Cataracts
What
are cataracts?
A
cataract is a type of vision
loss characterized by the collection
of protein within the lens of the
eye. The proteins in the lens are
usually scattered in a manner that
allows light to pass through and present
a clear image to the retina at the
back of the eye. When cataracts form,
the protein clumps together. Eventually,
light is not able to pass through
the congested areas and the vision
clouds.
What
causes cataracts to form?
Cataracts
are most closely associated with aging.
However, other factors are thought
to contribute to the formation of
cataracts, including:
-
Premature birth
- Infections
during birth
- Heredity
- Alcoholism
- Smoking
-
Medications
- Eye
injuries
- Diabetes
and other diseases
- Long-term
exposure to ultraviolet rays
What
are the symptoms?
Early
signs that point towards the development
of cataracts
include:
- Sensitivity
to light or glare
- Poor
night vision
- Nearsightedness
that consistently gets worse
- Cloudy,
filmy, fuzzy, or blurred vision
- Distorted
images
- Double
vision
- Faded
colors
- A
change in pupil color
However,
cataracts typically start to form
long before vision is impaired. Tests
by your eye doctor are much more likely
to detect a cataract before it has
serious effects.
What
are the treatments for cataracts?
There
are no medications that can halt the
formation of cataracts. Glasses may
temporarily overcome the nearsightedness
caused by cataracts, but cannot impact
their formation. The only real cure
for cataracts is surgery.
Cataract
surgery has a very successful record:
there is no more frequently performed
surgical procedure in the United States.
It is typically performed outpatient,
and only a local anesthetic and sedative
are usually necessary. In the basic
procedure, the cataract surgeon begins
by making an incision in the eye at
the edge of the cornea. Through this
incision, the surgeon removes the
cloudy lens. The capsular membrane
behind the lens is left in place.
A plastic lens implant is put in place
of the natural lens. The incisions
are closed, typically with dissolvable
stitches.
There
are two primary types of cataract
surgery. The most commonly used method
is called phacoemulsification. The
incision in this procedure is very
small. A probe is inserted through
the incision. Using ultrasound, the
probe breaks up the lens so that it
can be suctioned out. If possible,
a soft, foldable lens implant is used
so that it can fit through the small
incision. Sometimes, however, the
doctor must use a rigid lens, and
the incision will have to be slightly
larger.
Another
method of cataract removal that is
used is called extracapsular extraction.
If a cataract is particularly advanced,
then the ultrasound probe may not
be able to break up the lens. In this
case, the cataract surgeon makes a
slightly larger incision and removes
the lens almost intact. Only the cortex
of the lens remains inside the capsule,
and this is sucked out. Then a replacement
lens is inserted.
While
many people associate lasers with
cataract removal, lasers are not used
to replace the lenses themselves.
If, after cataract surgery, the membrane
behind the lens implant begins to
cloud up, then lasers are sometimes
used to put a small hole in the center
of the membrane to restore visual
clarity.
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