CATARACT
 
 
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What is Cataract (Chitta Motia)?
Cataract commonly called as Chitta Motia in vernacular, is a clouding of the clear natural crystalline lens in the eyes. This is a normal outcome of the aging process but may also result out of trauma to the eye, heredity or diabetes. It is because of heredity that one sees infantile cataracts in some newborn babies.
Just as a dirty camera lens can spoil a picture, a cataract can prevent light from focusing clearly inside the eye. Cataract develop in almost everyone sooner or later. About one half of all people between the age of 52 and 64 have a cataract. Factors other than aging may cause cataracts as well. Cataracts sometimes occur relatively early in life due to such factors as injury, excessive sunlight, toxic chemicals, changes in the body's metabolism, or drugs.

Symptoms of cataract
Whatever the cause, cataracts typically result in blurred or fuzzy vision and sensitivity to light.

How cataracts affect your lifestyle?
People with cataracts, even when wearing glasses, typically have difficulty : Seeing in the distance or reading Distinguishing road signs at dusk Recognizing colours Recognizing friends and family at a distance driving at night. Cataract can be diagnosed only by a thorough eye examination. An eye care practitioner must determine whether a cataract or other eye disorder may be affecting a patient's vision.

Treatment of cataract
The decision to treat a cataract is reached by the eye care practioner and the patient together. This decision is based on the degree to which the cataract is impairing vision and the effect of the impairment on the patient's quality of life. Today's cataract surgery is a marvel of medical technology. Often, it is performed as an outpatient procedure, under local anesthesia. In most cases, the incision is so small that the eye heals rapidly with little or no discomfort. In the surgical procedure, the clouded natural lens is removed, leaving behind the lens capsule. Next, a man-made lens is inserted into the lens capsule of the eye. The man-made lens is called an Intraocular lens, or IOL for short. The proven procedure offering maximum benefits to patients is to undergo phacoemulsification surgery and to get a foldable lens implanted.

The only treatment for cataract is surgical intervention through which the cloudy natural lens is removed and replaced with a clear artificial lens. A cataract can be operated at any stage. In India, there is a myth that cataract’s should only be operated when “mature”. This may actually lead to complications.

Cataract surgery
Cataract surgeries are microsurgeries and are broadly categorized into two:

Extracapsular Cataract Extraction (ECCE): This involves removing the cloudy lens in one piece leading to a large incision of 10 to 12 mm on the eye. Through this incision, the artificial lens is also implanted and then the cut is sutured.

Phacoemulsification (Phaco): This is the latest advance in cataract removal wherein a small ultrasonic probe is inserted into the eye through a cut of 3.2mm or less. This probe breaks (emulsifies) the cloudy lens into tiny pieces and gently sucks these out of the eye. The surgeon then implants the replacement lens through this cut.

There are two kinds of lenses used in Cataract surgeries:

Choices of IOL's available
Basically, there are two different types of IOL's: Rigid & Foldable

Among the foldable IOLs there are 2 options available :
Monofocal IOLs are designed to provide good vision at one distance- usually far- so most people need glasses after surgery for close-up activities like reading or craft.

The other choice is the Multifocal IOL, which offers proven benefits for today's cataract patients. It is designed to provide good distance vision, intermediate vision, and near vision. Compared with monofocal IOls, Multifocal IOl can reduce the need for glasses in activities like reading, viewing text on a computer screen, or watching a movie.

While non-foldable lenses are made up of PMMA, a hard plastic material, Foldable lenses are either made of acrylic or silicone. The advantage of a foldable over a non-foldable lens is that the incision is very small and consequently the recovery period is much faster. Whichever the lens used, cataract surgery is a small procedure wherein the patient is discharged after a couple of hours and can safely go back home the same day.

Post surgery, in certain patients, a very thin film develops over the artificial lens. The treatment is a painless 10 minutes OPD procedure wherein the doctor cuts away this film through a process using a Laser.

 

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