What Is Cataract? Causes, Symptoms and Treatment Methods?

What Is Cataract? Causes, Symptoms and Treatment Methods?

A cataract is defined as the clouding of the eye lens, which is normally transparent. People with cataracts often describe looking outside through a frosted glass or a fogged window. Blurred and cloudy vision caused by a cataract can make daily activities more difficult, such as reading, writing, driving at night in the dark, noticing road signs, or making out the facial expressions of the person in front of you. Cataracts usually develop over time rather than suddenly, and in their early stages they do not affect the quality of vision. Since this can delay diagnosis and treatment, it is important not to neglect routine doctor check-ups so that symptoms and abnormal findings are noticed early. In the early stages of cataract, simpler methods such as working in well-lit environments and using eyeglasses may be preferred, while in later stages of cataract, more advanced intervention may be required. When the vision loss or visual impairment caused by a cataract reaches a level that prevents daily life activities, cataract surgery is needed. Cataract surgery is known as a surgical procedure that can be applied to almost all patients and greatly improves the quality of vision. Cataract surgeries are safe and are the only treatment method.

What Is Cataract?

A cataract is a dense, cloudy area that forms in the lens of the eye. It is a condition in which proteins in the eye prevent the lens from transmitting clear images to the retina. Images that do not fall clearly on the retina form clusters and reduce the quality of the image. The retinal layer of the eye converts the images, that is, the light, coming from the eye lens into electrical signals and carries them to the brain via the optic nerve (the visual nerve). A cataract may occur in both eyes or in one eye. A cataract is usually not a painful or irritating condition. Because it may cause sensitivity to light, pain may be seen in some patients. Cataract, which can develop slowly and silently, can be seen in the great majority of elderly people.

What Are the Symptoms of Cataract?

A cataract appears silently and may not cause any symptoms in the early period, but later it can cause some commonly seen complaints:

Blurred and unclear vision

Vision problems that increase especially in the dark at night

Seeing colors as faded

Needing very bright light to read

Excessive sensitivity to light

Double vision in the eye with the cataract

Constant need to change prescription eyeglasses

What Are the Causes of Cataract?

The underlying causes of cataracts are quite varied. The components that make up the eye lens are mostly water and proteins. When proteins are damaged over time and through various exposures, they can turn into permanent protein particles that cause cloudiness in the eye lens. This affects the quality of vision and prevents clear sight. This process is an undesirable condition that occurs especially with aging. Common causes of cataract can be listed as follows.

Advanced age

Diabetes

High blood pressure

Obesity

Smoking and use of tobacco products

Alcohol use

Radiation therapy applied especially to the upper part of the body

Steroid treatments

Medications used in the treatment of diseases such as arthritis (joint inflammation) and lupus

Medications used in the treatment of various psychotic disorders such as schizophrenia and bipolar disorder

Previous eye inflammations

Certain eye surgeries

Eye injuries and trauma

Excessive sun exposure without protective measures such as sunglasses or a hat

How Is Cataract Diagnosed?

If cataract symptoms are present, it is recommended to consult a specialist eye doctor for further tests and examination by a specialist physician. To investigate the presence of a cataract and evaluate it, and to measure the visual field, the specialist eye doctor performs a comprehensive eye examination. During the tests, the pupil (the black part in the middle of the eye) is dilated with eye drops so that the eye and the eye lens can be seen more clearly. When the pupil has dilated sufficiently, the doctor completes the examination. The tonometry test, used to measure intraocular pressure, works on the principle of a special machine blowing air into the eye and obtaining an image. This procedure is painless and is preferred for detailed examination of the optic nerve and retinal layer located at the back of the eye. Testing vision quality at different distances, checking sensitivity to light, and evaluating color perception are among the other tests that may be applied.

How Is Cataract Treated? How Is Cataract Surgery Performed?

If cataract symptoms are mild, it may be possible in some cases to create a treatment plan with eyeglasses and contact lenses. However, cataracts are often a condition that worsens over time and requires intervention. In cataract treatment, cataract surgery is usually planned under the guidance of a specialist eye doctor. Patients who do not prefer surgery may be directed to stronger prescription eyeglasses, lenses containing magnifiers, and specially manufactured coated sunglasses to prevent glare. Many cataract patients wait until they have surgery when reading is severely impaired or driving becomes difficult. Cataract surgery may also be preferred in cases where a cataract is an obstacle to the treatment of other eye problems. In a surgical procedure called phacoemulsification, the eye lens is broken up, and ultrasound waves, that is, a phaco device, are used to remove the small fragments that result from the breakdown. In another procedure called extracapsular surgery, the cloudy part of the eye lens is removed through a small incision, and after the surgery an artificial intraocular lens is placed in the area where the natural eye lens was. Cataract surgeries are generally quite reliable, and the success rate of surgical procedures is high. Some risks that may be seen in cataract surgery can be listed as infection, bleeding, and retinal detachment; however, the likelihood of such complications is quite low. Many cataract patients can be discharged on the same day as cataract surgery.

Frequently asked questions that often come to mind include: What happens if I don't have surgery, or how can I get better vision without cataract surgery? In patients with early-stage cataract, vision loss may be minimal or not affect daily life. In such cases, there are not many options beyond polarized sunglasses, reading and working in adequately lit environments, and using a magnifying glass while reading.

What Are the Types of Cataract Surgery?

Modern cataract surgery types are based on the procedure of replacing the lens inside the eye with an artificial lens. The commonly preferred types of surgery are as follows.

Phacoemulsification

The procedure of cleaning the cataractous lens using ultrasound energy and placing the lens through a small incision.

Laser Cataract Surgeries

These are surgeries that include a curved incision method that can also correct astigmatism in patients who have astigmatism. Instead of the surgeon making a manual incision in the eye by hand, the incision is made with a laser, and the cataractous lens can be replaced with this method.

What Are the Types of Lenses After Cataract Surgery?

There are lens types that can be preferred in place of the natural lens after cataract surgery, and the type of lens is chosen according to the patient's lifestyle. The intraocular lenses used are FDA and CE approved. Intraocular lenses also have an aspheric feature that improves image quality.

Monofocal Lenses

They are preferred to maximize the quality of vision at specific distances. After surgery, reading glasses are generally needed for near vision.

Multifocal Intraocular Lenses

These lenses, meaning multifocal lenses, help to see both near and far well by splitting light. With these lenses, patients generally do not need eyeglasses after surgery.

Accommodating Lenses (Lenses Capable of Accommodation)

Unlike monofocal lenses, which have traditionally been commonly preferred, the focal distance of accommodating lenses can be adjusted according to the activity of the muscles located in the eye.

Toric Intraocular Lenses

Toric lenses provide cataract treatment at the same time for those who have astigmatism, and patient satisfaction is above 95%.

What Can Be Seen After Cataract Surgery?

After cataract surgery, the following symptoms may be seen for an average of 2-3 days.

Itching

A mild stinging-like sensation of discomfort

Watery eye

Sensitivity to light

Blurred vision

Redness

Local anesthesia is applied during cataract surgery. The procedure is generally not painful or aching. After cataract surgery, eye drops prescribed by the doctor are used to prevent the development of infection and to control intraocular pressure. In some patients with mild pain, prescribing a painkiller is also possible. For several weeks after cataract surgery, touching the eyes, pressing on the eyes, and rubbing the eyes vigorously are not recommended, nor is lifting and lowering heavy objects. Following hygiene rules is important for eye health and for protection against infections.

Frequently Asked Questions About Cataract

After cataract surgery, the quality of vision improves to a great extent. There may still be cases where the use of eyeglasses or lenses is required after surgery.

When cataracts are present in both eyes, cataract surgery is generally performed about one week apart. In this way, enough time is allowed for the operated eye to heal. The intraocular lenses used in cataract operations are designed to be permanent and do not require replacement. In some rare cases, a second cataract surgery may be needed. The artificial lens placed may lose its transparency and become cloudy over months or years. In these cases, a laser surface cleaning procedure may be performed to remove the cloudiness on the lens surface.

A cataract can significantly reduce the quality of vision and may pave the way for permanent eye problems. Although advanced age is an important risk factor for cataract, cataracts can also be seen in young people. If there are changes in vision or abnormal symptoms, it is important to apply to a healthcare facility and undergo an examination by a specialist eye doctor. Because vision problems caused by cataracts make life considerably more difficult, cataract surgeries are recommended by specialists. Cataract surgeries provide improvement in approximately 90% of patients, while the procedures are effective, reliable, fast, and relatively painless.