When it comes to cataracts, many people immediately associate them with the elderly. This is not surprising, as cataracts are most prevalent in the elderly. However, cataracts are not unique to the elderly, and some basic knowledge about cataracts needs to be educated to the general public, and the following are some non-elderly cataracts.
What is the problem of having a “white-eyed” child?
People are most afraid of raising a “white-eyed wolf”, and they are cold-hearted when they find out that the fat baby they have worked so hard to give birth to is “white-eyed”. In fact, parents need not worry too much, because this “white light” eye is mostly congenital cataract (partial or complete clouding of the lens occurs in the first year of life), is a common eye disease among infants and children, but also the main cause of childhood blindness.
There are two causes of impaired lens growth and development.
① Endogenous factors: These are caused by chromosomal gene variants and have a hereditary and family history.
② Exogenous factors: This is the main cause of congenital cataracts, such as damage to the fetal lens when the mother is infected in the first two months of pregnancy, or when she suffers from infectious diseases such as rubella, chickenpox, measles, or mumps during the sixth month of pregnancy. Congenital cataracts can be caused by underactive thyroid, malnutrition, and vitamin deficiency. Congenital cataracts are still mainly treated by surgery. It must be emphasized that the proper timing of surgery is an important part in determining whether the child can recover his or her vision. In addition, corrective glasses should be worn early after surgery to avoid amblyopia; later, according to the patient’s eye development and visual acuity, the second phase of IOL implantation should be performed.
Traumatic cataract with or without IOL placement
People often say that they are “so sad that their hearts are cold” when they are emotionally frustrated; but for our beautiful eyes, the windows of our hearts, they may be “so injured that they are white”. This is because traumatic cataracts can be caused by eye contusions, penetrating injuries, chemical injuries, electric shock injuries and ionizing radiation, which can lead to lens clouding.
Traumatic cataract is a very special type of cataract that not only makes the eye “white” but also requires more trauma-related factors to be considered in its treatment. In addition to timely removal of the cloudy lens to prevent further infection, there are certain restrictions on the use of IOLs, and not all post-operative IOLs can be implanted, especially in traumatic cataracts, because serious post-operative complications can occur if IOLs are forcibly implanted.
Therefore, traumatic cataract should be implanted after surgery according to the specific situation. Phase I or phase II implantation should be chosen. Or not to put the IOL. The type of IOL also varies from person to person, for example, in general, anterior chamber type or suspension type IOL implantation can be used, and for patients with total iris loss, an IOL with iris is used.
What are the characteristics of cataracts in diabetic patients and treatment
Abnormal blood sugar in diabetic patients is a major cause of visual impairment. Abnormal blood sugar not only causes retinopathy, but also often causes cataracts. To treat diabetic cataracts, controlling blood sugar is the key, and only secondarily should you consider using eye drops in conjunction with cataract treatment.
If the cataract is so severe that surgery is necessary, then the key to surgery is also to control blood sugar. This not only facilitates wound healing, but also reduces the incidence of postoperative posterior cataracts as well as preventing further damage to the retina from blood sugar. Like diabetic cataracts, lens clouding due to metabolic disorders, or metabolic cataracts, are associated with medical disorders, such as galactosemic cataracts, twitchy cataracts, hypoglycemic cataracts, etc. The key to the treatment of these diseases is to treat the medical disease first and control the abnormal metabolism. Then only consider the ocular treatment of cataracts.
Can drugs and poisoning cause cataracts
As the saying goes, “it’s medicine that’s poisonous”. This saying is extremely true and is even more apt for the development of drug cataracts. Long-term application or exposure to drugs or chemicals that have toxic effects on the lens can lead to lens clouding, which is called drug and toxic cataract. Common drugs include glucocorticoids, chlorpromazine, pupil constrictors, chloroquine, etc. Chemicals include trinitrotoluene, dinitrophenol, naphthalene and mercury. For example, organ transplant patients who take anti-rejection drugs for a long time, or psychiatric patients who take anti-psychotic drugs for a long time are prone to drug cataracts.
The key to treating these cataracts is to stop the continued “poisoning” of the lens. The key to treating these cataracts is to stop “poisoning” the lens or to use drugs that can “detoxify” the lens. Even if the cataract is treated surgically, the patient should be taken out of the “toxic” environment as soon as possible after surgery.
Posterior cataracts that can be treated with laser
When doctors give the diagnosis of “posterior cataract”, many postoperative cataract patients are baffled. “Why do I still have cataracts after cataract surgery? Did I fall for the doctor’s trick again?”
In fact, after cataract extracapsular extraction or lens trauma, the lens cortex is not completely absorbed, and the remaining remnants become cloudy secondary to the residual capsule membrane of the lens, forming a layer of opaque mechanized film or, due to epithelial cell proliferation, transparent pearl-like vesicles. Those who severely affect their vision are called posterior cataracts, or posterior cataracts for short. The incidence of posterior cataracts in children with cataract surgery is almost 100%, which is related to the extremely high physiological metabolic function of children.
For this particular cataract, a laser is required, which means posterior cataractotomy done with the YAG laser. This is a procedure that uses the high energy of the YAG laser to open up the center of the posterior cataract to reveal a clear area in the center of the pupil area equivalent to the visual axis of the human eye, and the patient’s vision is immediately improved (some children with congenital cataracts require multiple laser treatments for their posterior cataract). If it is a very hard mechanized membrane, the YAG laser cannot cut through it and the posterior cataract can only be surgically cut out.