In today’s aging cities, the incidence of cataracts is increasing, and age-related cataracts are now the world’s leading cause of blindness. The “Vision 2020: The Right to See” initiative by the World Health Organization is a worldwide project to eliminate avoidable blindness, with the aim of eliminating cataracts as the main cause of disability and blindness.
So what is cataract?
In medical terms, we call cataracts the loss of vision caused by clouding of the lens inside the eye. The human eye is like a camera, and the lens is similar to the focusing lens of the camera. Through the changing convexity of the lens, we can see the objects at different distances in front of us.
It is evident that cataract is a disease closely related to age. So far, no drug has been developed to cure cataract, and the current drugs can only slow down the development of cataract. Since senile cataract has a very slow aggravation process, which is a degeneration of the lens caused by gradual aging of the human body, patients should not feel fearful about it. Moreover, patients usually have a gradual vision loss process over a long period of time, which does not interfere with daily life as long as reasonable measures are taken.
Cataract symptoms and course?
As the lens is part of the refractive system of the eye, early clouding of the lens is usually asymptomatic when it is mild or has not yet reached the visual axis. If you are driving at night, you may feel uncomfortable with the headlights of cars coming from the opposite direction. Some of them are very happy and feel that they are getting younger and younger and “rejuvenated”, but in fact, this is not a good sign. In fact, this is not a good sign. This is one of the symptoms of cataracts, which develop quite slowly, and when the clouding of the lens becomes severe, the vision will be greatly reduced. Fortunately, with the current level of medical technology, cataracts have become a curable eye disease.
A word of caution: many older adults between the ages of 50 and 70 have many other problems that can affect their vision at the same time. For example, refractive problems, and refractive changes are often accompanied by cataract disease course, and the mixed symptoms can bring a lot of troubles to patients. Therefore, patients should have a detailed eye examination to understand their eye condition, and usually, surgery can be considered for correcting vision to about 0.3.
Cataract surgery timing and indications?
When the visual acuity drops to 0.3, the low vision status has already affected the daily life and mobility of the elderly, it is necessary to restore the original vision through surgery to replace the IOL. Currently, the lens implantation surgery is the most ideal microscopic minimally invasive surgery, which has the advantages of short operation time, small incision, fast recovery of vision after surgery, and minimal harassment to intraocular tissues. All patients can recover their visual acuity after surgery. It is now common in developed countries for patients with visual acuity of 0.5 to undergo surgery, and the number of cases with such requirements is increasing in China; for a person who is engaged in delicate work and needs more visual acuity, surgery can be performed earlier. For a person who does not require high vision, it is not a bad idea to wait until the vision is below 0.3. In any case, the timing of surgery must be determined from the patient’s actual requirements and discussed between the doctor and patient. In addition, there are many types of IOLs for replacement. In China, due to economic constraints, the use of IOLs with good distance and near adjustment ability is not yet common, so there is a need to wear suitable glasses to help improve vision after surgery.
What should I do before surgery?
With the increasing popularity and maturity of cataract ultrasound extraction and IOL implantation, outpatient surgery under surface anesthesia is becoming the trend. Patients only need to be examined three days in advance and use antimicrobial eye drops. Patients only need to remain quiet and assisted for about 15 minutes during the surgery, without random coughing or movement, and the surgery can be completed successfully. Cataract surgery has evolved from simple sight restoration surgery in the past to refractive surgery in pursuit of higher visual quality. Before the surgery, the surgeon must understand the patient’s eye condition with the help of professional examination equipment and will have a prediction on the recovery of vision after cataract surgery. Patients also want to know how much vision can be restored through surgery. Usually we use type A and type B ultrasound to find out whether there is vitreous lesion, retinal detachment or intraocular mass, and also to find out the length of the eye axis and the condition of the lens. Electroretinography (ERG) is used to evaluate the retinal function. In order to exclude the visual impairment caused by macular degeneration and visual pathway disorders, VEP can be performed before surgery for monocular cataract patients. In addition, the macular function of immature cataracts can also be examined with a visual interferometer to determine the extent of postoperative vision recovery.
A series of examinations will be performed to rule out other eye diseases that may be hidden or coexisting, such as diabetic fundopathy, glaucoma, macular degeneration, etc., to avoid cases of non-improved vision after surgery. The surgery removes the cloudy lens and replaces it with an IOL equivalent to a +10 to +12D lens, which focuses the external objects on the retina. Although the IOL compensates for the refractive power of the own lens, the IOL is still defective in that it cannot change in convexity as freely as the own lens, so many patients have to rely on different glasses to obtain the most ideal visual status after surgery, therefore, both doctors and patients should communicate thoroughly about some clinical issues before surgery. In conclusion, from a practical point of view, let patients get rid of the inconvenience and pain caused by cataract as soon as possible. With the development of medical technology, it has become a reality to make patients see a bright and clear world in time What do we do after surgery?
After cataract surgery, patients may not adapt to the strong light at the beginning, so they can wear sunglasses to block the strong light, and also avoid collision with the operated eye to avoid poor healing of the incision and cracking.
1. The operated eye should be treated with antibiotic and hormonal eye drops in strict accordance with medical prescription to control the postoperative inflammatory reaction. If the condition permits, the family members should complete the eye medication, pay attention to clean hands before ordering eye medication, do not squeeze the eyeball, and avoid low head picking up objects and strenuous activities in the short term.
2, but also regular outpatient follow-up review of the operated eye, while the initial postoperative period should not be excessive eye use, so as not to aggravate eye congestion and visual fatigue.
3, 3 to 6 months after surgery, you can consider optometry to wear suitable distant and near glasses.