Updated: Jun 9
By Phornrak Sriphon,MD, Ophthalmologist, Eyelid Surgeon
"Peering Through the Veil: What Secrets Lie Behind Cataracts?"
"Cataract is a condition where the lens of the eye becomes cloudy.
This condition causes the main symptom of blurred vision, which can vary in severity. Typically, the blurriness develops gradually over months or years. To help explain what causes this blurred vision, here is a simple illustration below."
Do you see that the lens of the eye acts as a central element that allows light to pass through to the focal point or the retina? Therefore, when the lens becomes cloudy or develops cataracts, the light entering the focal point or the retina becomes scattered and insufficiently focused. As a result, the image that is sent from the brain appears blurry.
The nature of the blurry or distorted vision can vary, as mentioned before. For example, some people may experience more blurriness in bright light compared to dim light, or they may see overlapping images. Additionally, some individuals may have constantly changing vision that remains unclear even with the use of eyeglasses.
The causes of cataracts
Can vary, and they are influenced by several factors. Here are some common causes of cataracts:
Aging: Age-related cataracts are the most common type and typically develop as a natural part of the aging process. Over time, the proteins in the lens can clump together, leading to clouding and the formation of a cataract.
Genetic factors: Certain genetic mutations or inherited conditions can increase the risk of developing cataracts at an earlier age or make individuals more susceptible to cataract formation.
Trauma: Eye injuries or trauma can cause cataracts to develop. Damage to the lens can disrupt its structure and lead to the formation of a cataract.
Medical conditions: Certain medical conditions, such as diabetes, high blood pressure, and obesity, have been associated with an increased risk of cataracts. Additionally, long-term use of corticosteroid medications can contribute to cataract development.
Prolonged sun exposure: Chronic and unprotected exposure to ultraviolet (UV) radiation from the sun can accelerate cataract formation. Wearing sunglasses with UV protection and a hat can help reduce this risk.
Lifestyle factors: Unhealthy lifestyle habits, such as smoking and excessive alcohol consumption, have been linked to a higher incidence of cataracts.
It's important to note that while these factors increase the likelihood of developing cataracts, they do not guarantee the development of the condition. Regular eye examinations and adopting a healthy lifestyle can help minimize the risk and progression of cataracts.
Complication of cataract
Actually, cataract are a slow progressive condition, and complications are relatively rare. However, there is one potentially serious condition called acute angle-closure glaucoma that can occur when the cataract lens becomes fully mature and swollen, blocking the drainage channels in the eye. This can lead to a sudden and severe increase in eye pressure, causing intense eye pain. It is more commonly seen in individuals with advanced cataracts, as depicted in the image below.
Glaucoma (Acute Angle-Closure Glaucoma) due to mature cataract obstructing the drainage channels and causing a sudden increase in eye pressure, resulting in severe eye pain.
This condition is indeed called Phacomorphic Glaucoma, or acute angle-closure glaucoma resulting from a swollen cataract. Patients with this condition typically experience sudden eye pain, redness, and a dramatic decrease in vision. The pupil may appear abnormally dilated, and when light is shined into the eye, the iris may appear white instead of its normal color. In such cases, standard pain medications may not provide relief, and immediate medical attention is necessary.
Please note that if you are experiencing any symptoms or have concerns about your eye health, it is important to consult with a healthcare professional for an accurate diagnosis and appropriate treatment.
The treatment of cataract
Eyeglasses: In the early stages of mild cataracts, using eyeglasses with a prescription that can compensate for the changes in vision may be sufficient.
Magnification aids: As cataracts progress, magnifying lenses or devices can help improve vision for specific tasks such as reading or driving.
Surgical intervention: When cataracts significantly affect vision and daily activities, cataract surgery is usually recommended. During the surgery, the cloudy lens is removed and replaced with an artificial lens called an intraocular lens (IOL).
Lifestyle adjustments: Making certain lifestyle modifications, such as using brighter lighting, reducing glare, and wearing sunglasses with UV protection, can help manage cataract symptoms.
The primary and most widely used method of treating cataracts is through cataract surgery, which involves removing the cloudy lens and replacing it with an artificial lens. The most popular technique is called phacoemulsification, which utilizes high-frequency ultrasound to break up the old lens into small pieces for removal, followed by the insertion of a new intraocular lens. Cataract surgery is typically performed with a minimally invasive approach, involving a small incision of about 3 millimeters. In most cases, stitches are not required to close the incision. The surgical procedure is generally efficient and safe, taking approximately 10-30 minutes, depending on the surgeon's experience and the complexity of the case. Additionally, the insertion of an artificial lens can correct refractive errors such as nearsightedness, farsightedness, astigmatism, or presbyopia. It is important to consult with an ophthalmologist to determine the most appropriate treatment plan for your specific condition and to discuss any potential risks or complications associated with cataract surgery.
Types of artificial intraocular lenses (IOLs) include:
Monofocal IOL is an artificial intraocular lens that provides clear vision at a single distance, typically for distance vision. It can correct pre-existing refractive errors such as nearsightedness or farsightedness. Monofocal IOLs are commonly used in general hospitals in Thailand.
Toric IOL is an artificial intraocular lens designed to correct astigmatism. It addresses both the cataract and the astigmatism, providing improved vision by having different powers in different meridians of the lens.
Multifocal IOL is an artificial intraocular lens that provides vision at multiple distances. It is popularly used in private hospitals and internationally. However, the choice of intraocular lens depends on various factors, and consulting with the surgeon is necessary. Factors to consider include eye condition, occupation, and lifestyle, as different types of intraocular lenses have their advantages and disadvantages.
Complications of cataract surgery
Cataract surgery is a safe procedure with minimal side effects. However, there are potential complications that can occur, including:
Bleeding: There may be bleeding in the eye or around the eye as a result of the surgery or the use of anesthesia.
Clouding of the lens capsule: The lens capsule may become cloudy, causing blurred vision. This can be treated with a laser procedure called capsulotomy.
Infection: There is a small risk of infection following surgery. It is typically treated with antibiotics.
Detached retina: In rare cases, the retina may detach after cataract surgery. This requires immediate medical attention and further surgical intervention.
Eye pain and sensitivity to light: Some patients may experience temporary eye pain and sensitivity to light after surgery.
Dislocation of the intraocular lens: The artificial lens implanted during surgery may become dislocated or shifted. This may require additional surgical intervention to reposition the lens.
In more severe cases, there may be a loss of vision or visual impairment, although such cases are very rare. The recovery and visual outcome can vary depending on the individual's optic nerve condition. Some patients may require additional treatment or surgery, including laser therapy, to improve their vision.
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