KOCHI: For perfect vision, lenses in the eyes should be clear for light to pass straight through them. However, when the natural lens becomes cloudy or opaque due to cataracts, light gets refracted and scattered, resulting in blurred vision. People affected with cataracts usually face difficulty in seeing and experience glare at night.
When proteins in the lenses start to degenerate and clump together, it makes the lens cloudy - known as a cataract. Advancing age, diabetes, hypertension and tobacco use are proven risk factors for the development of cataracts in the eyes.
The symptoms of cataracts are progressive and cannot be corrected with glasses or contact lenses. Cataract is the leading cause of vision loss, reversible blindness and visual impairment in the country.
Cataract is commonly seen as an age-related disease. “The condition was earlier seen among people in their 60s or 70s. The trend has changed, though, as a result of changing lifestyles and a rise in chronic illnesses like diabetes and high blood pressure. Many individuals in their 40s and 50s are now being diagnosed with cataracts,” said Dr Umesh Krishna, senior consultant, at The Eye Foundation, Kochi. Age-related cataract is also known as senile cataract.
“If a cataract occurs before 50 years, we call it a pre-senile cataract, which accounts for a small percentage of people. In such cases, we look for other causes - like diabetes, hormone deficiencies or malfunctioning. Such conditions will be corrected as well,” said Dr Anil Radhakrishnan, consultant ophthalmologist, at Amrita Lasik Centre.
“Sometimes, cataracts occur in children in a small age group. It can be due to incidents when the child was in the mother’s womb or maybe without any causing factor. In such cases, we have to operate it very early,” he added.
“Kidney ailments, glaucoma, smoking, eye injuries, infection, ocular inflammation, prolonged use of certain medications, genetic or metabolic defect or certain infection and trauma can also lead to cataract,” said Dr Smruti Rekha Priyadarshini, consultant ophthalmologist, at LV Prasad Eye Institute (LVPEI), Bhubaneswar.
“Cataracts that occur after injuries to the lens are called traumatic cataracts. It can occur at any age,” added Dr Umesh.
Patients with cataracts experience cloudy vision, poor eyesight at night, difficulty in driving at night, glare of lights, difficulty in reading in dim light, coloured haloes or multiple images. Cataract surgery is the only way to remove cataracts and restore clear vision. The clouded lens is replaced by an artificial intraocular lens (IOL) during cataract surgery. IOL is an artificial lens that permanently stays in the operated eye. This lens aids the incoming light rays to focus accurately on the retina, thus enabling the patient to see clearly.
“There are no eye drops, medications and injections available. It can be removed only with surgery. It is a 10 to 15-minute procedure, a keyhole surgery - a minimally invasive procedure used to remove cataract-affected lenses and replace it with IOL. The patient may require a week of rest after the procedure. Dust particles and water droplets must be prevented from entering into the eyes in the initial days after the surgery,” said Dr Umesh.
“LVPEI offers various advanced, cutting-edge surgical techniques to treat cataracts in the form of manual small incision cataract surgery or phacoemulsification. Based on the type of cataract, the health condition of the patients and their lifestyle, the ophthalmologists recommend the best suitable option,” said Dr Smruti Rekha.
For the last six to eight years, laser cataract surgery has been available to treat cataracts. Cataract laser surgery by phacoemulsification is done through a very tiny incision that does not require any stitches to close it. The phaco machine emulsifies the cataract which is sucked out and a foldable lens (IOL) is inserted through the same tiny opening.
“Laser cataract surgery has its benefits. The procedure will be smooth and less time-consuming and the precision will be high. It also offers speedy recovery and good clarity of vision compared to traditional cataract surgery,” said Dr Umesh.
Various options of intraocular lenses are monofocal lenses (for distance correction only), toric lenses (correct astigmatism), aspheric lenses (better quality vision and enhanced contrast sensitivity), multifocal lenses (for near, intermediate and far distance, and reduce dependency on glasses), multifocal toric lenses (in case of astigmatic error), added Dr Smruti Rekha.
“Nowadays, the prevalence of cataract surgery has gone up. The predominant reason for that I believe is the visual demand has gone up significantly. Even a small diminishing of vision can affect people now. Especially, if he or she is having an active lifestyle - driving, working on computers or tablets,” Dr Anil added.
The cost of the procedure is around `10,000 to `15,000. “The patients are discharged on the day of the procedure itself, thus hospital charges can be excluded. However, the cost varies according to the implant and incision used,” said Dr Anil.
Two types of lenses are available. “If the individual chooses a mono-focal lens, he or she will have to wear glasses to read. If the multifocal lens is used, they do not have to. However, the cost is comparatively high,” added Dr Umesh. The cost of a lens varies from `15,000 to `1 lakh, according to the demand of the patient.
According to Dr Umesh, screening can help detect cataracts in the early stages. “It is recommended for everyone in their 40s and 50s to undergo screening. Cataract, if diagnosed early, is easier to remove. In advanced stages, we may have to perform manual small-incision cataract surgery,” he said.
(With inputs from Hemant Kumar Rout @Bhubaneshwar)