Cataract is a common and frequent disease in the elderly and has a great impact on their lives. Therefore, it must be carefully prevented and scientifically treated in order to protect the health of the eyes.
There is a tissue called “lens” in the structure of human eye, which is an important part of the refractive system of the eye. It is a biconvex lens, like the lens in a camera, and has a refractive effect on light. It changes the refractive power by contracting or relaxing the ciliary muscles, so that the focus of light on the retina can be accurately focused when looking far or near, and it also filters out some of the ultraviolet light to protect the retina. The lens is transparent, but if it becomes cloudy and opaque, it eventually affects vision and blurs the patient’s vision, which is called cataract.
The etiology of cataract: The etiology of cataract has not been fully elucidated accurately so far. Currently, medical science believes that there are various causes, such as aging, local nutritional disorders, diseases (diabetes, hypertension, other eye diseases, etc.), immune and metabolic abnormalities, trauma, long-term ultraviolet radiation, drug poisoning, radiation, and even genetic and emotional factors, which can cause lens clouding and lead to cataract. Clinically, cataracts are mostly seen in people over 50 years old, mostly in the 60s and 70s, and the older the age, the higher the incidence, and almost 100% of people over 80 years old suffer from cataracts. This indicates that cataract is actually a disease related to aging, except for congenital and trauma.
Clinical manifestations of cataract: blurred vision is the main symptom of cataract. The onset of cataract can be sequential in both eyes, with unilateral or bilateral blurring, and some people have progressive vision loss, glare, or monocular diplopia or increased myopia. Patients should go to the hospital for examination as soon as the above conditions appear.
Cataract treatment: At present, there are no less than dozens of drugs commonly used for the treatment of cataract, such as eye drops or oral Chinese and Western medicines, but clinically, there is no drug that can effectively stop or reverse the formation and development of the disease, and the drug treatment of cataract is currently in the exploration and research stage both at home and abroad. For some early-stage cataracts, Chinese medicine practitioners may use drugs to tonify the liver and kidney, and tonify the qi and blood to brighten the eyes, which may slow down the development of the disease to a certain extent and improve the vision of individual patients. The only and radical treatment for cataracts is surgery, which is a great achievement of modern medical development. In the past forty to fifty years, there were many blind people who had cataracts, so we hope that those who need surgery will not refuse this good thing to let them see again. Moreover, cataract surgery is now very mature, and the success rate is almost 100%, especially our Chinese doctors, because there are many clinical cases, there are more opportunities for surgery, so they are skilled, and the level of surgery is far more than that of ophthalmologists in other countries, which further increases the insurance factor of surgery, and patients’ fear of surgery can be dispelled. It should be noted that some people in the society nowadays take advantage of the elderly’s fear of surgery and claim that their drugs or health care products “can cure cataract”, which is unscientific. Otherwise, they may lose money and delay their illness, which will cause endless harm.
Cataract surgery is the use of ultrasound emulsification instrument, through about 3 mm size corneal or scleral incision, the application of ultrasound to crush the nucleus of the lens, so that it is celiac, and then together with the cortex, suction out, while implanting artificial lens. There is no anesthetic, no sutures, and under normal circumstances the entire procedure takes only three to five minutes. Compared with traditional cataract surgery methods, ultrasound emulsification surgery has better results and has become the most advanced and reliable cataract treatment method recognized internationally. So, what is the need for surgery? It is generally written in textbooks that “cataract patients with vision below 0.1 need surgery”. In fact, in clinical practice, there is no need to stick to this statement. Clinically, it is normal to operate on patients with visual acuity of 0.4 to 0.6, and some even operate on 0.8 to 1.0. What’s going on here? It turns out that although some patients have a vision of 0.8 to 1.0, they may only be able to see through a very small hole, but most of the rest is blurred, just like when we do not pull the curtain tightly, most of the outside of the window is invisible, but we only see some light outside from the place where it is not pulled tightly. Such a patient should also undergo surgery.
Fundamentally, whether surgery can be done or not depends on three things: first, the patient’s self-reported blurred vision (confirmed by examination to be caused by cataract) and request for surgery; second, the doctor’s medical skill; and third, the condition of medical equipment. From our doctor’s point of view, we advocate that the earlier cataract surgery is done, the better. If done early, the lesion is softer and the cloudy lens can be easily broken and extracted; while if done late, the lesion is hardened, just like a hard-boiled egg, it is not easy to be broken and extracted, and it is also easy to produce complications.
Postoperative patients need to pay attention to.
①Pre-operative whole body and local examination should be done as a way to assess the safety of the operation, and patients should not mind the trouble.
②Patients with hypertension, diabetes, infected lesions and cough should have their conditions controlled and stabilized before performing the surgery.
③ Wash your hair and do not use any cosmetics on your eyes the day before or on the day of surgery.
④ Order at least one day of anti-inflammatory eye drops (issued by the hospital).
⑤ Some patients who usually take anticoagulant drugs such as warfarin and aspirin should stop taking them three days before surgery to prevent bleeding.
⑥A family member must accompany you on the day of surgery.
⑦Patients should adjust their psychology, not to be nervous and fearful, be calm, and trust the doctor’s medical skills. From our doctor’s point of view, the greatest joy is to see the disease cured by our hands and the patient restored to health. Therefore, the goal of doctors and patients is the same.
Things to know and pay attention to after surgery are
①It is normal to have slight wound pain on the day of surgery, occasional headache and nausea, these symptoms will gradually disappear after a day.
②Do not rub your eyes with your hands to prevent infection.
③Lie flat in bed and rest as much as possible.
④Within one month of surgery, go to the hospital once a week for a review to check the recovery of the eyes; if there is stinging and redness of the eyes, a lot of eye discharge, constant tears and sudden loss of vision, go to the hospital immediately for medical consultation.
⑤ Post-operative eye drops are mostly hormone-containing and should not be used for a long time, and should be used or discontinued under the guidance of a doctor.
⑥Be careful not to contact the bottle with your eyes when ordering eye drops to avoid contaminating the eye drops. Also be careful not to put them together with other liquid drops to avoid serious consequences if you order them wrong.
(7) It is advisable to move slowly in daily life, and it is best to be accompanied by someone. When going out or sleeping, you can wear glasses or an eye shield for protection.
8) Try to avoid hard work such as lifting heavy objects, do not eat hard things such as crushed beans, irritating things such as chili and wine, and eat more vegetables, pears, bananas and honey to prevent constipation.
After surgery, a few patients may develop new cataracts, i.e., another layer of film grows behind the lens, which affects the vision. Do not be nervous, ask the doctor to make a laser to penetrate the film, then you can restore your eyesight.
The IOL can be used for the rest of your life, but this does not mean that you will never suffer from eye disease or blurred vision again. In fact, there are many different causes of blurred symptoms, not just cataracts. We are just saying that that cataract problem is solved, and other eye diseases still need to be prevented.
Prevention of cataracts: We talked about the causes of cataracts earlier, and this lays the foundation for prevention. Now that we know how cataracts are obtained, we should prevent them from the opposite direction of those causes. For example, we should pay attention to health care and slow down aging; have a reasonable diet structure and diversify food to ensure adequate nutrition; actively treat diabetes, hypertension and other eye diseases; strengthen physical exercise to improve immunity and promote normal metabolism; be careful in all movements in life and try to slow down to prevent trauma; wear sunglasses when going out in bright light to prevent ultraviolet radiation; be cautious in medication to prevent drug poisoning; be psychologically calm and maintain optimism to eliminate negative emotions. Maintaining optimism and eliminating negative emotions are all beneficial to cataract prevention.