A cataract is a clouding of the lens, regardless of the cause, size, amount, location, density, and whether it affects vision. Cataracts are commonly caused by ageing, trauma, metabolic diseases, drug intoxication, radiation damage, and so on. The most common type of cataract in clinical practice is senile cataract.
What are the dangers of cataracts?
The main danger of cataracts is the loss of vision to varying degrees and even blindness. Cataract is one of the leading causes of blindness not only in developing countries, but also in developed countries. At present, about 17 million people worldwide are suffering from severe vision loss due to cataracts, and the number of newly blinded patients with cataracts is increasing every year.
The incidence of senile cataract in China is significantly higher in the south than in the north, with the highest incidence in Tibet. As people live longer, the prevalence of senile cataracts will also increase year by year. In addition, when cortical cataract develops into the swelling phase (also called immature phase), the lens gradually absorbs water and becomes more cloudy and swollen, pushing the iris forward and causing the anterior chamber to become shallow. At this time, patients with closed-angle glaucoma qualities are prone to glaucoma attacks.
What types of cataracts are there?
Cataracts can be classified according to the principle of classification. According to the age, they can be divided into congenital, youthful, adult and senile cataracts; according to the cause of their occurrence, they can be divided into traumatic cataracts, concurrent cataracts, metabolic cataracts combined with systemic diseases, cataracts caused by drugs and poisoning, developmental cataracts and posterior cataracts. There are also various classifications based on the location of the clouding, the degree of clouding, and the form of the clouding.
What is senile cataract?
Geriatric cataract, also called age-related cataract, is the most common type of cataract, mostly seen in middle-aged and elderly people over 50 years old. It is a degenerative change that occurs gradually during the aging process of the lens. Most of them have bilateral onset, but the onset can be either first or later. In recent years, ophthalmologists have found that age-related cataracts are the most common type of blindness among the elderly, accounting for 49.77% of the cases, and the percentage increases with age. Nearly 90% of people over the age of 60 can have lens clouding, but most develop very slowly, which in turn affects vision. It can take months to years from onset to maturity.
What does it feel like to have a cataract?
The main symptom is progressive vision loss. In the early stages patients often have a fixed black spot in front of their eyes, or they may have symptoms of diplopia or hyperopia in one eye. Depending on the type of cataract, the clinical presentation can vary. For example, nuclear cataract develops very slowly, and the patient’s vision is still good at the beginning, then gradually decreases and becomes nearsighted, and the vision can be improved with glasses and can read and write without glasses, which is called second sight. Subcapsular cataract, on the other hand, can affect vision at an early stage because the clouding is mostly located in the central axis.
Why should I have regular eye exams if I have cataracts?
The only symptom of cataract is painless visual impairment. However, many eye diseases have symptoms similar to cataracts, so when you feel abnormal vision, you must go to the hospital and have a careful specialist examination by an ophthalmologist to identify whether you have a cataract. Some patients do not go to the hospital regularly for checkups. As a result, they are not aware of other painless eye diseases, such as chronic angle-closure glaucoma, macular degeneration, fundus and vitreous hemorrhage, and so on. When the vision is seriously impaired, the above diseases have developed to a more serious degree to mean that the best time for treatment is missed. In this case, even if cataract removal is done, satisfactory vision cannot be restored.
What treatments are available for cataracts?
With the aging of the population, senile cataract has become a common and frequent disease worldwide. Surgical removal of the clouded lens is still the most effective method (short-term plan), while slowing down the development of cataract (long-term plan) has also made meaningful progress in some aspects with the exploration of the pathogenesis of cataract and the gradual advancement of research on drug prevention and treatment. At present, there are many anti-cataract drugs sold at home and abroad. Although theoretically they try to treat them from preventing the abnormal metabolism and protein degeneration of the lens, there is no precise and simple scientific quantitative detection method and comparison of the change of crystal clouding, but only from the patient’s subjective feeling and change of vision, so there is no exact evaluation of the efficacy.
When is it time for cataract surgery?
In the past, the traditional belief was that cataract surgery could only be performed when the cataract was mature, which was a viewpoint formed by the limitation of traditional surgical methods. With the development of modern medicine, ophthalmic microsurgery has become very mature and common, and modern cataract extracapsular extraction and crystal ultrasound emulsification surgery can also achieve good treatment results for immature cataracts. Therefore, in order to improve the quality of life, cataract patients can undergo surgery when they feel that their visual impairment has affected their normal work or life, instead of waiting until the cataract is mature.
Is it bad to wait for the cataract to mature before having surgery?
Yes, because this will make cataract patients and their families enter a dangerous misunderstanding, thinking that the vision loss is only due to cataract, and waiting in a long chaotic life, so that they do not know that they have other eye diseases, delaying the treatment, resulting in the final failure to restore their eyesight even after cataract surgery. Secondly, for patients with nuclear cataract, the older the nucleus of the cataract is, the more difficult and longer the surgery will be, and the more energy is needed for ultrasound emulsification. The higher the energy required for ultrasound emulsification, the greater the damage to the corneal endothelium, and the greater the likelihood of future corneal clouding. In some cases, the traditional large incision approach has to be used in order to avoid these negative consequences.
Can elderly people undergo cataract surgery?
In February 1999, the World Health Organization (WHO) and international non-governmental organizations (NGOs) jointly launched the “Vision 2020, The Right to Sight for All” initiative, with the following goals To eliminate avoidable blindness worldwide by 2020. Therefore, advanced age, diabetes, hypertension, and senile encephalopathy are somehow not a reason to refuse surgery. All people have the right to see, as long as their systemic diseases are controlled and their health indicators are within the scope of the surgery.
How is cataract surgery done?
With the advancement of medicine and the rapid changes in medical technology, cataract surgery has become safer, shorter and less painful for patients. The most widely accepted and used surgical method in clinical practice is the ultrasound emulsification technique. In this method, the cloudy lens is broken up by ultrasound and aspirated through a 3mm diameter incision, and then a folded IOL is implanted through this 3mm incision. The procedure takes about 10 minutes or so, the patient is in no pain, and the best vision is obtained the day after the procedure. With the development of science and technology, cold super-emulsion cataract surgery and ultra-small incision super-emulsion surgery have also gradually come into people’s view, bringing a boon to cataract patients.
Can cataract surgery still be done if one is suffering from diabetes, hypertension and other systemic diseases?
The answer is yes, it can be done, however, the systemic diseases should be controlled in a stable state before the surgery is performed. In particular, it should be suggested that for diabetic patients, cataract surgery is performed not only to improve vision and quality of life, but also to facilitate observation of the retina under the eyes and early detection of diabetic retinopathy to facilitate control of disease progression. Therefore, for diabetic patients, not only can cataract surgery be done, but it is also very necessary.
Why is it necessary to implant an IOL after cataract surgery?
The lens is like a magnifying glass in the human eye, it has a degree. If the cataract is simply removed without implanting an IOL, the eye will be highly farsighted, and it will be very unclear to see things.
How should IOLs be selected?
The current IOLs can be divided into two categories, hard IOLs and soft IOLs. Hard IOLs have an optical diameter of about 5.5 to 6.0 mm, and because they cannot be folded, Gu needs to go through a large incision to be implanted in the eye. The folding soft IOL has the same optical diameter as the soft IOL, also about 6 mm, but because it can be folded, it can be implanted into the eye through an incision of less than 3 mm, so it can overcome the disadvantages of the hard IOL, and the recovery from surgery is fast, greatly reducing the patient’s pain. However, this kind of IOL is very demanding in terms of material and process, and generally relies on foreign imports, so the price is higher, costing about $2,000 or even more. With the development of technology, many IOLs with more advanced design concepts, such as aspheric IOLs, multifocal adjustable IOLs, blue light filtering IOLs, and some special types of IOLs, have been applied to the clinic to bring better visual quality to cataract patients. Patients can choose IOLs according to their financial situation and needs under the guidance of doctors.
What should I pay attention to after cataract surgery?
After cataract surgery, patients can move normally and do not need bed rest. However, they should avoid strenuous exercise, heavy lifting, bending and head bowing in the short term, and the elderly should avoid constipation. In terms of diet, adequate nutrition is needed, especially to provide sufficient high-quality protein, while eating sufficient vegetables and fruits to supplement vitamins. All of these can facilitate recovery after surgery. However, for patients with co-morbid systemic diseases, especially diabetes, the diet still needs to be controlled according to the requirements of systemic diseases.
How can I avoid getting senile cataracts?
Age-related cataracts are one of the manifestations of human aging, just like people grow gray hair and wrinkles when they get older. So far, there is no method to avoid the occurrence and development of cataracts, but some healthy lifestyles, such as consuming sufficient vitamins, avoiding smoking and drinking alcohol, reducing ultraviolet stimulation, and carefully treating systemic diseases such as diabetes and kidney disease, are good ways to slow down the A good way to delay the occurrence and progression of cataracts.