Cataracts & Treatment – A Guide for Patients
This information has been prepared to provide you with some understanding about cataracts & their treatment. If you have any further questions after reading this, please do not hesitate to contact the Clinic on 087-3288009.
The human eye functions just like a camera. Light passes through the lens of the camera and is focused on the film. Your eye also contains a lens but instead of a film, there is the retina at the back of the eye, where the image forms.
Normally, the lens in the eye is a clear transparent structure through which the light can freely pass and focus on the retina. A cataract is a clouding of the lens and as it develops it results in blurred vision. As the cloudiness increases, the vision will continue to deteriorate. Cataracts may affect both eyes at different rates or they may affect only one eye.
As we get older, failing vision due to cataract can occur thereby interfering with everyday activities that we have always taken for granted such as reading, driving & watching T.V.
However, other factors such as diabetes, trauma & even some medications can contribute to the development of cataract. So although cataracts have the potential to severely impair vision, the good news is that they are treatable.
Indeed, with current advances & improvements in microsurgical techniques, the treatment of cataracts has become a highly successful procedure.
Vision is restored by surgical removal of the cloudy lens and replacing it with an artificial lens (intraocular lens or IOL) also referred to as the lens implant. Measurements are taken before your operation in order to choose the correct strength or power of the implant for your eye.
Cataracts can be removed at any stage of their development but the ultimate decision lies with the patient. Age or physical conditions are seldom obstacles to undergoing the surgery. The timing depends on how much the cataract interferes with your vision & therefore your daily activities. If reading, watching TV or driving are compromised then surgery may be advisable.
Some Specific complications of cataract surgery may include:
- Rupture of the capsule at the back of the lens & disturbance of the gel (vitreous) at the back of the eye that can sometimes result in poor vision.
- Loss of all or part of the cataract into the back of the eye, requiring a further operation.
- Infection in the eye (endophthalmitis) which can lead to loss of sight or even the eye.
- Detached retina which can lead to loss of sight.
- Blood collection inside the eye.
- High pressure inside the eye.
- Clouding of the cornea.
- Swelling of the retina (macular oedema).
- Prolonged inflammation following the surgery (Uveitis or Scleritis).
- Incorrect strength or dislocation of the implant.
- Bruising of the eye or eyelids.
- Allergy to the eye drops.
Most complications are not predictable before surgery & can occur regardless of the experience of the surgeon. However when they do occur, they can in most cases be treated effectively. In a small number of cases, further surgery may be required. Very rarely, some complications can result in blindness.
Overall cataract surgery has one of the highest success rates of any type of surgery. More than 95% of patients have improved vision following surgery. However, your chances of an improvement in vision are reduced if you have another eye condition such as diabetes, glaucoma or age-related macular degeneration.
The most widely used technique to remove the cloudy lens is phacoemulsification. This is a small incision, surgical technique where a microsurgical incision is made in the eye & a tiny ultrasound probe is used to break up the cataract before it is removed from the eye with suction. Your lens is encased in a capsule or bag & this is left intact after removal of the cataract in order to provide support for the lens implant.
Anaesthesia
You can be given either a local or general anaesthesia (where you are asleep). Local anaesthetic is a drug induced numbness & you will be awake for the surgery. There are two ways for administering local anaesthetic for eye surgery & you will be given an opportunity to discuss these options prior to your surgery:
- Anaesthetic Drops – these are the same as those used to measure pressure of the eyeball (intraocular pressure) during the initial consultation with Dr. Gallagher. These drops cause stinging but are very safe & cataract surgery can be performed using these drops.
- Injection around the eye – this kind of anaesthetic for cataract surgery is usually referred to as either peribulbar or retrobulbar anaesthesia. A common side effect during injection is pain or discomfort for a brief period at the beginning of the injection. Complications are rare but bleeding, sticking the needle into the eyeball & injection of anaesthetic into a vein at the back of the eye can occur. If they do occur, they may cause problems with your retina, heart rate or breathing & your operation may be cancelled.
You will experience little or no discomfort during or after the procedure & assuming that there are no other problems with your eye; you should enjoy improved vision soon after the surgery.
However based on your own particular needs, glasses may subsequently be required for certain activities such as reading or driving. Your eye will take 3 – 6 weeks to heal but there should be few, if any restrictions on your activities.
Remember to use your eye drops as instructed after surgery, avoid rubbing the eye as well as swimming & strenuous lifting. If you have any worries or doubts about post-operative activities, please do not hesitate to contact us.
Once your cataract has been removed, it cannot develop again. It is possible however for the bag or capsule that supports your implant to become cloudy & this can blur your vision. However to deal with this, a straight forward laser procedure is performed, again on an outpatient basis. It is fast, painless & quickly restores your vision & no restrictions on activities are required.
We hope this information has been useful in helping you to understand cataracts & their treatment. From our point of view we will do our very best to ensure that you have a safe, comfortable & successful cataract procedure.
If you have any further questions before your surgery, Dr. Gallagher will be pleased to answer them for you.
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