camera lens, focusing light onto the retina for clear vision. It likewise adjusts the eye’s focus, letting us see things plainly both up close and far away.

The lens is mostly made of water and protein. The protein is arranged in an accurate manner in which keeps the lens clear and lets light pass through it.

But as we age, some of the protein may clump together and start to cloud a little area of the lens. This is a cataract, and over time, it may grow bigger and cloud more of the lens, making it harder to see.

No one understands for sure why the eye’s lens modifications as we age, forming cataracts. However researchers worldwide have identified aspects that might cause cataracts or are associated with cataract development. Besides advancing age, cataract risk factors consist of:

Ultraviolet radiation from sunlight and other sources
Diabetes

Hypertension
Obesity
Cigarette smoking

Prolonged use of corticosteroid medications
Statin medicines used to lower cholesterol
Previous eye injury or swelling

Previous eye surgery
Hormonal agent replacement therapy
Substantial alcohol intake

High myopia
Family history

One theory of cataract development that’s gaining favor is that lots of cataracts are brought on by oxidative changes in the human lens. This is supported by nutrition studies that show fruits and veggies high in antioxidants might help prevent certain types of cataracts (see listed below).

Cataract Prevention

Though there is significant controversy about whether cataracts can be avoided, a number of studies recommend specific nutrients and nutritional supplements may reduce your risk of cataracts.

One large, 10-year research study of female health specialists discovered that greater dietary intakes of vitamin E and the carotenoids lutein and zeaxanthin from food and supplements were related to substantially decreased dangers of cataract.

Good food sources of vitamin E include sunflower seeds, almonds and spinach. Excellent sources of lutein and zeaxanthin consist of spinach, kale and other green, leafy veggies.

Other research studies have actually revealed antioxidant vitamins such as vitamin C and foods containing omega-3 fats may decrease cataract risk.

Another step you can require to decrease your risk of cataracts is to use protective sunglasses that block 100 percent of the sun’s UV rays when you are outdoors.

Cataract Treatment

When symptoms begin to appear, you may have the ability to improve your vision for a while utilizing brand-new glasses, strong bifocals, zoom, appropriate lighting or other visual aids.

Consider surgery when your cataracts have actually advanced enough to seriously impair your vision and impact your life.

Lots of people consider bad vision an inescapable fact of aging, however cataract surgery is an easy, relatively painless procedure to gain back vision.

Cataract Surgery

Cataract surgery is extremely effective in restoring vision. In fact, it is the most frequently carried out surgery in the United States, with more than 3 million Americans going through cataract surgery each year, according to PBA.

Nine from 10 people who have cataract surgery regain excellent vision, somewhere between 20/20 and 20/40.

During surgery, the cosmetic surgeon will eliminate your clouded lens and in many cases change it with a clear, plastic intraocular lens (IOL).

New IOLs are being established all the time to make the surgery less complicated for cosmetic surgeons and the lenses more handy to patients. Presbyopia-correcting IOLs potentially assist you see at all distances, not simply one. Another new type of IOL blocks both ultraviolet and blue light rays, which research indicates might harm the retina.

Also, men ought to be aware that specific prostate drugs can cause intraoperative floppy iris syndrome (IFIS) during a cataract procedure.

Indications for cataract surgery

Cataract is a staged process that develops over a fairly long period of time. There are several stages of the disease, which are characterized by varying degrees and quality of changes, as well as their symptoms.

Initial stage

Symptoms may be absent or may be manifested as blurred vision, light haze, or slight doubling of objects. Examination by an ophthalmologist may reveal small centers of destruction (more often on the periphery of the crystalline lens).

Immature cataract

Foci of destruction embrace a larger area, visual acuity drops drastically, and patients may notice

Progression of myopia

Blurring in front of the eyes
Iridescent circles around bright objects

Indistinguishability of colors or shades, the image “fades”
Hypertrophied or, on the contrary, decreased sensitivity to light – it is impossible to distinguish objects against the light, on sunny days there is lacrimation, eyes threading

Mature cataract

Pathological changes in the crystalline lens progress and become visually noticeable: the pupil of the patient becomes cloudy and gets whitish. Subjectively, there are difficulties in distinguishing the contours and borders of objects, colors fade, light perception is inadequate or may be completely absent, and it is difficult to orientate in space. Often requires special care.

Preparation for cataract surgery

After comprehensive examination of the eye and establishing a diagnosis of cataract, a consultation with an ophthalmic surgeon is scheduled during which the choice and the calculation of the IOL is performed after determining the anamnesis, evaluating the objective state of the eye, evaluating the visual habits of the patient and his/her wishes.

Before cataract surgery, it is necessary to undergo a general examination, which may include: general clinical and biochemical blood tests, urinalysis, blood tests for especially dangerous infections (hepatitis C, B, HIV, syphilis), tests for COVID-19, ECG, CT scan, and consultation with a general practitioner. Additional tests may be prescribed at the discretion of a specialist.

This examination may take place in the ophthalmology clinic where the surgery will be performed, or at the place of residence. However, you should remember that the results of the tests are valid for a limited period of time.

On the day of surgery, you should avoid food and drink. By the time of the procedure you should:

Be sure to be free of infectious diseases, be in remission of chronic disease
Calm down and bring the pressure to normal (hypertensive people are advised to take the usual hypotensive agents, use light sedatives)

Prosthetics of the eye lens

In case of cataract, the operation is performed on an out-patient basis under local anesthesia. It lasts about 15-20 minutes, after which the patient is transferred to a general ward and remains under observation by doctors at the clinic for several hours. The operated eye is covered with a protective bandage, and then the patient can go home. Hospitalization is not necessary as the operation is minimally invasive.

Within a month it is important to observe the regime prescribed by the doctor and use the medication. At the same time, visual activity is not contraindicated. From the first days after the surgery, as soon as the vision returns, it is possible to do the usual things.

How does of lens substitution surgery take place?

An hour before the surgery, the preparation begins, during which eye-dilating antibacterial drops and anesthetics are applied.
In the operating room the patient lies in a comfortable bed, looking at the bright light of the microscope. He or she is conscious and communicates fully with the surgeon.

The ophthalmic surgeon opens the crystalline lens capsule through a micro puncture of the cornea and uses a special ultrasound instrument, a phacoemulsifier, to grind up and aspirate the turbid crystalline lens.
An elastic artificial crystalline lens is implanted into the freed space and takes up its physiological position independently
At the end of the operation, a special sterile sticker is placed over the eye.

During the procedure the patient feels no pain. He can feel the water running and a light touch on the head.

The only thing the patient sees is the bright light of the microscope.

Rehabilitation period

After cataract surgery, rehabilitation period is 30 days and includes taking medicines, but also following a special regime prescribed by the doctor:

It is necessary to guard against infectious diseases, avoid hypothermia, crowded places
Protect the operated eye from mechanical influences.
Do not scratch, rub, or apply pressure to the eye.

You must never use the sauna, swimming pool, sauna, or go for a swim in open water.
Wash your head carefully and avoid getting water in your open eye socket.

The patient will notice the improvement of vision in the first hours after the operation, but the final stabilisation of the visual functions will only happen by the end of the first month after the operation, so it is not advisable to start wearing glasses or contact lenses before this time.

Complete recovery and adaptation of the eye will be completed within 1-3 months after the lens replacement. If necessary, the surgery on the second eye can be performed after 1 week.

The cost of the surgery

Usually however, you can intend on your cataract surgery costing around $3,500 to $3,900 per eye. The total cost of cataract treatment for a patien can vary:

$ 3,000 to $5,000 per eye for basic cataract surgery

$ 4,000 to $6,000 per eye for laser-assisted cataract surgery or treatments using advanced lens implants.

Can cataract be cured without surgery

Specialists know that this disorder is a change in the structure of the crystalline lens which is irreversible, and there is no cure for cataract without surgery. There is no conservative or alternative means of treatment – neither diet, massage, nor any folk methods. Currently, there is not a single recorded case in world practice of cataract resorption. It is like boiling a chicken egg and waiting for it to come back to its former liquid state. The same morphological changes occur in the lens, and there is no going back. There are simply people who deceive others by promising miracle cataract drops or supplements. Simple-minded people believe and “buy” these stories, spend money, drink something. The only effect may be to slightly slow down the progression of the disease, but that is all. In the end, nothing is resolved, and precious time is lost.

Cataract treatment, drops

Medics know that the leading pharmaceutical companies in the world have been working on the search for cataract drops and pills for years, investing millions of dollars in the development. And if such a drug were invented, it would have been put into practice long ago. But, alas, the developments so far have had no results. And 90% of the advice of “well-wishers” is pure deception. To date, surgical intervention remains the only effective method to combat cataracts.

Good to know: Eye Drops After Cataract Surgery

Cataract surgery – it’s not scary

Until a couple of decades ago, cataract extraction was a difficult task for both the doctor and the patient. In the early days of cataract surgery, one had to wait for the cataract to mature until the lens was completely clouded. At that time, there was no technique or equipment that would allow for an earlier operation. The surgery itself was quite traumatic, with a significant incision of the eye and suturing. Moreover, the person had to stay in the hospital on bed rest for several weeks. Only after that, he was allowed to get up little by little, with great restrictions in terms of work, both visual and physical. The day after the surgery, the patient could see only 10% at the most, and full-fledged vision appeared 2-3 months later.

Today, thanks to advances in science and technology, cataract removal procedures have become much easier. The modern surgery is performed on an out-patient basis, takes 5 to 7 minutes, and in complicated cases – up to 30 minutes, after which the patient goes home the same day. Usually, by that time, the patient can already see (the vision gradually manifests itself in the next few hours after the operation) and the maximum vision is achieved in a few days. Of course, there may be some discomfort, such as lacrimation, a feeling of a foreign body in the eye, or a slight thread. But immediately go to the doctor only when pain occurs. Such cases are rather the exception. This is confirmed by reputable, experienced surgeons who perform thousands of such operations each year. According to their observations and practice, 99% of surgeries are performed without any complications, which is a strong argument not to be afraid of the operation and not to delay it, and definitely see an ophthalmologist.

Useful things to remember

So cataract treatment without surgery is a myth and there are no eye drops for cataract resorption. The disease usually develops in both eyes, but with varying degrees of intensity. Both eyes are not operated on at the same time, although the time limit is minimal. In case of a favorable outcome after the operation on one eye it is possible to remove the cataract on the other eye within a day. The contraindications for the operation are minimal – a period of acute inflammatory processes in the eye or individual organism peculiarities related to intolerance to the operation. This will be determined by a specialist, especially since the patient must be examined and analyzed before the operation.