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OPHTHALMIC - CATARACT : Fill the form below

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FAQs for CATARACT

Cataracts usually form slowly. You may not know you have them until they start to block light. Then you might notice:

  • Vision that’s cloudy, blurry, foggy, or filmy
  • Nearsightedness in older people
  • Double vision in the affected eye
  • Changes in the way you see color
  • Problems with glare during the day
  • Problems driving at night (glare from oncoming headlights etc)
  • Trouble with eyeglasses or contact lenses not working well

Doctors don’t know exactly what causes cataracts, so there’s no proven way to prevent them. But since cataracts and other conditions, such as glaucoma, are common in older adults, it’s important to get your eyes checked regularly. This is really important if you have a family history of eye problems or have been exposed to things that could cause trouble with your eyes.

Adults should see an eye doctor at least every 2 years until age 50, and then every year after that.

Before

  • The patient needs to instill some antibiotic eye drops about 4 times a day in both eyes for about 3-5 days before the surgery. Some oral medicines & dosage as pre-medication as decided by the eye surgeon.
  • The treatment for any other systemic diseases is to be continued even on the day of surgery except that anti-coagulant or blood thinning medicines may have to be discontinued a few days prior to operation.

After

  • Avoid head bath for a few days to 1 week
  • Avoid rubbing, pressing, massaging, heat, dust, dirt and bright sun for 1 month (use sunglasses outdoors)
  • Avoid heavy weights and strenuous physical activity for 1 month
  • Avoid swimming and splashing of water on eyes for 1 month
  • Continue other treatments advised by other doctors’ e.g. for Diabetes, High Blood Pressure, Asthma, etc.
  • Patient can resume most of the normal life activities from the next day.

In cataract surgery the natural lens of the eye is removed. This leads a significant decrease in the optical convergence power of the eye or hypermetropia. Intraocular lenses are small lenses made of polymers and implanted into the eye in place of natural lens to help focus the light on to retina. When it comes to intraocular lenses (IOLs) for cataract surgery, there are number of different types of materials that eye surgeons can select from. 

Foldable lenses are made of two types of material – hydrophilic and hydrophobic acrylic – the latter being better in terms of long term results and least possibility of posterior capsule opacity. Both hydrophilic and hydrophobic lenses incorporate UV filters, but hydrophilic IOLs are constructed from aliphatic materials: the UV filter is less efficient when compared with aromatic-based hydrophobic materials.

Lens Material - Silicone, Hydrophilic & Hydrophobic Acrylic :

  • Silicone was used in older lenses & gave good optical results in the immediate post-operative period. But these lenses were somewhat bulky and lead to severe thickening of anterior & posterior capsules (membrane covering of natural lens which is left behind to provide support for artificial intraocular lens). This lead to deterioration of vision and required treatment by YAG Laser Capsulotomy.
  • Hydrophilic Acrylic lenses are soft contacts are made of pliable hydrophilic ("water-loving") plastics called hydrogels. Hydrogels absorb significant amounts of water to keep the lenses soft and supple. These lenses are highly flexible and slim, therefore, can be introduced through extremely small incisions. They have good immediate visual results but suffer from tendency to cause thickening of posterior lens capsule.
  • Hydrophobic Acrylic lenses are slightly less flexible and somewhat thicker than their hydrophilic counterparts. But they are extremely inert and do not lead to lens capsule thickening. Due to these properties they are ideal for use in children, young adults and the eyes predisposed to inflammation. Being hydrophobic in nature it is possible to incorporate a color tint to avoid blue chromatopsia after surgery.
     

The optical design of the intraocular lenses are :

  • Monofocal IOL – Monofocal lenses have a single focal length and unlike the natural lens do not possess the ability to change the focus. The lens is single focal length which is usually aimed to focus at mid or far distance. As a consequence the person needs to wear glasses for reading near print and sometime for far. However, the quality of vision & contrast achieved with this lens is far better. For patients who need sharp vision and better contrast and do not hesitate in wearing reading glasses, monofocal lenses are most suitable.
  • Multifocal IOL – The lens has two focal lengths – one to focus the far objects and one to focus near objects. This is achieved by having multiple optical zones fashioned in the lens in the form of alternating rings for distance and near. This leads to splitting of light into distance and near foci. As a result both the distant and near objects can be focused in the eye at the same time. The need for wearing spectacles is minimized, however, at the cost of loss of some contrast sensitivity, glare and image quality. Moreover, these lenses are expensive and need a period of adjustment after both eyes are implanted with the same type of lens. Those who do not want dependence on reading glasses but are willing to compromise on contrast and sharpness of vision, can opt for multifocal lenses.
  • Spheric IOL - Spheric are the conventional lenses where both surfaces of the lens are uniformly curved or are part of a sphere. These lenses have inherent problem of spherical aberrations caused by excessive bending of light at the edges.  Spheric lenses, though lack the sharpness & contrast to some extent but have better depth of focus leading to slightly better near vision.
  • Aspheric IOL -- Aspheric or advanced optics lenses have their curvatures flattening out towards the periphery or edge, thereby, minimizing spherical aberrations. Aspheric lenses give much sharper vision and better contrast but due to decreases depth of focus, the need for reading glasses becomes more urgent.
  • Toric Lenses - Toric lenses is a modified monofocal lens besides having spherical power, also have cylindrical power which corrects astigmatism present in the eye. Toric lenses are especially useful in patients with high degree of against the rule corneal astigmatism which is not amenable to correction but incision placement.
  • Non-toric - Non-toric lenses do not have any cylindrical power. Eyes with no or negligible astigmatism require non-toric lens and the eyes with significant astigmatism would benefit from toric lenses. 
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