A cataract catastrophe

Cataracts have become a common issue that deteriorates the quality of vision. This is especially common in the elderly as the cataract formation probability increases with age. Dr. M. Wijetunge, retired Consultant Eye Surgeon of the Ragama Teaching Hospital, clarified on what cataracts are and answered many questions that are raised at forums with regard to this condition in the eyes. 

Definition
The eye consists of many parts. The cornea, pupil, iris, lens, retina, are some of the most talked about parts of the eye. Light rays focus on the retina. “The lens and the cornea refract light rays fallen on the retina. The refractive power of the cornea is higher than that of the eye lens. The eye lens is a transparent component that allows light rays to pass through. It consists of a capsule and an inner portion. The lens comprises proteins. When these proteins thicken, the lens develops a white opaqueness which prevents light rays from passing through, ultimately creating difficulties in vision. This is known as a cataract,” explained Dr. Wijetunge. 

 
Causes   
Most of these conditions relating to cataracts develop due to age. There are other risk factors too that contribute to the formation of cataracts. “Some diseases such as diabetes, some endocrinological problems that result in a decrease in calcium levels in the blood can also contribute to the formation of cataracts. Trauma to the eye, use of certain eye drops, medicinal drugs used for cholesterol management, exposure to UV radiation through sunlight and exposure to other radiation sources, infections, physical and chemical are some other causes. The majority of cataracts form with age,” Dr. Wijetunge said. There are some cases of cataracts that are inherited and appear at birth. They are known as congenital cataracts.   

Symptoms   
According to Dr. Wijetunge, cataracts show symptoms of a gradual decrease in vision. Vision becomes blurred with time due to the progression of the cataract. “There are instances where vision may be weak in the mornings, but improves during the evenings. With age, especially after the age of 40 years, people tend to develop presbyopia. When people suffer from presbyopia, they become long sighted and can’t see things that exist within a short distance. But the opposite happens when a person suffers from a cataract. They become short sighted and are unable to see things that exist within long distances. Glares from vehicle headlights and other bright light sources cause discomfort to the eye,” Dr. Wijetunge accentuated.   

Diagnosis   
“If the cataract is severe and has developed over a period of time, it can be identified with the use of a torch,” said Dr. Wijetunge. The pupil of the eye is dilated and the eye is examined for any cataract developments which will be visible as some sort of a white formation in the eye. Dr. Wijetunge mentioned that there are other methods such as the use of instruments to examine the eye regarding cataracts. A retinoscope and an ophthalmoscope are some such instruments that can be used in the aid of cataract detection.   

Treatment   
The only option regarding cataract treatment is surgery. “The impaired lens with the cataract formation is replaced with an artificial lens during this surgery. This operation which is performed to remove the cataract is known as phacoemulsification. The eye lens is composed of a capsule and an inner portion. The cataract forms in the inner portion due to the thickening of proteins. Through cataract surgery, the inner part of the lens is removed and substituted,” Dr. Wijetunge explained. He further explained the procedures of the surgery. “A 2.2mm cut is made in the cornea. Aspiration of the lens is followed by the injection of a foldable lens into the eye through the cut made in the cornea,” he explicated. The surgery is only a one-day operation which lasts for about 5-10 minutes. The patient isn’t made unconscious and a gel is applied to the eye as anaesthesia. The eye will be kept covered for one day. Usually the patient’s vision will be restored to normalcy after one day. The patient is prescribed eye drops as post-surgery medication. “The surgery does not hinder the patient’s ability to continue with day-to-day activities. A person can take a shower 4 days after surgery,” he informed. Congenital cataracts can also be treated through surgery. But there is a minor complication. “Some people inherit cataracts by birth. This is a congenital condition. This too can be treated by surgery. The only problem is that infants can’t undergo surgery right away. They have to wait until they reach a minimum age of 2 years to undergo phacoemulsification. The reason is that they are still developing. Their eye lenses are hard to measure in order to replace the impaired lens with an artificial one as the eye lenses are still growing,” Dr. Wijetunge explained.   

Prevention   
Avoiding steroid eye drops and use of sunglasses to prevent exposure to UV from sun light are a few ways in which the risk of cataract formation can be minimized. Preventing traumatic incidents to the eye is equally important.