FAQ - Cataract

Cataract

What is cataract ?

To know about cataract, it is necessary to know the structure and function of the human eye. The lens in the eye focuses the rays of light that fall on most sensitive spot of the screen behind it to form a clear image. The clouding of this transparent lens is called cataract.

What causes cataract ?

The most important cause is old age. It is also suspected that the ultraviolet rays from sunlight hasten the formation of cataract. Cataract may also be present at birth i. e. congenital. Although the exact reason is not known, infection in the pregnant mother due to pathogens such as rubella (known as German measles) is suspected to be the cause. Other causes Injury to the eye Frequent inflammation (swelling) of pupils and other eye infections. Risk of cataract increases in persons having diabetes Use of certain drugs such as steroids for a long period

How to recognize the onset of cataract ?

Slow deterioration of vision (eyesight). Person starts seeing double vision. Frequent change in the number for the spectacles. Pupil appears whitish.

What is the treatment for cataract ?

Removal of the opaque lens of the eye through surgery is the only treatment available. Several non-allopathic drugs are used for the treatment of cataract. But, there is no scientific proof regarding the usefulness of these drugs.

When to operate ?

With the advent of “microsurgery” (i.e. surgery using a microscope) and improved technology in stitching the wound (suturing), it is not necessary to wait till the cataract is “ripe”. The time of the operation can vary with the patient’s need, i. e. a busy person in his forties and still having about 80% of his vision in the affected eye may need a cataract operation. This can be safely done.

Are there any essential tests to be done before the operation ?

A thorough check-up by an ophthalmologist (eye specialist) is a must. The following medical examinations are also essential as most patients are old. A general check-up for blood pressure and other illnesses. Blood examination to find out the level of haemoglobin, white blood cell count and blood sugar Urine examination ECG for heart, chest x-ray for persons above sixty years of age. Examination and treatment of tooth infections to avoid these infections from spreading to the post operative wound of the eye. Examination of the eye with a special instrument to find out the “number” of the artificial lens to be fitted is also needed. This helps in avoiding the use of thick and heavy glasses (spectacles) after operation. These special instruments are nowadays available in most cities.

What happens if cataract operation is not done ?

The vision or eyesight lost due to cataract can never be restored without operation. In some patients, the vision deteriorates slowly and it may take a few .years for considerable loss of eyesight. However, in some cases this happens very quickly. If the person is able to carry out his day-to-day activities effectively despite the cataract, there is no need to rush for the operation. However, once the cataract is “ripe” there is no choice but to operate. The excessively “ripe” cataract leads to complications such as glaucoma, which results in severe vision damage. The eye reddens, sheds excessive tears and there is severe pain in the eye. If it results in loss of sensitivity of the retina to light, blindness of the eye becomes irreversible.

What is an artificial lens implant ?

In the cataract operation, the opaque lens is removed and the patient can see through that eye only with the help of “plus ten” glasses. There are three alternatives for restoration of clear vision after operation 1. Use of glasses bearing “plus ten” power 2. Use of contact lens 3. Implantation of an artificial lens in place of the opaque lens. The third alternative is the best. A comparison between use of “lens implant” and of spectacles is given in the following chart : The (ens implant is expensive. But nowadays Indian-made lenses are also available. They are also good. The lens implantation operation has to be done ‘ under a microscope by a specially trained eye surgeon. Therefore, it costs more. This type of surgery has now become quite common. However, it may not be always possible in cases with frequently inflammed pupils and some other illnesses of the eye.

How is the operation performed ?

A few days before the operation the patient is given eye drops to be put in the eye and some tablet to be taken orally. This should be meticulously carried out. Patient is admitted at the hospital either the previous night or sometimes a few hours before the operation, no food should be eaten 4-6 hours prior to surgery. A cup of tea may be allowed. On admission, some eye drops are put and the eyelashes are cut. This is not painful and the eyelashes will grow again. Local anaesthesia is given to the eye to make it numb with the help of a fine needle. A small cut is made around the pupil through which the opaque lens is taken out. Nowadays the artificial lens is implanted in its place and cut portion around the pupil is sutured. The operation takes about half-hour. During the operation the patient should lie down in a relaxed manner and cooperate with the surgeon.

Does the operation cause any problems or complications ?

A cataract operation preformed with proper care by a trained expert generally does not create complications. However occasional complications, despite proper care, may occur due to unexplainable reasons. Occasionally, during operation, there may be excessive bleeding and difficulty in fixing the artificial lens. Bleeding, opening up of the wound due to broken stitches, increase or decrease in tension on the eyes, can occur soon after the operation. Sometimes, infection gets in despite all precautions. Complications such as inflammation of pupils, increased tension in the eye, detachment of retina, etc can also occur at any time after surgery. In most cases, timely, treatment of such problems saves the eye. Therefore, occurrence of such symptoms should not be ignored and an ophthalmologist (eye specialist) should immediately be consulted.

If both the eyes have cataract, are they operated simultaneously ?

No, because if an infection sets in after operation, both eyes would be harmed. Therefore, only one eye at a time is operated upon.

When are the stitches removed ?

The cut around the pupil is finely stitched with the help of a special thread, which is as thin as hair. This thread does not get absorbed. Neither does it irritate the eye. The stitches need not be removed. Sometimes, ‘interrupted’ type of stitches are used. In such cases, the stitches are removed after about 1-11/2 months, if stitches start hurting, and have to be removed, do not worry about it.

What care should be taken after the operation ?

The patient should lie flat on the back for 12 to 14 hours after surgery. One should not turn on the side, which is operated upon. However, occasionally one can turn on the other side i.e. the side which is not operated upon, as this does not put strain on the wound. One may take tea, coffee or other liquids after 2 hours. One can walk to the toilet with proper support. Soft solid food can be taken after a few hours. Hard food items should not be eaten as they are likely to exert stress on the eye-wound while chewing. Patient may be allowed to go home after a few hours provided the journey does not involve strong jerks and exposure to dust. Some doctors prefer to keep the patient in hospital for 24 hours, particularly if the patient is very old.

The following instructions should be strictly followed.

One should take full rest at home for atleast 48 hours. One may get up for food and to visit the toilet. Different eye drops prescribed by the doctor should be put without fail. For 8 days, the eye should be carefully cleaned with sterilized cotton (kept in boiling water for 20 minutes). Hands should be thoroughly washed with soap before doing this The bandage on the eye is removed one day after the operation However, one should wear dark glasses to protect the affected eye from bright light and dust for a month. One may watch TV by wearing goggles, a week after the operation. It is advisable to use goggles for a month when awake. Bending, jerking movement and lifting weights should be avoided for a month. Keep away from small children to avoid accidental hit on the affected eye. Normal work can be resumed after a month on the advice of the doctor. It takes time to get proper judgement of depth and three-dimensional vision. This is more so when lens implant is not done. Activities such as cooking and climbing steps should therefore be done very carefully to avoid accidents.

Is normal vision restored after operation ?

Generally, good vision is restored a fortnight after the operation. However, in certain cases, full vision is not restored despite lens implant, due to old age, diabetes, high blood pressure or retinal problems. In 20-30% of the cases of lens implants, the membrane behind the lens becomes opaque. In such cases, a fine hole is made in this membrane with the help of laser rays. This helps in restoration of vision. No anaesthesia is required for this laser treatment as it is painfree. It is not possible to predict as to which patient would need this treatment. It must be noted that the cataract operation itself is not done with laser rays but laser treatment is given afterwards only if required. The lens implantation does restore vision to a great extent but it does not become absolutely normal. This is because this lens does not have the natural ability of quick adaptation from distant vision to near vision (or vice versa). Therefore one has to use glasses either for distant vision or near vision. However the “power’ of this glasses is low. In cases where lens implantation is not done, various limitations listed in the chart are unavoidable.

What is ‘stitchless’ cataract operation ?

This is a relatively new technique of performing the cataract operation in which ultrasonic waves are used to emulsify (liquefy) the lens ( phaeco-emulsification). This liquefied lens can then be sucked out from a very small incision. The healing of this very small incision is much faster and normal activities can be resumed in 8 days. The shape of the cornea gets less distorted and hence there is less need for use of cylindrical lenses after the operation. This operation cannot be done in certain types of cataracts, it can lead to the same complications as in the usual cataract operation. It costs much more and is better reserved for those affording patients who have to resume work within 8 to 10 days.

 

Asmita Movement


You are here: Home

Academics

Sample image

Careers at Gupte Hospital

Sample image

Contact Us

Sample image
You can reach us at: 904,
Bhandarkar Road, Pune 411 004.