How To Prepare For Cataract Removal?

: Admin : 2022-02-14

What is a Cataract?

A cataract is a disease that forms a type of clouding in the clear lens of the eye. If an individual has a cataract, their vision becomes a bit like looking through a frosty or fogged-up window. Clouded vision caused by cataracts can make it more difficult to read, drive a car or see properly. Cataracts generally develop slowly and don't disturb the eyesight in the early stage. But with time, cataracts eventually interfere with the vision and makes the vision blurry.

Stronger lighting and eyeglasses might help an individual deal with cataracts. But if impaired vision interferes with the usual activities, one might need cataract surgery. Cataract surgery is a safe and effective procedure to remove cataracts.

 What are the possible signs and symptoms of Cataracts in the eye?

Signs and symptoms of cataracts can be:

• Clouded, blurred and dim vision
• Increasing difficulty with vision at night
• Sensitivity to light and glare
• Need for brighter light for reading and other activities
• Seeing halos or round objects around lights
• Frequent changes in eyeglass
• Fading or yellowing of colours
• Double vision in a single eye

A cataract does not show in the beginning. The cloudiness in the vision caused by a cataract may affect only a small part of the eye's lens and one may be unaware of any vision loss. As the cataract grows larger, it clouds more of the lens and distorts the light passing through the lens. This leads to more noticeable symptoms. If someone is seeing a clouded or blurred vision, he or she should immediately go for an eye check-up. If someone develops sudden vision changes, such as double vision or flashes of light, sudden eye pain, or sudden headache, they should take a doctor’s appointment.

Who Are More Likely To Get Cataracts?

Most people start getting cataracts around age 40. But one probably won’t notice symptoms until after age 60. Rarely, babies are born with cataracts due to a birth defect. But generally, Cataracts are common among older people. More than 50% of people age 80 and older have had cataracts.

However, one might develop cataracts if they:

• Smoke cigarettes.
• Live in an area with bad air pollution.
• Use alcohol heavily.
• Have a family history of cataracts.

Is It Possible To Get Cataracts In Both Eyes?

One can get cataracts in both eyes. But one eye may be worse than the other or develop at a later time. In both cases, surgery needs to be performed. However, surgery is done separately and one eye at a time. The doctor may suggest waiting for at least 1 to 2 weeks between each surgery.

How many types of cataracts are there?

The types of cataracts are:

• Nuclear Cataract:  Cataracts that affect the centre of the lens is Nuclear Cataract. A nuclear cataract may at first cause more near-sightedness. But with time, the lens gradually turns more densely yellow and further clouds the vision. The lens may even turn brown with time. Advanced yellowing or browning of the lens can lead to difficulty distinguishing between shades of colour.
• Cortical Cataracts: Cataracts that affect the edges of the lens is Cortical Cataract. A cortical cataract begins as whitish, wedge-shaped opacities or streaks on the outer edge of the lens cortex. As it slowly progresses, the streaks extend to the centre and interfere with light passing through the centre of the lens.
• Posterior Subcapsular Cataracts: Cataracts that affect the back of the lens is Posterior Subcapsular Cataracts. A posterior subcapsular cataract starts as a small, opaque area that usually forms near the back of the lens, right in the path of light. A posterior subcapsular cataract often interferes with an individual’s reading vision, reduces the vision in bright light, and causes glare or halos around lights at night. These types of cataracts tend to progress faster than other types.
• Congenital Cataracts: Some individuals are born with cataracts or develop them in childhood. They are Congenital Cataracts.  These cataracts may be genetic or associated with an intrauterine infection or trauma. Congenital cataracts don't always affect vision, but if they do, they can be removed soon after detection.

What is Cataract Removal?

Cataract removal is surgery to remove the cataract that is the clouded lens from the eye. If an individual develops clouded vision or cataracts, surgery is done to remove to help one see better. The procedure almost always includes placing an artificial lens (IOL) in the eye.

Cataract surgery is an outpatient procedure meaning thereby an individual likely do not have to stay overnight at a hospital. The surgery is performed by an ophthalmologist and is safe.

How A Patient Should Prepare Before The Cataract Removal?

A patient should see an ophthalmologist and assure a regular check-up of the eyes. If the doctor prescribes surgery, the patient should be prepared before the cataract removal. Before surgery, the patient must go for a complete eye exam and eye tests suggested by the ophthalmologist.

The doctor generally uses ultrasound or a laser scanning device to measure the eye. These tests help determine the best IOL for the patient. Usually, the doctor will try to choose an IOL that can allow an individual to see without glasses or contact lenses after surgery. Some IOLs provides both distance and near vision, but they are not for everyone. The doctor always suggests which one is the best and the patient should understand what his or her vision will be like after the IOL is implanted. Also, one should surely ask questions so that he or she knows what to expect of the surgery. The doctor generally prescribes eye drops before the surgery. One should follow instructions exactly on how to use the drops and take proper medications or avoid certain medicines before cataract removal.

How Is Removal Of Cataract Performed?

The normal lens of the human eye is clear and transparent. When a cataract is developed, the lens becomes cloudy and the vision becomes blurred. This blocks light from entering the eye. Without enough light, one cannot see as clearly.

Cataracts are painless. They are most often seen in older adults. Sometimes, children are born with them. Cataract surgery is usually done if one is unable to see well. Cataracts usually do not permanently damage the eye, so doctors prescribe the best surgery for the patient.

The cataract removal is safe and performed by an ophthalmologist.  Adults are usually awake for the procedure. Local anaesthesia is given using eye drops or a shot is given to the patient. This reduces the pain. Children usually receive general anaesthesia. This puts them into a deep sleep so that they are unable to feel pain. The doctor uses a special microscope to view the eye. A small cut or incision is made in the eye. The lens is removed depending on the type of cataract.

There are several ways of removal of the lens. Doctors suggest the ideal one depending on the type of cataract. They are:

• Phacoemulsification: With this procedure, the doctor uses a tool that produces sound waves to break up the cataract into small pieces. The pieces are then suctioned out. This procedure uses a very small incision.
• Extracapsular Extraction: The doctor uses a small tool to remove the cataract in mostly one piece. This procedure uses a larger incision.
• Laser Surgery: The doctor guides a machine that uses laser energy to make the incisions and soften the cataract. The rest of the surgery is done like phacoemulsification. Using the laser instead of a scalpel may speed recovery and be more accurate.

By following these techniques, the cataract is removed and a manmade lens, called an Intraocular Lens (IOL), is usually placed into the eye to restore the focusing power of the old lens (cataract). It helps to improve the vision. The doctor then closes the incision with very small stitches. Usually, a self-sealing method is used. If there are pending stitches, it is removed later. 

The surgery is safe and lasts less than half an hour. Most of the time, just one eye is done. If the patient has cataracts in both eyes, the doctor may suggest waiting for at least 1 to 2 weeks between each surgery. Each eye surgery is done one at a time and proper medication should be taken after the surgery for a speedy recovery.

What To Do Post Cataract Removal?

Cataract surgeries are not much hectic and take very less time. The patient can go home the same day of the operation. But before going home, the patient should once again see the doctor and wear a patch over the eye until the follow-up exam. The patient should use eye drops to prevent infection, treat inflammation, and proper medication that helps with healing. The follow-up exam occurs on the next day. The patient should have someone or any family member drive him or her home after the surgery. In some cases, the patient might have stitches. The patient then needs to make an appointment to have them removed.

 What Can Be The Risks Post Cataract Removal?

Certain factors increase the risk of cataracts. They are:

• A cataract is seen with increasing age
• People with diabetes are more likely to get cataract
• Excessive exposure to sunlight can cause cataract
• Smoking can cause cataract
• People with Obesity are most likely to get cataract
• High blood pressure of a person can cause the disease
• Previous eye injury or inflammation is another aspect of forming a cataract
• The previous history of eye surgery might be a risk of getting cataracts again
• Prolonged use of corticosteroid medications can cause cataract
• Drinking excessive amounts of alcohol can cause damage to the eye
• Very rare complications can include infection and bleeding. This can lead to permanent vision problems.

In some cases, the entire lens cannot be removed. If this happens, a procedure to remove all of the lens fragments will be done at a later time. Afterward, vision can still be improved.

 What Are The Preventive Measures And Tips For Recovering After Cataract Surgery?

Cataracts can’t be prevented or slowed from occurring. One should follow the steps to prevent the disease:

• One should have regular eye examinations. Eye examinations can help detect cataracts and other eye problems at their earliest stages.
• One must quit smoking and drinking. One should ask his doctor for suggestions about how to stop smoking and drinking. Medications, counselling and other strategies are available to limit the addiction.
• One should wash their hands well before and after using eyedrops and touching the eye. Try not to get soap and water in the eye while bathing or showering for the first few days.
• One should manage other health problems. One must follow other treatment plans if he or she has diabetes or other medical conditions that can increase the risk of cataracts.
• One must perform light activities for a speedy recovery. One should consult a doctor before doing any strenuous activity, resuming sexual activity, or driving.
• One should choose a healthy diet that includes plenty of fruits and vegetables. Adding a variety of colourful fruits and vegetables to the diet ensures that one is getting many vitamins and nutrients. Fruits and vegetables have many antioxidants, which help maintain the health of the eyes.
• Antioxidants in pill form can prevent cataracts. But a large population study recently showed that a healthy diet rich in vitamins and minerals was associated with a reduced risk of developing cataracts. Fruits and vegetables have many proven health benefits and are a safe way to increase the number of minerals and vitamins in the diet.
• One should wear sunglasses to protect their eyes. Ultraviolet light from the sun may contribute to the development of cataracts. Wearing sunglasses that block ultraviolet B (UVB) rays can be effective when we are outdoors.

Recovery might take nearly about 2 weeks. If someone needs new glasses or contact lenses, one can usually have them fitted at that time. one should keep the follow-up visit with the doctor regularly.