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Catract
 
A cataract is clouding of the eye's transparent natural lens and causes cloudy or foggy vision. Inside the eye, behind the iris, is a transparent lens that focuses light rays on the tissues of the retina behind the eye. When a cataract develops the lens becomes cloudy and prevents light rays from passing onto the retina. The picture the retina receives becomes dull and fuzzy. Cataracts usually form slowly and people experience a gradual blurring of vision. When this makes normal daily activities difficult it is time to get the cataract operated on.

Cataracts do not permanently impair vision and you will not go blind from a cataract. A simple operation will restore sight. Most forms of cataract develop in adult life and can occur any time after the age of 40. However, even young adults and children can develop cataracts.

The normal processes of ageing cause the lens to harden and become cloudy, but cataracts can also be caused by injuries to the eye like cuts, blows or burns to the eye. Its common symptoms are glare from lamps and sunlight, frequent change of glasses, difficulty in reading small print and cloudy vision.
DIAGNOSIS AND TREATMENT
In the early stages of cataract vision maybe improved by spectacles. But once diagnosed and and when the cataract progresses to the point that it interferes with daily activities an operation to remove the cataract is required. Surgery is the only effective way of removing the cloudy lens. It cannot be removed by laser, change in diet, or pills.
HOW IS A CATARACT REMOVED?
  1. Conventional Surgery: Normally a cataract is removed by making a 12 mm cut in the eye. A plastic lens, known as an Intraocular Lens (IOL), is permanently placed in the eye. Patients are advised to rest for one month. Normal vision after this surgery is usually attained after 6 weeks. The surgery costs Rs. 5000/-.
  2. Phacoemulsification (phaco) with Nonfoldable IOL: In this technique the cataract is removed with the help of an ultrasound machine and a rigid IOL is inserted through a 5 mm size incision. Sometimes, a single suture might be necessary. This surgery costs Rs. 6,500/-
  3. Phaco with foldable IOL: The cataract is removed through a small 3 mm slit in the eye and a foldable IOL is implanted. Sutures are not required.  This procedure can be completed without an eye injection and costs Rs. 10, 500/-
  4. Advantages of Phacoemulsification:
    Fast recovery of normal vision (usually within a week)
    Very few restrictions.
    No need for sutures.
SURGERY
If our ophthalmologist thinks your cataract should be removed you will be given a date for the operation. However, you must get clearance from a specialist physician before making an appointment.

Surgery is usually done as an outpatient procedure but a hospital stay maybe required in some cases. Surgery usually takes about 3 to 4 hours from the time of arrival to departure from the hospital. Every patient should be accompanied by an attendant, who must be an adult. A nurse will organise any tests for your general health, such as blood tests and electrocardiograph (ECG), to make sure you are healthy enough for surgery.

After surgery you will be sent home with post-operation instructions. In some cases the operated eye will be bandaged. You must return to hospital for removal of the bandages and a re-examination of your eyes. Post-operation medicines and other instructions will be explained in detail together with a further follow-up schedule.

If you have cataracts developing in both eyes you will not have treatment to both eyes at the same time. It is common for cataract to develop more quickly in one eye than the other and the more seriously affected eye is usually operated on first. Timing of an operation will be decided by an ophthalmologist.
RESULTS
The visual recovery following a cataract surgery depends not only on uncomplicated surgery but also on the condition of the retina and the optic nerve. Recovery may be slow if the nerves have become weaker due to other co-existing diseases like Glaucoma, Diabetic Retinopathy, Age Related Macular Degeneration (ARMD), Uveitis, past injuries etc. Every effort is made to diagnose and detect these problems prior to surgery. However, it may not be possible to do this in a case of advanced cataracts.

All surgery has its own risks. If complications occur during or after surgery vision recovery may be incomplete, or absent. Glasses may be required for reading and for clear distant vision even after Intra-ocular lens implantation surgery.
Can everyone have this operation?
A plastic lens implant is not suitable for some patients. In such cases the lens is removed and a contact lens (a lens fitting on the eye) or special glasses are given to the patient to correct vision. These are usually fitted some weeks after the operation.
Information for Parents:
Babies can be born with cataracts - congenital cataracts. If a child is born with a cataract surgery is usually performed as soon as possible to allow the child's sight to develop naturally.
If the cataract is not removed the child's eyesight will not develop normally as the brain does not 'learn' to see pictures properly.
Glaucoma can follow cataract surgery in children, particularly when cataract surgery has been performed very early in life.