The lens of the human eye loses its original transparency and turns bluish due to natural aging process as it ages, which is called cataract. Studies have shown that 8% of 50-year-olds, 27% of 60-year-olds, 57% of 70-year-olds, and 80% of 80-year-olds have cataracts that require surgical treatment. Cataracts are a progressive deterioration of vision, which is not corrected even with glasses. If one eye is normal and the other eye has cataracts, it may not be noticeable after the cataract has progressed significantly.
The most common cause of cataracts is senile cataracts that occur naturally with age. Other causes include congenital cataracts caused by genetic predisposition, trauma, diabetes, uveitis, skin diseases, overexposure to ultraviolet rays, overuse of drugs such as adrenal cortical hormones, vitamin E deficiency, and excessive drinking or smoking.
As the lens in the eye becomes cloudy, vision loss occurs. As the refractive index of the lens increases, things that were difficult to see due to presbyopia suddenly become visible. The symptoms that can be felt characteristically are as follows.
- Bright colors appear blurred.
- It is hard to see when you go out in a bright place.
- It is difficult to read in the dark.
- Even if the glasses are replaced, vision does not improve.
- Things appear blurry, double and triple.
- The vision of the glasses is gradually distorted.
Diagnostics and Tests
Cataracts can be suspected by hearing the patient’s age, medical history, and symptoms. For diagnosis, the pupil is enlarged using an iridodilator, and then the degree and position of the lens turbidity is confirmed by slit lamp microscopy (a test method that allows the eyes to be enlarged up to 40 times to be seen in detail by some microscopic examination). In addition, a visual acuity test measures how much vision has been deteriorated by cataracts.
Cataracts are not a disease that requires urgent treatment, but surgery is the only treatment if your vision has progressed enough to cause discomfort to your daily life. Cataract surgery removes the cloudy lens and then inserts an artificial lens into the capsular bag. The time required for surgery is about 20-40 minutes, and most patients undergo partial anesthesia rather than general anesthesia. Recently, even if a cataract operation is performed, the patient is not hospitalized and is stabilized for 3 to 4 hours after the operation and then discharged the same day. Patients should be careful not to get water in their eyes for about a week after surgery, and for a month, refrain from entering public baths, swimming pools and saunas. Eye drops such as antibiotics and anti-inflammatory drugs are used for about 4 weeks. During this period, the surgical site is healed and vision is restored.
Progress and Complications
After cataract surgery, more than 95% of patients have improved symptoms, and more than 90% of patients who have undergone an intraocular lens implant have their vision restored to 0.5 or more. Dryness and insomnia may worsen about three months after surgery, but symptoms usually improve. And in some patients, postoperative cataracts may develop that cause the capsular bag to become cloudy after surgery, which is not done again and can be corrected by laser surgery.
In general, there is no way to prevent cataracts caused by natural aging. However, for people with diabetes, good blood sugar control can reduce the risk of cataracts that can occur as a complication of diabetes.
Frequently Asked Questions
1. When do I need surgery?
Cataract surgery itself, like any other emergency, does not require surgery immediately after being diagnosed. In general, surgery is recommended when you feel uncomfortable with your daily life. However, if cataract progresses a lot, it is not only difficult to perform surgery later, but there is a risk of glaucoma, so it is necessary to undergo regular checkups at least every six months after the cataract is diagnosed.
2. Will both eyes be operated at once?
If you have a cataract surgery for both eyes, you usually don’t do both at the same time a day. After monocular surgery, the vision of the opposite eye can be predicted more accurately by referring to the vision of the operated eye. Normally, cataract surgery is performed on the other side at a distance of one week.
3. Is it possible to operate even in the elderly?
Older age does not mean that surgery is impossible. Since cataract surgery is usually performed under local anesthesia, age is not a problem if the condition is healthy enough to cooperate during surgery.