Cataract Surgery - Symptoms & Treatment
A common cause of vision loss, a cataract is a gradually developing opacity of the lens or lens capsule of the eye. Cataracts commonly occur bilaterally, with each progressing independently. Exceptions are traumatic cataracts, which are usually unilateral, and congenital cataracts, which may remain stationary.
Cataracts are most prevalent in persons over age 70, as part of aging. Surgical intervention improves vision in 95% of affected people.
What Are the Different Types of Cataract?
There are three types of cataracts that affect different parts of the lens, have different symptoms and cause different vision problems.
Signs and symptoms
Here are some signs and symptoms of cataract:
These symptoms also can be signs of other eye problems.
When shining a penlight on the pupil, observation of a white area behind the pupil suggests an advanced cataract. Ophthalmoscopy or a slitlamp examination confirms the diagnosis by revealing a dark area in the normally homogeneous red reflex.
Cataracts require surgical extraction of the opaque lens and intraoperative correction of visual deficits with a lens implant (intraocular lens) for best visual results. This procedure is most frequently performed as same day surgery.
The following procedures are used to correct cataracts:
Some patients who have an extracapsular cataract extraction develop a secondary membrane in the posterior lens capsule (which has been left intact) that causes decreased visual acuity. But this membrane can be removed by the Nd: YAG laser, which cuts an area out of the center of the membrane, thereby restoring vision. However, laser therapy alone can't be used to remove a cataract.
Possible complications of surgery include the loss of vitreous (during surgery), wound dehiscence from loosening of sutures and flat anterior chamber or iris prolapse into the wound, hyphema, pupillary block glaucoma, retinal detachment, and infection.
Correction of visual deficits
A patient with an IOL implant may experience improved vision almost immediately if the retina is intact. The IOL implant usually only corrects for distance. To protect the eye postoperatively, some patients wear an eye patch for 6 to 8 hours, while others may have a collagen shield (similar to a contact lens) that dissolves in 24 hours. The patient will then need either corrective reading glasses or a corrective contact lens, which will be fitted 4 to 8 weeks after surgery.
If no IOL has been implanted, the patient may be given temporary aphakic cataract glasses; in about 4 to 8 weeks, he'll be refracted for his own glasses.
The primary prevention involves controlling associated diseases and avoiding exposure to factors known to promote cataract formation.
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