The eye is like a camera, and the lens is a transparent biconvex lens, just like the lens of a camera, through which light is clearly imaged on the retina. When the lens is cloudy, the transmission of light is affected and the vision becomes unclear. Cataracts are classified as developmental, senile, traumatic, toxic, and complications, all of which are caused by protein degeneration of the lens and clouding.
Geriatric cataracts, as the name implies, are age-related, which simply means that as a person ages, the lens becomes cloudy with age. The pathogenesis of senile cataracts has not been fully revealed so far and may be related to ageing, long-term overexposure to ultraviolet light, genetic factors, malnutrition, etc.
Cataract is a blinding disease, but it can be cured surgically. In the long history of mankind, cataract surgery has gone through several stages of development, and modern cataract ultrasound-emulsification surgery is nearly perfect. The procedure uses an ultrasonic emulsification machine to crush and aspirate the nucleus and cortex of the lens through a corneal or scleral incision of about 3 mm, preserving the posterior capsule of the lens so that a posterior chamber IOL can be implanted. The significant advantage is that the surgical incision is small, only 3 mm when the folded lens is implanted, the incision heals quickly after surgery, the corneal astigmatism is small, and satisfactory vision can be obtained at an early stage.
However, many people still have many misconceptions and misunderstandings about the treatment of senile cataract.
The first misconception is the excessive belief in drug treatment. At present, there is no special medicine for cataract. Many elderly people believe in medication for a long time and do not seek medical treatment in time even when their vision decreases, sometimes even delaying the best time to treat the eye disease. Even if the cataract is too advanced, it may not be able to return to the best visual quality even if it is treated by surgery. Therefore, one should not be overly superstitious about the effect of drugs on senile cataracts. Once the vision loss is serious, one should seek medical consultation and choose surgical treatment at an earlier stage.
The second misconception is that surgery can only be done when you can’t see. Some people think that surgery can only be done when the cataract is mature, i.e., completely invisible, which is an outdated view. With the application of small incision ultrasound emulsification technology and foldable IOLs, surgery can be performed as long as the vision is lower than normal and affects work and life. At this time, the surgical incision is small, less painful, less complications, faster post-operative recovery and better quality of vision. Moreover, overripe cataracts can also cause serious complications such as secondary glaucoma and uveitis; meanwhile, overripe cataracts are very large and hard, and ultrasonic emulsification surgery requires relatively large energy, which is damaging to the eyes. Generally speaking: elderly people can consider surgery when their cataract corrected vision is below 0.4.
The third misconception is that the elderly cannot have surgery. Some people think that surgery is unnecessary or dangerous because they are too old to have surgery. In fact, the current advanced cataract surgery has basically broken through the age limit, from 100-year-old people to children as young as 3 months old, all of them can be operated, and the real operation time only takes 10 minutes. Moreover, some elderly people with high blood pressure, diabetes and heart disease can be operated as long as their blood pressure, heart function and blood sugar are controlled by internal medicine within the relatively normal range.
The fourth misconception is that posterior cataracts can occur after cataract surgery, so why suffer the pain of surgery again. Post-operative cataracts occur in 10%-20% of patients who undergo surgery, which means that the capsule lining the IOL becomes cloudy after surgery and affects vision. If a posterior cataract occurs, it can be treated with laser therapy to restore vision immediately without the need for surgery.
The fifth misconception is that there is no harm in not having surgery when the cataract is ripe, that is, you cannot see. This view is very wrong and dangerous. These eye diseases mostly occur in the middle and late stages of cataract, such as expansion stage and overripe stage, which can not only cause blindness, but also sometimes cause serious inflammation in the eye, resulting in atrophy of the eyeball. Some patients may have to have their eyes removed because of long-term eye pain that is unbearable. Therefore, it reminds us that cataracts must be treated surgically when they reach a certain level.