With the popularization of science in recent years, patients and patients’ families have become more and more knowledgeable about cataract, but there are also some biases and misconceptions. Using the holidays, based on the interview in People’s Daily Online in September, we have compiled “50 Frequently Asked Questions on Cataract Prevention and Treatment”, hoping to make people’s understanding of cataract more systematic and comprehensive through an easy-to-understand Q&A format, and provide a little help for cataract prevention, diagnosis and treatment.
The concept of cataract
1.What is cataract?
Cataract is a disease with a very high incidence. Anyone who has used a camera knows that a camera has a lens, and the human eye has a convex lens-like structure behind the pupil, which is the lens of the camera. Once the lens is cloudy, it will block the vision just like a dirty camera lens, and this is cataract.
2.What are the types of cataracts?
According to the cause, they can be divided into: age-related, traumatic, concurrent, metabolic, radiation, etc.
According to the time of onset, it can be divided into: congenital type and acquired type
According to the morphology of lens clouding: punctate, coronal and lamellar cataracts, etc.
According to the location of lens clouding, it can be divided into: cortical, nuclear and subcapsular cataracts, etc.
3.What are the common clinical manifestations of cataract?
Since cataract is the most common in the elderly, we will mainly talk about the common clinical manifestations of cataract in the elderly. Usually, the most obvious manifestation of cataract in elderly people is that their vision is affected, and there may be some other symptoms, such as: the original presbyopia, seeing far away is normal, but seeing near is not clear, but after getting cataract, the presbyopia is better, seeing near is clear, seeing far is not clear; some elderly people have double vision, which is called diplopia; some elderly people feel that seeing is like a layer of fog. But in the case of strong light, the vision is extremely blurred, and it is even difficult to distinguish the face of an acquaintance across the street; then there is the problem of night vision. These are the early manifestations of cataract.
Causes of cataracts
4.What are the causes of cataract?
Except for traumatic cataract, radioactive cataract, congenital cataract and diabetic cataract, which have clear causes, the formation process of cataract may have various factors and the situation is quite complicated. The pathogenesis of common senile cataract has not been fully revealed so far, and it may be related to ageing, long-term excessive exposure to ultraviolet light, genetic factors, poisoning, certain inflammation in the eye, malnutrition, etc. In China, it has been confirmed by investigation that the incidence of cataracts is relatively higher in highland areas and areas with more sunlight radiation. This is because long-term exposure to ultraviolet radiation, which can affect the oxidation-reduction process of the lens and cause degeneration and clouding of lens proteins to form cataracts. In addition, diabetes, galactosemia and hypothyroidism, which are common in clinical practice, can also cause cataracts.
5. What are the causes of congenital cataract?
The incidence of congenital cataract is also relatively high among infants and children. Congenital cataracts generally occur in infants and children within one year after birth. Many of them are due to genetic factors, that is, several generations of ancestors have such genes, which are passed from generation to generation. In some cases, the mother is infected with a virus because she had a cold or flu during pregnancy, and this, combined with the indiscriminate use of medication, can cause cataracts in children after birth. There are also occurrences in premature babies, many of whom develop cataracts because they are placed in a warm box after birth and inhale high levels of oxygen. There are also some congenital cataracts that are not well understood. Then, there are diabetic cataracts caused by metabolic diseases like diabetes.
6. It is said that excessive salt intake and cell phone radiation can cause cataracts, is this correct?
There is no definite evidence that excessive salt intake can cause cataracts, and there is no evidence from authoritative institutions that cell phone radiation can cause cataracts.
Cataract risks and incidence
7.What are the dangers of cataracts?
Among the blind eye diseases, cataracts are among the top ones. Of course, with the change of people’s life in these years, many patients have received cataract surgery and regained their sight. Cataract was certainly the first eye disease that caused blindness in the early years, especially before the liberation, and now there are about 5 million blind people with cataract in China.
8.How high is the incidence of cataract in the elderly in China?
In China, the incidence of cataract in the elderly is extremely high, generally at the age of 45, and the incidence increases with age.
Cataract diagnosis and prevention
9.What are the symptoms of early cataract?
They are mainly manifested in the following aspects.
Vision loss: In any type of cataract, vision loss occurs in the initial stage.
Refractive changes: The original presbyopia is reduced and myopia is increased.
Due to swelling of the lens, there is monocular diplopia or hyperopia, i.e., overlapping of what is seen.
Glare: Decreased contrast sensitivity in bright light, glare at night under headlights.
Small and large black dots or streaks of shadow appear in front of the eye, commonly known as flying mosquitoes.
10.How is cataract diagnosed?
The diagnosis of cataract is not difficult. The doctor can confirm the diagnosis through dilated pupil examination if there are signs and symptoms mentioned above. Cataracts are sometimes associated with other diseases of the eye and may cause other complications, so you must be seen by an ophthalmologist. Once you are diagnosed with a cataract, you must have regular checkups and keep an eye on the progress of the cataract.
11. Is cataract a common cause of blindness in the elderly?
This statement is not true. Cataract is an age-related eye disease that causes visual impairment, especially after the age of 60, but there are also many other eye diseases as we age. For example, the incidence of diabetes is relatively high, and after years of elevated blood sugar, vascular problems will occur, often resulting in a series of diabetic retinopathy such as fundus hemorrhage, which can also cause vision loss or blindness. Another disease is age-related macular degeneration. As people age, the normal macula of the human eye will become diseased, resulting in vision loss, even to the extent of blindness, which is not cataract. Then there are other fundus diseases such as fundus hemorrhage caused by abnormal blood vessels, which can cause vision loss, and some others such as corneal diseases and glaucoma, which can affect vision.
12.How to prevent senile cataract?
The cause of senile cataract is not completely understood even now, so its prevention has been an important issue explored by the ophthalmic medical community. Clinical research shows that prevention can be done in the following aspects.
Hygienic use of the eyes: prevent the eyes from receiving long-term and large amounts of ultraviolet radiation, and the time spent reading, writing and watching TV should be properly controlled. Go outdoors every 1-2 hours to let your eyes rest for a while, and do not read in dark places. If you have farsightedness, myopia or astigmatism and other refractive errors, you should go to the hospital for optometry or to a regular professional optician to wear the right glasses to avoid eye strain. Do not just go to the stall or irregular optical store, without the correct optometry, buy a pair of glasses to wear, which will bring damage to the eyes. The elderly can wear sunglasses with UV protection when they go out in strong sunlight.
Reasonable arrangement of diet: three meals a day to ensure adequate nutrition, should eat more vitamin C, vitamin E rich food, less greasy, too salty food, such as apples, bananas, saints fruit and other vitamin-rich fruit, eat more spinach, sea green, broccoli and other dark green vegetables, eat more fish and other protein-rich food. Avoid smoking and alcohol, and avoid overeating.
Prevent dehydration. When the human body is dehydrated, the metabolism of fluid in the body is disturbed and some abnormal chemicals will be produced, which will damage the lens and lead to cataracts. Therefore, once you encounter diarrhea, vomiting and heavy sweating caused by various reasons, you should promptly replenish water, while usually you only need to drink plain water or tea.
Avoid cataract susceptibility factors. The lens is sensitive to various ionizing radiation, such as X-rays, infrared rays, ultraviolet rays, etc. Various chemical poisons and drugs in life can cause cataracts, such as glucocorticoids and chlorpromazine in drugs, trinitrotoluene (TNT), fluoride and various heavy metal ions in chemical agents.
In addition, we should keep emotionally relaxed and happy, quit smoking, ensure sufficient sleep, pay attention to eye hygiene and health care, and actively prevent and treat systemic chronic diseases such as diabetes.
13.How to prevent concurrent cataract?
The prevention of concurrent cataract is to actively treat the primary cause of cataract. Actively prevent and treat eye diseases such as iridocyclitis, chorioretinitis, glaucoma and retinal detachment. Once a patient has a complicating cataract, the lens and fundus should be checked regularly for further treatment measures in addition to active treatment of the primary cause. Complicated cataract is more difficult to treat and operate, has more complications, and the treatment effect is worse than that of senile cataract, so it is more important to prevent the occurrence of complication cataract.
14.When is the best time to start prevention of cataract?
However, the root cause of cataracts is not clear, especially the cause of aging, which is a metabolic problem, such as hair turning white, how to prevent hair from turning white?
15.How should cataract patients pay attention to their diet?
A reasonable and balanced diet is not only good for cataract but also for other organs of the body. Excessive intake of protein is a very unhealthy diet.
16.How to use the eyes to be healthy?
The most important thing is to pay attention to the combination of work and rest, for example, now we all use the computer, some people even use the computer 24 hours, continuous combat, and some people will look at the video overnight, which is not a healthy way to use the eyes. We generally say that each person should rest for 10 to 15 minutes after using the eyes for an hour or so, which is the best. For many people who work more intensely, may not be able to do this, after two hours of work should take a break, go out and look at the outdoor scenery, let the eyes rest. This is one of the most basic principles of eye care.
17. To what extent do cataract patients need to go to the hospital when they have symptoms?
It is recommended to go to the hospital when you find that your vision is gradually decreasing, for early detection and treatment.