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Cataract – My doctor says get operated : Should I ?

• What is cataract ?

The normal human eye is like a camera. To focus images as in a camera it has a lens. This is normally optically transparent. With age or due to certain factors like trauma it starts losing its transparency and becomes opaque. The development of opacity in the lens or its capsule is called as cataract. In Hindi it is called Safed Motiya . Not to be confused with Kala Motiya, which is Glaucoma and a very different eye disease.
The more denser the opacity (cataract) the more obstruction to light will this cataractous lens cause. Thus as the density and amount of cataract increases the vision of the patient decreases.

• So when do I get operated for cataract ?

Today, with the modern technology it is not advisable to wait till the cataract matures ( becomes fully opacified) for getting the cataract surgery done. Somewhere between early cataract and advanced cataract lies the right time for surgery.

• How to ascertain this right time for surgery ?

If you feel that your vision has dropped to a level which hampers your daily activities and your doctor has attributed the cause of loss of vision mainly to cataract i.e. the other components of the eye like cornea (outermost transparent layer of the eye), retina (the light sensitive part of the eye where images are formed , akin to film in a camera) or optic nerve (the nerve transmitting images to the brain) etc. do not seem to be contributing to your loss of vision , the time has come for you to get cataract surgery done.
Apart from this if your doctor feels that your cataract is hampering his/her visualization of the internal structures of the eye like the retina and the retina has to be examined for various reasons, he/she might ask you to consider getting a cataract surgery done.

• Is there any particular season of the year when cataract surgery is to be done or to be avoided ?

With modern technology there is no time of the year when you should not get operated. A particular season is bad to get surgery done is a myth.

• What is the latest technique today to remove cataract ?

The most commonly used latest procedure for cataract surgery is called Phacoemulsification. It uses ultrasound energy to emulsify the cataractous lens enabling the surgeon to then remove it through a very small opening made in the eye.
Also through this small opening an artificial lens can be implanted into the eye to compensate for the removed natural lens. If a foldable lens is used the opening need not be enlarged and the surgery is sutureless. In case less expensive non-foldable lenses are implanted the opening in the eye has to be slightly enlarged and may require a few sutures for closure at the end of the surgery.

• Are Intraocular lenses harmful and how long do they last ?

Intraocular lenses today are a boon to cataract surgery. They are absolutely safe. The lenses today are made of materials which are absolutely inert and do not undergo changes inside the body. Thus there is no question of how long they last…. the lenses last a lifetime.

• When can I resume work after Phacoemulsification surgery ?

After an uncomplicated phacoemulsification recovery is very fast. Few precautions are required for a few days and work can usually be resumed within a week of surgery.

• What precautions are to be taken after surgery ?

Care has to be taken to prevent injury and infection. So do not rub the operated eye. Use eye drops as prescribed by the doctor. Do not put water in the operated eye for a few days. You do not need to bandage the eye unless told by your doctor. Use sterile cotton or boil cotton in water to sterilize it, cool it to room temperature and then use to gently clean the eyelids.

• Do I need to wear glasses after cataract surgery ?

Your doctor will check your power a few weeks after cataract surgery. If standard intraocular lenses are used then you will require glasses post-operatively, which might be for near vision, distance vision or both. Glasses may not be required if latest multifocal intraocular lenses are used. However the experience with these lenses is limited and very precise intraocular lens power calculation and placement in the eye is required if they are to be used. Also they are said to reduce the contrast/brightness of the image. Due to these drawbacks the most common intraocular lenses being used presently are monofocal and thus post-operatively glasses are required by many patients.

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