Cataract .

What is CATARACT

A cataract is a clouding of the normally clear lens of eye, which affects vision. It can occur in one or both eyes. Most Cataracts are age-related and people after the age of 50 years should get their eyes checked by an ophthalmologist.

About Cataract

In our eyes, we have a natural lens that acts as a camera. The lens bends light rays that enter the eye in a manner that the rays fall on the retina and help us see clearly.

However, as age Progresses, the lens loses its transparency and starts to get cloudy, which leads the vision to deteriorate, and it is like looking through a foggy or dusty car windshield making things look blurry, hazy or less colourful.
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Cataract Surgery

by Dr Chandni Kotak

Cataract Surgery

by Dr Chandni Kotak

grade 3

Cataract

Importance of regular
eye check-up in Cataract

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Most people see with both eyes, so in a patient with cataract only in one eye or one eye operated, may not realise till the cataract is very advanced in the other eyes; thus lies the importance of regular eye checkup

Blurred Vision

.Blurred Vision

Your vision will appear blurred or hazy (it's like looking through a frosty or fogged-up window ). You will not be able to see clearly for a distance, near or both.

reading Difficulty

.reading Difficulty

Difficulty in reading, whilst in some patients near vision will actually improve with hampered distance vision

Signs And Symptoms
cataract of grandfather

Difficulty in driving

Difficulty in driving

Difficulty in driving due to glare (spreading of oncoming headlight)

Daily activities hampered

Daily activities hampered

Your routine life gets disrupted due to decreased vision & daily activities gets affected

Treatment Surgery is the only treatment for cataract.

Surgery is the only treatment for cataracts. Medicine, Eye Drops will not help. Nowadays, we can operate in the early stages if a patient’s lifestyle is hampered. With advancements in surgical techniques and new lenses, we get excellent results in all stages of cataracts, even the early cataractous stage.

The procedure is a very simple one, virtually painless and fairly complication-free. It’s a fifteen minutes procedure and your in and out time of the hospital is 2-3 hours.

The lens is removed using ultrasound energy and a new artificial lens is placed. This is called phacoemulsification (commonly referred to as laser surgery )

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Type of
Lenses

The lens that is usually placed in your eye will help you see clearly only for distance. You will need glasses for near vision. These are called mono-focal lenses. However with recent advances, we now have lenses that correct distance, intermediate and near vision. So you are virtually glass free for most of the activities. These are called trifocal lenses.

Mono Focal

This lens will help improve your vision for distance, primarily however for intermediate and from your work, you will need glasses.

Edof Lens

These are called extended depth of focus lenses. They will help you improve your vision for distance and for intermediate work, which would mean a laptop, your computer, or maybe if you’re working in the kitchen, this will take care of those needs. And yes, probably 80% of your near work will be taken care of. But you will need glasses for fine works.

tRIFOCAL

Trifocal lenses will take care of your distance, intermediate and your near vision, which is your mobile and reading books for very fine work, very fine print, like maybe a newspaper, or if you’re reading in dim light, you may need glasses with a minimal correction. But by and large, you will be glasses free for 90% to 95% of your time.

Fear of an injection in the eye- Don't worry !!

We now operate without an injection using topical eye drops to anaesthetise the eye. Don't Worry !!

Overview & FAQ

It is patient dependent. Whether the Symptoms of cataracts hampering the patient’s lifestyle or is it hampering your work? If you're facing issues because of your contracts, like say, if you're a driver or if you have a lot of night time driving, while you're coming back late from office/work while driving, the glare from the light is hitting your eyes and it's getting uncomfortable for you, then yes, we do operate.
Also in some cases, if a patient needs to travel and wants to get the cataract Surgery done before that. So technology in cataract surgery has advanced so much that we can operate on the earlier cataracts as well.

Hence you discuss your needs with your doctor and you can make a decision to operate accordingly.

It is a very simple surgery. The surgical process does not take more than 15 minutes. So your in and out time from coming into the hospital where you are doing the surgery is done till you discharged is not more than 2 hours

Cataract surgery technology has advanced so much, and we are taking smaller incisions now. So your recovery period is really less. So if a patient really needs to go home or he needs to go to work, work or there are certain unavoidable functions that they need to go, I will say you can go. You can go as soon as you are comfortable. It may be the next day, it may be two days, and it may be a week. If you are comfortable moving out, you can I can give you permission to move. However yet when you're going out, you will have to wear protective glasses to avoid an infection in your eye. Also, Protect your eyes from any dust or any dirt going into your eyes. So that is a precaution that you would have to take. Apart from that, as soon as you're comfortable, you can move out.

We now operate without an injection using topical eye drops to anaesthetise the eye.

Yes, Cataract Surgery is covered under insurance. And most companies will give you your entire reimbursement.

Unfortunately, no, this isn't a cashless surgery. You will have to pay up in advance and you will be reimbursed later by your company.

Treatment Cost for Cataract Operation

The average cost of cataract surgery in Mumbai is usually between Rs. 18,000 to Rs. 95,000. However, the prices may vary depending upon the hospitals in different cities. It is majorly dependent on the type of lens you are choosing for the  cataract treatment.

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Monofocal

Approx Rs 18,000

Hospitalization, Doctor charge, Hospital Charge, Monofocal Lens charges, etc

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Popular

Edof lens

Approx Rs 65,000

Hospitalization, Doctor charge, Hospital Charge, Edof Lens Charges etc

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Most Advanced

Trifocal Lens

Approx Rs. 95000 /

Hospitalization, Doctor charge, Hospital Charge, Trifocal Lens charges etc

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What causes eye cataracts?

The major cause for cataract is age. Other than that, various factors can cause the formation of cataracts like:

Previous or untreated eye injury

Diabetes and Hypertension

UV radiation

Long exposure to sunlight

Medications such as corticosteroids, can increase the risk of developing cataracts.

Hormone replacement therapy

Types Of Cataracts

Nuclear Cataracts

Nuclear Cataracts

These cataracts form in the center of the lens and cause a yellowing or browning of the lens and happens almost always due to aging.
Cortical Cataracts

Cortical Cataracts

These take shape on the outside edge of your lens, ie cortex. They start as triangular white wedges, that point toward the center of your eye.
Posterior Subcapsular Cataracts

Posterior Subcapsular Cataracts

These cataracts form on the back surface of the lens and cause a blurriness or glare.
Anterior Subcapsular Cataracts

Anterior Subcapsular Cataracts

Anterior subcapsular cataract results from fibrous metaplasia of the lens epithelium. This type of lens opacification is associated with ocular trauma, inflammation or irritation, atopic dermatitis, electrical burn and irradiation are typical scenarios.
Diabetic Snowflake Cataracts

Diabetic Snowflake Cataracts

It occur at younger ages in diabetic patients due to osmotic stress from intracellular accumulation of sorbitol in the lens secondary to elevated intraocular glucose.
Traumatic Cataract

Traumatic Cataract

A cataract can develop after trauma to the eye, either by blunt force (like a blow to the eye) or by something penetrating into the eye. Most of the traumatic cataracts lead to eye lens swelling, but the type and clinical course depend on trauma and the integrity of the capsular bag.

Cataracts Diagnosis

Test For Cataract

To determine whether you have a cataract, your doctor will review your medical history and symptoms, and perform an eye examination. Your doctor may conduct several tests, which includes: 

Visual acuity test

A visual acuity test uses an eye chart to measure how well you can read a series of letters. Your eyes are tested one at a time, while the other eye is covered. Using a chart or a viewing device with progressively smaller letters, your eye doctor determines if you have 20/20 vision or if your vision shows signs of impairment

Slit-lamp examination

A slit lamp allows your eye doctor to see the structures at the front of your eye under magnification. The microscope is called a slit lamp because it uses an intense line of light, a slit, to illuminate your cornea, iris, lens, and the space between your iris and cornea. The slit allows your doctor to view these structures in small sections, which makes it easier to detect any tiny abnormalities.

Retinal exam

To prepare for a retinal exam, your eye doctor puts drops in your eyes to open your pupils wide (dilate). This makes it easier to examine the back of your eyes (retina). Using a slit lamp or a special device called an ophthalmoscope, your eye doctor can examine your lens for signs of a cataract.

Applanation tonometry

This test measures the fluid pressure in your eye. There are multiple different devices available to do this.

The severity of Cataracts

Cataracts usually progress gradually and take years to mature. Over time, the cataract will cover more area of your natural lens as it becomes severe. The severity of cataracts are
eye-glyph

Early Cataracts

It is the beginning stage of cataracts at which the lens is almost clear but the ability of the lens to change focus is compromised. Due to this, symptoms like blurry vision, glare from lights, and increasing eye strain will start to appear.

Immature Cataracts

At this stage, the protein starts to accumulate on the lens, making it cloudy and slightly opaque. Along with vision problems, other symptoms like light sensitivity will also appear. You may need eyeglasses or anti-glare lenses to see nearby

Mature Cataracts

In this stage, the cataract starts to mature, and the opacity of the lens further decreases. The lens will appear milky white or amber in colour and the vision will also be considerably affected.

Hypermature Cataracts

It is the most serious stage of cataracts at which the damage to the lens is significant. If not removed at the right time, a hyper-mature cataract may cause inflammation in the eye or increase eye pressure which can cause glaucoma.

Risks & Complications

Though risks and complications are rare during cataract surgery, the cataract surgeon still looks out for risks like

  • Inflammation can occur in the eyes as the cornea or sclera is cut to perform the surgery.

  • Drooping eyelid 

  • Dislocation of the artificial lens 

  • Glaucoma 

  • Secondary cataract

The effects of cataracts are determined by how fast it is advancing. In the beginning, cataracts will negatively impact your daily life as you won’t be able to read, work, drive, or follow any of your hobbies due to reduced vision.
Eventually, if cataracts are left untreated, they will cause total blindness that will be irreversible.

Normally, once the eye lens is replaced, there are usually no complications. Still, in rare cases, cataract surgery may fail to improve your vision. It usually happens when other underlying conditions are present, such as glaucoma or macular degeneration and they are the primary cause of eye damage.

Cataract surgery procedures

Phacoemulsification

Phacoemulsification is a type of cataract surgery involving using ultrasound energy to break up and remove the cloudy lens that has developed in the eye. It is the most common cataract surgery and is often preferred because it is less invasive than other types of surgery and has a shorter recovery time.

Extra-capsular Cataract Extraction

Extra-capsular cataract extraction (ECCE) is a type of cataract surgery that involves making a larger incision in the eye and removing the cloudy lens in one piece. It is not as commonly performed as phacoemulsification, which is a more modern and less invasive technique.

During ECCE, the surgeon will make a larger incision in the eye and remove the front part of the lens capsule, which is the thin, transparent membrane that surrounds the lens. The cloudy lens is then removed in one piece. The surgeon may also use a laser to assist with the surgery.

Laser Cataract Surgery

Laser-assisted cataract surgery (also known as femtosecond laser-assisted cataract surgery) is a type of cataract surgery that involves the use of a laser to perform some of the steps of the surgery. It is a more precise and accurate method of cataract surgery, and it may be a good option for people who have certain medical conditions or who have particularly hard cataracts.

During laser-assisted cataract surgery, the surgeon will use a laser to create precise incisions in the eye and to soften and break up the cloudy lens. The surgeon will then use traditional surgical instruments to remove the pieces of the lens.

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How to prepare for Cataract Surgery

Cataract surgery requires some physical, emotional and mental preparation as well as financial support. Hence, it is advisable to accompany a family member or a close friend while consulting for cataract surgery. This can help you make the decision for the right type and right lens for cataract surgery.

Before undergoing cataract surgery, you will need to undergo a fitness assessment by a physician to ensure that your body functions and common parameters like BP, Blood Sugar, ECG etc are well controlled

Your ophthalmologist may recommend stopping certain medications before your surgery.

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