|
When a cataract is small, you may not
notice any changes in your vision. Cataracts tend to grow slowly, so
vision gets worse gradually. Some people with a cataract find that
their close-up vision suddenly improves, but this is temporary.
Vision is likely to get worse again as the cataract grows.
Back to Top
What are the
different types of cataract?
According to the National Eye
Institute, part of the National Institutes of Health, cataract types
are subdivided accordingly:
-
Age-related Cataracts
The majority of cataracts are related to aging.
- Congenital
Cataracts
Some babies are born with cataracts or develop them in
childhood, often in both eyes. Some congenital cataracts do not
affect vision, but others do and need to be removed.
- Secondary
Cataracts
Secondary cataracts develop primarily as a result of
another disease occurrence in the body (i.e., diabetes).
Secondary cataract development has also been linked to steroid
use.
- Traumatic
Cataracts
Eye(s) that have sustained an injury may develop a
traumatic cataract either immediately following the incident, or
several years later.
-
Nuclear Cataract
This is the most common type of cataract, and the most common
type associated with aging. Nuclear cataracts develop in the
center of the lens and can induce myopia, or nearsightedness --
a temporary improvement in reading vision which is sometimes
referred to as "second sight." Unfortunately, "second sight"
disappears as the cataract grows.
- Cortical
Cataract
This type of cataract initially develops as wedge-shaped spokes
in the cortex of the lens, with the spokes extending from the
outside of the lens to the center. When these spokes reach the
center of the lens they interfere with the transmission of light
and cause glare and loss of contrast. This type of cataract is
frequently developed in persons with diabetes, and while it
usually develops slowly, it may impair both distance and near
vision so significantly that surgery is often suggested at an
early stage.
-
Subcapsular Cataract
A subcapsular cataract usually starts as a small opacity under
the capsule, at the back of the lens. This type of cataract
develops slowly and significant symptoms may not occur until the
cataract is well developed. A subcapsular cataract is often
found in persons with diabetes, myopia, retinitis pigmentosa,
and in those taking steroids.
Back to Top
How is cataract
detected?
To detect a cataract, an eye care
professional examines the lens. A comprehensive eye examination
usually includes:
Visual acuity test: This eye
chart test measures how well you see at various distances.
Pupil dilation: The pupil is widened with eyedrops to allow
your eye care professional to see more of the retina and look for
other eye problems.
Tonometry: This is a standard test to measure fluid pressure
inside the eye. Increased pressure may be a sign of glaucoma.
Your eye care professional may also
do other tests to learn more about the structure and health of your
eye.
Back to Top
How is it treated?
For an early cataract, different
eyeglasses, magnifying lenses, or stronger lighting may improve
vision. If these measures don't help, surgery is the only effective
treatment. The surgeon removes the cloudy lens and replaces it with
a substitute lens.
A cataract needs to be removed only
if it affects your vision so much that it interferes with your daily
activities. You make that decision. If you decide on surgery, your
eye care professional may refer you to another specialist to remove
the cataract. If you have cataracts in both eyes, the surgeon will
not remove them both at the same time. You will need to have each
done separately.
Sometimes, a cataract should be
removed even if it doesn't bother you. For example, if it prevents
examination or treatment of another eye problem such as age-related
macular degeneration or diabetic retinopathy, a cataract should be
treated.
Back to Top
Cataract Surgery
If you've chosen to have surgery,
it's helpful to know more about it. This section describes the types
of cataract surgery, lens substitutes, and what you can expect
before and after surgery.
Is cataract surgery effective?
Cataract removal is one of the most
common operations performed in the Jordan today. It is also one of
the safest and most effective. More than 90 percent of people who
have cataract surgery have better vision afterward. However, even
with the best results, your vision may not be as good as before the
cataract.
Back to Top
How is a cataract removed?
Phtolysis
Almost everyone develops cataracts as
they age. The cloudy or opaque areas on the normally transparent
lens of the eye can lead to blurred vision, sensitivity to light and
glare, increased nearsightedness or distorted images. The new Dodick
System is the first laser system approved by the FDA for the removal
of cataracts. During the surgery, a physician makes two tiny
incisions - nearly half the size used in traditional cataract
surgery. This technique promotes faster healing. The 10-minute
procedure removes the cloudy lens and replaces it with a new
artificial lens, and the patient can return home immediately with no
stitches or eye patches.
Phacormulsification:
Phacoemulsification ("phaco") was
developed in the search for a way to extract cataracts through a
smaller incision. It has become the preferred technique for cataract
extraction. An ultrasound or laser probe is used to break the lens
apart without harming the capsule. These fragments are then
aspirated out of the eye. A foldable intraocular lens (IOL) is then
introduced through the 3mm incision. Once inside the eye, the lens
unfolds to take position inside the capsule. No sutures are needed,
as the incision is self-sealing.

The risk of astigmatism and
sudden pressure changes inside the eye are minimized. The procedure
is safe enough to be done under topical anesthesia (anesthetic
eyedrops). Visual rehabilitation is extremely fast and patients
don't need to suspend their everyday activities.
Extracapsular Extraction:
This is a rather old technique in
which a 12mm incision is performed in the eye to extract the lens as
a whole. The lens' capsule is left in place to hold an intraocular
lens. Multiple sutures are required to seal the eye after surgery.
These sutures must be carefully tightened not to produce
astigmatism.
Back to Top |