Cataract of the eye
Cataract of the eye is a disease that manifests itself with age. In this article, we will discuss the symptoms, treatment and prevention of eye cataracts and tell you what to do if you encounter it.

80% of all causes of visual impairment can be prevented or cured (WHO data)1. The most common cause of reversible blindness is cataracts.

What is an eye cataract

Cataract is a disease characterized by clouding of the lens of the eye.2. The lens is a lens whose main function is to refract light rays and evenly direct them to the retina. With a cataract, the clouded lens stops transmitting light, and vision deteriorates up to complete loss.3.

What you need to know about cataracts

Causesage changes,

heredity,

injuries, eye diseases, diabetes, etc.

Symptomsdecreased visual acuity,

veil before the eyes,

fuzziness, blurring of objects.

Treatmentоперация
Complicationsedema, inflammation, secondary cataract
Who healsophthalmologist

This disease can be congenital or acquired. Acquired cataract is much more common. It can be age-related, traumatic, secondary (against the background of general systemic diseases) or develop as a result of various adverse factors.4, 5.

The development of cataracts is a consequence of the natural aging process. Age-related changes lead to the fact that the structure of the lens begins to change at the biochemical level.6. The protein that is part of the lens loses its transparency and begins to transmit light worse.

Due to cataracts in people, the quality of life is significantly reduced, the risk of injuries, falls, and accidents increases.7 – 9. Take care of your loved ones – take them to a consultation with an ophthalmologist.

Cataract symptoms

The main symptoms of cataracts that should alert you10:

  • decreased visual acuity;
  • feeling of a veil before the eyes;
  • fuzziness, blurring of objects;
  • pupil color change;
  • doubling of the image;
  • flickering flies, dots, glare, stripes before the eyes;
  • decrease in color sensitivity.

If you notice similar symptoms in yourself or your loved ones, you should consult an ophthalmologist!

Stages of cataract

Depending on the progression, a cataract in its development has 4 main stages11, 24:

  1. Early stages of cataract
  2. Immature cataract stage
  3. Mature cataract stage
  4. Overripe stage of cataract

Treatment of cataracts

Currently, the effectiveness of medical treatment of cataracts has not been confirmed by evidence-based medicine.

The only effective way to treat cataracts is surgery, which consists in replacing the clouded lens with an intraocular lens.

Cataract surgery is recommended for patients with visual impairment resulting in disability that no longer meets their needs and creates discomfort in daily life12.

Diagnostics

Cataract is diagnosed on the basis of an examination by an ophthalmologist and the results of instrumental studies. Suspect cataracts when examining the iris and pupil allows the presence of opacities in various parts of the lens. To confirm the diagnosis, the doctor conducts a series of diagnostic examinations.13,25:

  • Checking visual acuity.

To determine visual acuity, the doctor usually asks the patient to read letters or symbols on a special table. The smaller the font is able to recognize the patient, the higher his visual acuity.

  • Slit lamp examination.

The slit lamp allows the ophthalmologist to examine the patient’s eye under magnification: the cornea, iris, the presence of opacities in the lens.

Modern treatments

With the development of medical technology, new methods of treating various diseases appear. Modern treatment of eye cataracts is carried out using microinvasive techniques. One of the most effective cataract surgery is ultrasonic phacoemulsification.14.

This operation does not require general anesthesia (local anesthesia is used), it can be performed both on an inpatient basis and on an outpatient basis (in a day hospital)26.

The surgeon through a micro-incision (usually not exceeding 2,75 mm) introduces the tip of the instrument into the anterior chamber of the eye, which vibrates with the frequency of ultrasound and thereby destroys the lens substance to an emulsion. The lens masses are then removed from the eye using vacuum.

After removal of the clouded lens through the same incision, an intraocular lens is implanted into the eye, and the incision is sealed without suturing. This technique is widely used and rarely causes complications. 12, 27.

In addition, laser-assisted cataract treatment has become possible today. During this procedure, the surgeon makes incisions not with a knife, but with a laser, which acts more gently on the structures of the eye. The laser allows you to create a very even cut of the capsule and divide the lens nucleus into uniform parts, which greatly facilitates the work of the surgeon, especially in complicated cases of cataracts.15.

The choice of the method of surgical intervention is determined by the ophthalmologist! Depending on the anamnesis, concomitant diseases, indications and contraindications, the doctor will recommend the best cataract removal method that suits you.

How to prepare for cataract surgery?

As a preoperative preparation, the doctor will prescribe a number of medications in the form of eye drops. Before cataract surgery, it is recommended to take a shower, wash your hair, put on clean underwear (preferably cotton), and bring sunglasses. The last meal should be at least 4 hours before the operation. It is forbidden to drink alcohol before the operation, it is recommended to refrain from smoking16 – 17.

Is it possible to treat 2 eyes at once?

No, as a rule, operations for cataracts of the eye are performed alternately. Only after the restoration of the operated eye, the ophthalmologist will prescribe surgery for the second eye.28.

What interval should be between operations?

The exact interval between cataract operations is determined by the doctor. The break varies from 1 day to a month, depending on the speed of recovery of the previously operated eye and a number of other factors.28.

Recovery after surgery

After cataract surgery, patients quickly return to their normal lifestyle. At the moment, phacoemulsification of uncomplicated cataracts can be performed on an outpatient basis (depending on the medical institution), lasts 10-20 minutes, is performed under local anesthesia, without anesthesia, is characterized by rapid recovery of patients and minimal regimen restrictions in the postoperative period.

However, like any operation, phacoemulsification is still a surgical intervention, and therefore it is imperative to follow all the rules and recommendations of doctors in order to prevent the development of complications.18.

As a rule, patients can see within 2-3 hours after the completion of the operation. On the day of the operation, there may be pain in the upper part of the face (eye area, forehead, temples) and swelling – this is the body’s response to surgery. In the postoperative period, the use of eye drops prescribed by the doctor is mandatory, they contribute to the speedy recovery of damaged tissues29.

In the first two weeks after the operation, a restrictive regimen is important. Complete healing and recovery of the eye occurs in 4-6 weeks.

After the operation, it is important: take care of your eyes, do not overcool, limit physical activity, do not lift weights, do not use cosmetics 29.

Otherwise, you can lead a normal life – walk, work, read, write, sit at a computer, etc., just try to avoid eye fatigue. In the recovery period, in accordance with the recommended frequency, control visits to the doctor are very important. Subject to all the rules and recommendations, the occurrence of complications is unlikely 29.

If in the postoperative period symptoms such as fever, deterioration of health, chills, sharp pains in the eye, redness of the eye, lacrimation, pus discharge, swelling of the eyeball appear, you should immediately consult a doctor!19

Do I need to be in the hospital?

In many clinics, an operation to remove an uncomplicated cataract is performed on an outpatient basis (in a day hospital). Patients can go home within a few hours after surgery.16. The exact period of necessary stay in the clinic is determined by the attending physician.

How often do you need to visit a doctor after surgery?

Follow-up visits to the doctor are important after the operation. They are usually prescribed the next day, a week and a month after the phacoemulsification operation.12.

How soon after cataract removal can I fly an airplane?

The attending physician determines this period individually for each patient. In most cases, significant restrictions are not required20.

Prevention of cataracts

It is well known that senile cataract develops as a result of age-related changes in the body. Therefore, it is important to follow the rules of prevention throughout life, which will help delay the onset of the disease or diagnose cataracts at an early stage. Cataract prevention includes:

  • passing preventive medical examinations by an ophthalmologist every six months (for people over 50 more often);
  • rational nutrition, eating foods rich in vitamins, trace elements and antioxidants;
  • cessation of smoking, alcohol, drug use, etc.;
  • healthy lifestyle; the use of vitamins of groups E and C;
  • compliance with safety regulations and the use of personal protective equipment (protective masks, goggles) when working with hazardous substances in production and laboratories;
  • control over the course of diabetes (even a slight increase in sugar levels can lead to changes in the organs of vision);
  • control of cholesterol levels;
  • timely treatment of ophthalmic diseases;
  • maintaining hand and eye hygiene.

There are no universal methods of prevention. Everyone can develop a cataract, nothing guarantees the absence of the disease. These are only general recommendations aimed at preventing the early development of the disease and its progression.5.

Popular questions and answers

What are the consequences if the disease is not treated?

Cataract is a serious eye disease that requires treatment. It is very important to understand that microsurgical treatment is the only way to cure cataracts. In some cases, treatment must be started even if the symptoms of the disease are mild and vision is slightly reduced. Subsequently, untreated cataracts can lead to the development of complications.

To avoid serious complications, it is necessary to diagnose cataracts in time and treat them.

At what age should cataract surgery be performed?

There is no specific age at which cataract removal would be considered optimal. Cataract surgery can be performed at any age. Thanks to the progress of eye microsurgery today, it is not necessary to wait for the maturation of the cataract, when vision deteriorates significantly. The operation is performed when the patient becomes uncomfortable doing daily activities or performing work tasks.

Can the operation be performed free of charge?

Yes, cataract removal by phacoemulsification under the CHI policy has become available to patients in many clinics.

Is it possible to operate cataract and glaucoma at the same time?

Patients with a combination of cataract and glaucoma require an individual approach. Whether or not to combine cataract and glaucoma surgery is up to your doctor.

Do I need to change the artificial lens after implantation?

No, modern intraocular lenses retain their properties for a long time, so you should not worry about replacing them.

Can working at a computer or watching TV speed up the development of cataracts?

The opinion that working at a computer, reading books, watching TV contributes to the development of cataracts is not entirely true. Modern monitors can work up to 10 hours. The intensity of their radiation is very low, so it is not forbidden to work at a computer with cataracts. But a long stay in front of the monitor causes eye strain, fatigue, as a result of which metabolic processes and blood supply to the eye are disturbed.

With prolonged viewing behind the screens of gadgets, the development of dry eye syndrome, which occurs due to the drying of the tear film covering the mucous membrane of the eye, is possible. A person stares at the screen for a long time and continuously, which leads to dry eyes.

Will there be strict/lifelong restrictions on physical activity after surgery?

In the postoperative period, sports and weight lifting are prohibited for 3-4 weeks. After a full recovery (after about 1,5 – 2 months), the patient can live a full life, without restrictions, as before the operation.

Are there alternative methods of treatment?

Cataracts cannot be cured with traditional methods.

What complications can develop after cataract surgery?

Although modern technologies make it possible to minimize the development of postoperative complications, they cannot be completely eliminated.

A possible complication is swelling and inflammation. To stop these complications, doctors prescribe antibacterial and anti-inflammatory drugs.

IOL displacement. This complication occurs with improper fixation of the IOL or weakness of the ligamentous apparatus of the lens.

Secondary cataract – is manifested by clouding of the posterior lens capsule and a decrease in visual acuity in the postoperative period. This complication arises from the fact that cells capable of growth sometimes remain in the lens capsule after cataract removal. With their growth, symptoms characteristic of cataracts occur: cloudiness of the image, doubling of objects, decreased visual acuity. To eliminate this complication, laser treatment is used.

Increased intraocular pressure. To treat this complication, medications are prescribed that promote the outflow of intraocular fluid.

Hemorrhage in the eye occurs rarely and requires immediate treatment.

Expert Commentary

– Senile, or age-related, cataract is the process of normal aging of the lens. Almost every person after 60 years of age can find signs characteristic of the initial cataract. There is no need to be afraid of this diagnosis, says Natalya Kheralova, ophthalmologist, doctor of the second qualification category. – As a rule, cataract progresses rather slowly, and your ophthalmologist will help you determine the timing for surgical treatment. Also, the doctor will help in choosing the optimal intraocular lens for you, the model range of which is currently very large. Modern methods of surgical treatment of cataracts allow minimizing the risks and reducing the rehabilitation time to a minimum. Take care of your health and do not deny yourself the opportunity to enjoy life with all its colors!

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