Cataract

Overview

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A Cataract occurs when the normally clear lens of the eye becomes cloudy or opaque, which obstructs light from passing through to the retina. This can lead to blurred or dim vision. Cataracts are primarily age-related but can also occur due to other factors such as trauma or certain medical conditions.

This can lead to blurred or dim vision. Cataracts are primarily age-related but can also occur due to other factors such as trauma or certain medical conditions.

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Symptoms
  • Blurry Vision: Vision becomes increasingly blurry or hazy.
  • Glare: Difficulty seeing in bright light or experiencing glare from headlights or sunlight.
  • Double Vision: Seeing double in one eye, which can improve with closing one eye.
  • Color Distortion: Colors may appear faded or yellowish.
  • Poor Night Vision: Difficulty seeing at night or in low-light conditions.
  • Frequent Prescription Changes: A need for frequent changes in glasses or contact lens prescriptions.
Complications
  • Visual Impairment: Progressive vision loss that affects daily activities.
  • Increased Risk of Falls: Poor vision can increase the risk of accidents and falls.
  • Glaucoma: In some cases, cataracts can lead to increased intraocular pressure, contributing to glaucoma.
  • Retinal Detachment: Severe cataracts can potentially increase the risk of retinal detachment.
  • Surgical Risks: Although cataract surgery is generally safe, risks include infection, bleeding, or damage to the eye.
Causes
  • Aging: The most common cause of cataracts, where proteins in the lens gradually break down and clump together.
  • Genetics: A family history of cataracts can increase the risk.
  • Trauma: Injury to the eye can lead to cataract formation.
  • Medical Conditions: Diseases such as diabetes can increase the risk of developing cataracts.
  • Medications: Long-term use of corticosteroids can contribute to cataract formation.
  • Radiation Exposure: Exposure to ultraviolet light or radiation can increase risk.
Prevention
  • Regular Eye Exams: Early detection through routine eye exams can help manage cataracts before they severely impact vision.
  • UV Protection: Wearing sunglasses that block UV rays can help protect the eyes from cataract development.
  • Healthy Diet: Consuming a diet rich in antioxidants, vitamins, and minerals (such as vitamin C and E) may support eye health.
  • Avoid Smoking and Excessive Alcohol Consumption: Both smoking and heavy drinking are associated with an increased risk of cataracts.
  • Manage Health Conditions: Controlling underlying conditions like diabetes can help reduce the risk of cataracts.
Risk Factors
  • Age: The risk of cataracts increases with age, typically developing after age 60.
  • Family History: A genetic predisposition to cataracts can increase risk.
  • Diabetes: People with diabetes are at a higher risk of developing cataracts.
  • Smoking: Tobacco use is a known risk factor for cataract formation.
  • Excessive Sun Exposure: Prolonged exposure to UV light without protection can increase risk.
  • Medications: Long-term use of steroids and certain other medications can contribute to cataract development.
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How is it treated?

  • Eyeglasses and Contact Lenses: In the early stages, changes in glasses or contact lenses can help manage symptoms.
  • Cataract Surgery: The most effective treatment, typically recommended when cataracts significantly impair vision. The procedure involves:
  • Phacoemulsification: A small incision is made, and the cloudy lens is broken up with ultrasound and removed. A clear artificial lens (intraocular lens or IOL) is then implanted.
  • Extracapsular Cataract Extraction: Involves removing the lens in one piece and is less common with modern techniques.
  • Post-Surgery Care: Includes using prescribed eye drops, wearing an eye shield, and attending follow-up appointments to ensure proper healing.
  • Cataract surgery is generally safe and effective, with a high success rate in restoring vision. Early diagnosis and intervention can help manage symptoms and improve quality of life for individuals with cataracts.
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How is it Diagnosed?

Cataract is diagnosed primarily through a detailed eye examination by an ophthalmologist. The first step involves recording the patient’s medical history and vision complaints, especially blurring, glare, difficulty with night vision, and changes in color perception. A visual acuity test is conducted to determine how clearly a person can see at various distances. This is typically performed using an eye chart.

The next key diagnostic tool is a slit-lamp examination, which provides a magnified view of the structures at the front of the eye. This allows the doctor to closely examine the lens for cloudiness or opacification, the hallmark sign of a cataract. Dilated eye examination follows, in which special drops are used to widen the pupil, allowing the doctor to examine the lens and retina more thoroughly.

Additionally, retinal examination and tonometry may be done. Retinal examination helps rule out other vision-affecting diseases such as macular degeneration or diabetic retinopathy, while tonometry measures intraocular pressure, important in excluding coexisting glaucoma.

In some cases, potential acuity meter (PAM) and brightness acuity test (BAT) may be used to assess how much vision might improve after cataract surgery. Ultrasound of the eye (A-scan biometry) may be performed before surgery to measure the eye and help select the appropriate lens implant.

The diagnosis of cataract is confirmed when the lens shows significant opacity and is responsible for the visual symptoms experienced by the patient. Early detection enables timely treatment and prevention of vision loss.

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