Managing Cataract

Cataract is the most common eye ailment among the elderly. Clouding of the eye lens with age can interfere with routine activities, hence requiring a surgery for removal of cataract. We spoke to Dr. Kaushik Murali, Director at Sankara Eye Hospital, Bangalore and Dr. Alpna Lamba, Eye Surgeon at a leading hospital in Kurukshetra to get you more insights and also dispel some myths associated with cataract.

Don’t ignore your vision problems. Pic: Silver Talkies

What is Cataract?

Cataract is caused due to excessive building up of proteins, resulting in a cloudy effect on the surface of the eye lens. Hence it is also called ‘safed motia’. While cataract is mainly age-related it can also be congenital, injury induced, radiation exposed or induced due to secondary conditions like diabetes.

Do I have Cataract?

The most common symptoms associated with cataract are blurry vision, poor night vision, strong glare or double vision. There may be a need for brighter light to read or a fading or yellowing of colors. Another common presentation could be a frequent prescription change in your eyeglasses or contact lenses.

It is important to remember that these symptoms can also be a sign of other eye problems. If you have any of these symptoms, check with your eye care professional.

How to proceed for treatment?

If either of the above symptoms is present, one should visit an ophthalmologist for eye examination. The doctor can see the abnormal lens using a viewing instrument Slit – Lamp. The examination would include a measurement of your vision for distance and near and also tests of your eye pressure (tonometry) and a dilated examination of your retina. If you have a total cataract (mature cataract) an ultrasound scan may be ordered to study the structure of the eye behind the cataract. Sometimes if the cataract is in very early stage, the doctor might just change the prescription of your glasses and advise you 3 or 6 monthly follow ups.

A cataract surgery

Pic: Wikimedia Commons

When should I get operated?

A common myth is that cataract should not be operated till it is fully mature. Today the indication for cataract surgery has changed from what it was 20-30 years ago.

A cataract being a gradual condition, your doctor may wait till the condition starts interfering with your routine activities like driving, reading and watching TV among others. You and your ophthalmologist should decide together when surgery is appropriate.

How is life after cataract surgery? 

Today cataract surgery is not only safe and effective but it is the most commonly performed surgery in the world. Advancement in medical techniques and instruments has made cataract surgery a fairly safe and successful procedure. However certain care is advised to reduce the risk of infection or inflammation. A course of eye drops is prescribed and in due course a new eyeglass prescription too.

People with cataract are at an increased risk of falls due to poorer vision. A Cochrane review, which analysed all studies on the subject, noted that women who were operated for cataract had a significant reduction of falls. (Cochrane Database Syst Rev. 2012 Sep 12;9:CD007146.)

A more recent study seemed to indicate a shorter time lag between surgeries for both eyes as they noted an increased risk of injurious falls after first- and second-eye cataract surgery which has implications for the timely provision of second-eye surgery as well as appropriate refractive management between surgeries. (Age Ageing. 2014 May;43(3):341-6.)

Can I do something to prevent or reduce the risk of developing cataract?

The only known treatment for cataract is a surgery with an intraocular lens (IOL) implant.

As against popular belief anti-cataract drops available in the market have no definitive role in prevention of cataract. However habits like smoking and intake of alcohol increase the risk of cataract formation. Hence quitting these habits is advised.

Blocking ultraviolet sunlight by means of sunglasses or hats may also help to delay cataract. Research also suggests healthy eating habits too can reduce the risk of age-related cataract. Consuming green leafy vegetables, fruit, and other foods with antioxidants is recommended.

People over the age of 60 are advised to visit a qualified ophthalmologist at least once every two years for a comprehensive, dilated eye exam. This enables looking out for cataracts and other eye diseases common among the elderly, like macular degeneration and glaucoma. Early prevention and good eye care is important for the treatment of any eye condition.

— Coordinated by Nidhi Chawla