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Symptoms of Cataract
Common complaints of cataract patients are:
Painless blurring of vision.
Glare and reduction of vision in bright light.
Frequent change in eye glass power.
Double vision in one eye,
Fading of colors.
Treatment
Only treatment available for it is operation. No medicines can remove
cataract or slow the progress of its growth. No one can predict how fast a cataract will grow.
When to operate
In earlier days, because of higher complications associated with cataract surgery and poor quality of vision by thick glasses required after surgery, the surgery was delayed till patient had very poor vision ( Less than 20/200 ) by almost mature cataract. Now with improved methods -
the surgical risks have gone down, Intraocular Lenses give good vision - we find no reason to wait for maturity, affecting the life style of a person. Only indication for surgery now days is difficulty in managing the work. It is only you to decide whether blurred vision is preventing you to do the things you like to do. For some even slight visual interference may be bothersome needing early surgery while others may be happy with marked visual loss due to cataract.
Lens Induced Glaucoma
When Cataract matures there may be swelling of lens tissue blocking the drainage angles leading to sudden rise
of the pressure in the eye ( Lens induced glaucoma).
There is severe pain and the features are similar to acute congestive glaucoma.
Immediate reduction of eye pressure followed by immediate cataract surgery may save the eye. However it involves higher surgical risk.
Methods
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In the beginning
whole lens was removed and thick glasses were given to replace it. The
wound was left open and patient was not allowed to move at all till the wound healed on its own.
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With the development of stitches mobility of patient was increased and he was allowed to
move on same day with some restrictions. These stitches were thick and caused irritation and
so needed removal.
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Operating
Microscope
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Microsurgery: with the advent of microscope it was possible to do surgery under magnification. This gives better light combined with magnification and better overall view of eye making the surgeon’s job easier. Surgery under the microscope
is called microsurgery. Finer sutures were also invented giving lesser post-operative irritation to the patient and stitches need not be removed. Now a days most of eye surgeries are done under
microscope. |
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Extracapsular cataract surgery : In this we break the cataract and remove
anterior layer and inside of cataract leaving behind a thin layer of lens,
posterior capsule.This layer is supposed to protect the retinal complications
and gives support for Intraocular implantation.
Here the incision size is about 12 mm and it need stitches to close the wound.
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Larger incision with stitches in extracapsular cataract surgery
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Intra ocular lens
(IOL) : These are powered lenses made to be inserted in the eye. These are permanent lenses and are usually not removed. Lens power is calculated by a machine called biometer. This reduces the lens power required in the specks after cataract surgery. It makes person life easier as :
- heavy glasses
are replaced by light weight glasses.
- thick glasses caused magnification effect making walking difficult for many.
- as the power in thick glass is only in
center the side vision is also affected making smaller visual field.
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Intraocular Lens
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