The eye is an optical system much like a camera. In order for outside light and images to reach the macula clearly they first have to be refracted in the eye's ...


The eye is an optical system much like a camera. In order for outside light and images to reach the macula clearly they first have to be refracted in the eye's outermost transparent layer the cornea and then the lens inside the eye. Normally, both these layers are transparent. A cataract is when the lens inside the eye loses its transparency and takes on an opaque appearance.

While there are many types of cataract they are generally categorized in three main groups:
1. Age-related cataracts
2. Congenital cataracts
3. Secondary cataracts: These are formed as a result of the long-term use of certain drugs (such as cortisone) or by blows or metabolic diseases (such as diabetes).

The most common forms of cataracts are age-related. While there is not known cause, there are many risk factors such as diet and UV light. Depending on how the lens is becoming opaque, the patient may first have trouble seeing at distance or up close. The more opacity increases the more distant and near sight will deteriorate to the degree where they impact the patient's social life.

Surgery is used to treat cataracts. Regardless of the kind of surgical procedure that is performed, the lens that has lost its transparency is removed and replaced with an artificial lens inside the eye. If a lens is not placed inside the eye patients will have to use very powerful glasses or contact lenses after the operation.

The old surgical method. This method involves removing the entire lens in the cataract operation. As the lens' refractive nature is taken away the patient develops severe hypermetropia after the operation. The patient has to wear thick glasses or contact lenses in order to see clearly. This type of surgical procedure is no longer performed unless absolutely necessary.

This is a more advanced surgical method. The cataract is removed while preserving the lens' posterior capsule during the operation and an artificial intraocular lens is implanted. The lens needs to have reached a specific degree of maturity in order for this kind of operation to be performed. This type of operation involves a wide incision of the cornea and stitches. Since the stitches placed in the eye create a certain degree of astigmatism the patient regains functional sight once the stitches are removed 8-10 weeks after the operation.

In operations performed using the phacoemulsification method, which is the most advanced method in use today, the clouded lens is emulsified (broken up) with the help of ultrasonic waves while preserving the posterior capsule and an intraocular lens is implanted that adapts more comfortably to the inner eye. The advantage of this method is that it allows the entire operation to be performed through a small incision in the cornea without the need for stitches to the eye. Since the astigmatism caused by stitches no longer occurs, the patient regains functional sight quickly. Patients are able to resume their normal social life immediately after the operation. The lens needs to be fully mature in order for this technique to be carried out. Surgery can be performed after the patient's sight starts being obstructed and before sight is completely obscured.
With people having more activities today, those people with cataracts need to be able to get back to their daily lives as quickly as possible.
The phacoemulsification method is the most widespread method used in the developed countries right now. The short recovery period and the absence of post-operation astigmatism are the reasons why this method is the one most preferred by patients.

Surgery is used to treat cataracts. Laser surgery for cataracts:
Applies the same principles used in the phacoemulsification technique, just that laser light not ultrasonic waves is used to emulsify the lens. Since only a small incision is made in the cornea no stitches are needed and recovery is fast.
Regardless of which surgical technique is used for people undergoing normal cataract surgery afterwards there can sometimes be a clouding in the capsule in which the intraocular lens is placed. This cloudy layer is pierced by an emulsifier known as a YAG laser. However, this is a treatment that is carried out after the operation. AFTER THE OPERATION!
* Pressure must not be applied to the eye for a while afterwards and blows to the head should be avoided.
* The medication given by your doctor after the operation should be taken regularly.
* For 2-4 weeks after the operation your doctor will adjust your prescription depending on your need for glasses.
* People who have had cataract surgery must have regular eye examinations for the next 6-8 months.

*If your distance or near sight starts to deteriorate or if sight becomes blurred this could be the start of a cataract.
* Treatment of congenital cataracts is important. As the eye has not learned how to see this could lead to amblyopia if time is lost.
*Far or near sight functions could deteriorate or be lost completely.
*An increase in intraocular pressure may be observed.
* Amblyopia could develop.
* It could lead to "uveitis" or inflammation of the uvea part of the eye.
* Since the eye's macula and retina cannot be seen in examinations this could make it more difficult to diagnose and treat inner-eye problems.
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Ada Eye Clinic and Surgery Unit