Clouding of the lens is a normal part of getting older. Most Americans older than 60 have some degree of clouding of the lens. After age 75, as many as 70 percent of Americans have cataracts that are significant enough to impair their vision.
In the early stages, stronger lighting and eyeglasses can help you deal with the vision problems. But at some point, if impaired vision jeopardizes your normal lifestyle, you might need surgery. Fortunately, cataract removal is one of the safest, most effective and most common surgical procedures.
Signs and Symptoms?
Cataracts don’t typically cause any change in the appearance of your eye. Pain, redness, itching, irritation, aching in your eye or a discharge from your eye aren’t signs or symptoms of a cataract, but may be signs and symptoms of other eye disorders.
What causes a cataract?
How do Cataracts reduce vision?
The lens consists of three layers. The outer layer (capsule) is a thin, clear membrane. It surrounds a soft, clear material (cortex). The hard center of the lens is the nucleus. If you think of the lens as a piece of fruit, the capsule is the skin, the cortex is the fleshy fruit and the nucleus is the pit. A cataract can form in any part of the lens.
Cataracts occur in three main types:
Cortical. A cortical cataract begins as whitish, wedge-shaped opacities or streaks on the outer edge of the lens cortex. As it slowly progresses, the streaks extend to the center and interfere with light passing through the center of the lens. Both your distance and near vision can be impaired. Focusing problems and distortion are common. You may also have problems with glare and loss of contrast.
Subcapsular. A subcapsular cataract starts as a small, opaque area just under the capsule of the lens. It usually forms near the back of the lens, right in the path of light on its way to the retina. This type of cataract may occur in both eyes but tends to be more advanced in one eye than the other. A subcapsular cataract often interferes with your reading vision, reduces your vision in bright light and causes glare or halos around lights at night.
Screening and diagnosis
Slit-lamp examination. A slit lamp allows your eye doctor to see the structures at the front of your eye under magnification. The microscope is called a slit lamp because it uses an intense line of light — a slit — to illuminate your cornea, iris, lens and the space between your iris and cornea. The slit allows your doctor to view these structures in small sections, which makes it easier to detect any small abnormalities.
Retinal examination. In this procedure, your eye doctor puts dilating drops in your eyes to open your pupils wide and provide a window to the back of your eyes. Using a slit lamp or a special device called an ophthalmoscope, he or she can examine your lens for signs of a cataract and, if needed, determine how dense the clouding is. Your eye doctor will also check for glaucoma and, if you have blurred vision or discomfort, check for other problems involving the retina and the optic nerve.
Cataracts can’t be cured with medications, dietary supplements, exercise or optical devices. In the early stages of a cataract when symptoms are mild, a good understanding of the condition and a willingness to adjust your lifestyle can help. Some self-care approaches, such as using a magnifying glass to read or improving the lighting in your home, may help you deal with the effects of having a cataract.
This is possible thanks to a tiny, micro-incision, commonly called the “self-sealing” incision. It is called “self-sealing” because the eye’s natural internal pressure holds the incision tightly closed allowing the eye to heal without stitches. The self-sealing is made at the edge of the “clear cornea,” and is less than 2.5 mm in length. The clear cornea is the transparent covering of the front of the eye.
The cataract is situated inside the lens capsule, which is like an elastic bag that holds the lens in place. To remove the cataract, the front portion of the lens capsule is carefully opened. The cataract is gently broken apart using ultrasonic vibrations and vacuumed out of the lens capsule. This technique is called phacoemulsification. The lens capsule is left undisturbed so a tiny lens implant can be inserted in place of the original lens.
Intraocular Lens Implant
Today, patients receiving IOLs often enjoy the best vision of their lives. Thanks to sophisticated formulas used to calculate the corrective prescription power of the lens, the IOL not only replaces the need for thick glasses, it can also correct the eye’s existing refractive error. (need for glasses)
There are two basic types of IOLs: foldable and hard. Foldable lenses are made of silicone or acrylic and can be rolled up and placed inside a tiny tube. The tube is inserted through a very small incision less than 2.5 mm in length. Once inside the eye, the IOL gently unfolds. Hard plastic lenses are appropriate in certain circumstances determined by the surgeon. Since they cannot be folded, they are placed through a slightly larger incision.
Selecting the best implant…