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What is a cataract?
A cataract means that the eye’s lens has become clouded to the extent that it impacts on clear vision. Although they are most often a consequence of ageing, cataracts can occur in babies and children (although the causes of cataracts in children are largely unknown).
Cataracts generally develop in both eyes (although it will usually be more advanced in one eye). However, when surgery is required in both eyes, each cataract surgery procedure will usually be undertaken a few weeks apart.
What are cataract symptoms?
The most common symptoms of cataracts in adults are reduced or clouded vision, along with increased sensitivity to bright lights or glare. This could in turn mean that you have problems driving at night. Reading in a dim light may also be challenging.
Needing to change your glasses prescription, or having to wear glasses when you didn’t previously need them, may also be suggestive of cataract formation.
Different types of cataract
Ophthalmologists generally classify three different types of cataract according to the part of the eye that they affect.
Nuclear sclerotic cataract
Affecting the central part of the eye lens (known as the nucleus), this is the most common type of cataract, and can cause the lens to harden and turn yellow. Although a nuclear sclerotic cataract can in some cases lead to a temporary improvement in close-up vision through changes in the eye’s ability to focus, over time there will be a deterioration in overall vision quality.
In this less common form of cataract, the cortex (the outer part of the lens) clouds over and ‘spokes’ pointing in towards the centre are formed. If you have this type of cataract, glare can make it difficult to see clearly, and/or depth perception can also be affected.
Posterior subcapsular cataract
The symptoms of this form of cataract include excessive sensitivity to light, difficulties with reading and glare (e.g., seeing a ‘halo’ effect around objects). This type of cataract can develop quite quickly, especially in diabetics or anyone who has used corticosteroids for extended periods of time.
The way cataracts develop can be unpredictable, and in some cases cataracts treatment may not be required. However, once the condition begins to affect the clarity of your vision, you will need to consult an eye specialist to discuss the optimum time to undergo cataract surgery. This may not be urgent, but over time it is highly likely that eye surgery will be required.
What is cataract surgery?Cataract surgery is the procedure whereby a clouded natural eye lens is removed and replaced with a clear lens implant (known as an intraocular lens or IOL). This plastic lens then performs almost the same function as the eye’s natural lens. Cataract eye surgery is a minimally invasive surgery that can be performed as a day surgery procedure under local anaesthetic for adults, or under general anaesthetic for children.
How to prepare for cataract surgery
Once the decision to undergo cataract surgery has been made, there are steps that you will need to follow in preparation:
- If you notice any changes in your health ahead of your cataract surgery, you should advise your surgeon, as it is important to ensure you have no infections in the eye.
- If you are taking prescription medication, you should continue to do so.
- You might be given eye drops to administer in the days before your surgery.
- If you wear contact lenses, you will likely need to avoid wearing them for a few days before your cataract eye surgery.
- Fasting may or may not be required ahead of your surgery, although it is advisable to stay away from alcohol and heavy foods.
Cataract surgery for kids
Although cataracts are most commonly the result of ageing and so affect older people, cataracts in children do occur.
As is the case with adults, children with cataracts will also suffer from the lens of the eye becoming clouded, which affects their quality of vision. However, while adults can sometimes avoid cataract surgery, it can be more urgent in children. Untreated cataracts can have permanent adverse effects on a child’s vision, causing interruption of visual development due to an immature and developing brain. This is why an eye specialist for kids may recommend paediatric cataract surgery in some cases.
What to expect after cataract surgery
Although in most cases the cloudy lens is replaced by plastic intraocular lens during cataract surgery, as a baby’s or child’s eye is still growing, an intraocular lens may not be inserted at the time of the initial procedure. Instead, the IOL (or clear lens implant) may be inserted during a second operation at a later date when your child is older.
When it comes to recovering from cataract surgery, there are some things that your paediatric eye specialist may recommend, including wearing glasses or contact lenses. Ongoing treatment may also be required to repair developing eye-brain connections, in order to help clear images to focus on the retina.
Consult a Cataract Surgeon Near You
If you think your baby or child may have cataracts, or that pediatric cataract surgery may be required, then an eye specialist for kids can advise you about the necessary steps.
Dr Swati Sinkar is a highly experienced paediatric eye specialist who specialises in treating cataracts in children. You can arrange a consultation with Dr Swati at her private rooms in North Adelaide.
Frequently Asked Questions - Cataract Surgery
Cataracts generally develop in both eyes at the same time, but the condition will often be more advanced in one eye than the other.
It is estimated that around 700,000 people in Australia have cataracts.
Recent research would seem to suggest that there are steps that can be taken with regard to diet, lifestyle and medical check ups that may be able to slow down or inhibit the growth of cataracts.
Although there is not enough evidence, it’s been thought that a healthy diet rich in antioxidants and certain vitamins can produce positive results in terms of slowing the progress of cataracts. This is because oxidative stress (caused by insufficient antioxidants in the body) is thought to damage enzymes and proteins in the eye’s natural lens, and causes the lens to become clouded.
Therefore, eye surgeons would recommend eating foods that are rich in antioxidants, plus supplementing your diet with vitamins B, C and beta carotene to reduce the risk of cataracts forming, or to slow down their progress.
Shielding your eyes as far as possible from the sun may help to prevent the onset of cataracts. Wearing a hat when outside, as well as sunglasses that offer 100% UV protection is essential to prevent potential damage to the eyes.
As well as damaging your overall health and wellbeing, smoking may also hasten the onset of cataracts. Cigarette smoke contains chemicals that harm your body’s cells and cause oxidation which, as discussed above, may lead to the natural lens of the eye becoming clouded.
Although your ophthalmologist will not be able to prevent cataracts from developing, it nevertheless pays to have regular checkups (particularly as you get older), to ensure that they are diagnosed as early as possible, or so that, if present, their development can be carefully monitored by your eye surgeon.
While it is possible to live with cataracts for some time without them impacting your life, there can be a significant deterioration in the quality of life. In particular, as the majority of people with cataracts will likely be over 60 years of age, there is an increased risk of falls as a result of impaired vision, and this can ultimately impact on the ability to live independently. It can also affect the driving ability and some may find it difficult to hold a driver’s license if the vision is reduced beyond the legal limits.
Currently, surgery is the only treatment available for cataracts. However, it is believed that there are ways in which diet and lifestyle can help to delay their onset or slow their growth.
In cases where both eyes require cataract surgery, they will be operated on separately, usually a few weeks apart. After surgery, cataracts do not generally return and so the procedure will normally only need to be undertaken once for each eye.
In the most extreme cases cataracts can severely impair vision or even lead to blindness.