What is cataract? What are the symptoms and treatment?
Clouding of the lens, which is the part of the eye that focuses light, is called cataract. This condition, which can lead to vision loss, causes blurred vision. It may also cause blurred vision.
People with cataracts may experience complaints such as constantly needing new glasses. It may also appear that car headlights or other light sources are shining in some people with cataracts. Advanced stage cataract can be detected by looking at the eye. However, it is necessary to visit an ophthalmologist to make a definitive diagnosis. Loss of vision may be due to reasons other than cataracts. Therefore, the ophthalmologist performs a comprehensive eye examination and reviews other causes that may lead to this condition. During the examination, it is checked how well people see near and far. In addition, tests are used to determine how far away from the focal point one can see. Apart from these, eye pressure is measured with a device and it is investigated whether there is nerve damage by looking at the back of the eye with the help of devices. If people who are found to have cataracts have vision loss, the treatment method to be applied is surgery. During surgery, the cloudy lens is replaced with an artificial lens. However, not every person with cataracts will need surgery. However, surgery helps significantly improve vision, especially in people with severe cataracts.
What is Cataract?
Cataract is the loss of transparency in the lens of the eye, which usually occurs with increasing age, causing blurred or distorted vision, or can progress to severe vision loss that can be treated. Its origin comes from the Latin word “catarractes” and means waterfall. Because, especially in severe cases, when you look at the cataracted eye from the outside, the presence of a foam-shaped white opacity resembles the sparkling waters of a waterfall. Cataract disease is one of the most important causes of vision loss worldwide. Malnutrition, metabolic disorders, excessive exposure to sunlight or other radiation sources, trauma, or the use of certain medications such as cortisone can accelerate cataract formation. Although there is no proven medical treatment yet, normal vision can be restored in many patients thanks to modern microsurgical techniques combined with intraocular lens implantation. While there were 12.3 million blindness worldwide due to cataracts in 1990, this number increased to 20 million in 2010. However, due to advances in cataract surgery and the increase in surgeries performed in most parts of the world, the rate of cataract-related blindness continues to decrease.
What are the Types of Cataracts?
Cataracts are classified as nuclear, cortical or posterior subcapsular cataracts, depending on the area affected during examination. However, because most patients have one or more of these classifications, cataract types are used more frequently in research rather than clinically.
Nuclear cataract: Opacification or color change is observed in the middle part of the lens. In this section, progressive yellowing, browning, opacity and sclerosis (hardening) occur. However, progress is often very slow. Complaints such as significant dulling of colors and whites may be observed. The brightness in colors can be noticed when compared to the other eye. Distance vision is affected more than near vision, and visual acuity may decrease. However, visual impairments that do not cause discomfort, especially in elderly individuals, may not be detected without examination.
Cortical cataract: The outer cortical layers surrounding the nucleus in the center of the lens are affected. It is especially common in people with diabetes. Although it is easily detected during eye examination with a biomicroscope (a low-power microscope with light that shows the structures in the eye closely), it is generally not noticed by patients because it does not impair vision much. Cortical cataracts, which usually progress slowly, may also occur due to trauma.
Posterior subcapsular cataract: Opacification is observed in the outer rear part of the lens. This type of cataract, which is usually seen in younger people, may occur due to corticosteroid use, diabetes or trauma. Even if the decrease in visual acuity is slight, it may cause complaints such as bright sunlight or glare from headlights. Typically, distance and near vision are equally affected. It tends to progress more quickly than nuclear cataracts.
Congenital cataract: Another type of cataract is congenital cataract. In this type, the disease occurs congenitally and can generally be classified as above according to the area where the opacification occurs.
What are the Causes and Symptoms of Cataract?
Cataract may occur depending on age, as well as many different conditions such as trauma, uveitis, scleritis, radiation, metabolic effects caused by systemic diseases such as myotonic dystrophy, and topical corticosteroid use. Conditions such as smoking, exposure to sunlight, poor lifestyle habits (such as irregular nutrition or insufficient physical activity), metabolic syndrome, diabetes, HIV/AIDS, systemic corticosteroid use or long-term use of high-dose inhaled corticosteroids. leads to an increased risk of developing cataracts. The development of cataracts is a painless process that can progress slowly or quickly at rates that vary depending on individuals. In patients with cataracts, symptoms usually occur in both eyes. Complaints such as difficulty in driving at night, especially due to the glare of oncoming vehicles’ headlights, and difficulty in reading roadside signs or fine print may be observed. Although most cataract cases occur after the age of 60, young people with cataracts often have risk factors such as steroid use or diabetes. Many patients complain of deterioration in near vision rather than deterioration in vision as a result of opacification of the eye lens.
How is Cataract Surgery Performed?
Surgery can be performed when complaints caused by cataracts begin to affect the patient’s ability to meet their daily living needs. Although non-standard surgical techniques are used in some types of cataracts that may occur due to trauma or uveitis, surgeries are generally performed to a certain standard. Local (regional) anesthesia is usually used in cataract surgery; In some cases, it can also be performed by putting patients to sleep with general anesthesia. The surgical technique called phacoemulsification is a frequently used method in cataract surgery. In this technique, a small incision is made on the eye and the lens is removed. A needle vibrating with ultrasonic energy is used to break down the hard middle part of the lens. Then, a new artificial lens is placed into the eye to correct refractive errors. The small incision may close on its own. The surgical procedure can usually be completed without the need for any stitches. This technique has the advantage of faster visual recovery since the incision is small and the risk of stitch-induced astigmatism is reduced. In another surgical technique called standard extracapsular cataract extraction, the lens nucleus is removed in one piece by making a large incision. During surgery, an artificial lens is placed inside the eye.
In case of cataract-related complaints, the main treatment method is surgery. Therefore, it is important to evaluate whether surgery is required for patients before starting surgical treatment. Generally, the presence of a cataract that prevents the patient from meeting his daily needs determines the necessity of surgery. Cataract surgery may not be performed in patients with the following conditions:
- If patients use glasses that provide adequate correction of visual defects
- If surgery is not expected to improve visual function
- Have medical conditions or eye diseases that may prevent safe surgery
- If postoperative care is inadequate.
The main treatment for cataracts used today is surgery. If left untreated, it can cause serious problems such as blindness. For this reason, people who are disturbed by the headlights of oncoming vehicles while driving at night, who see faded colors, and who cannot see far or near should definitely apply to health institutions for an eye examination.