When a patient is diagnosed to have cataract the following questions pop up immediately:
- Is it unusual at this age?
- Can it be cured with medication of any sort?
- Is the surgery a must? What if I do not get operated?
- How long can the surgery be avoided?
Cataract is the commonest cause of gradual, painless, progressive diminution of vision
in middle-aged and old people. The reaction of a patient varies from utter shock, disbelief to acceptance
and discussion of further treatment.
While cataract is known to occur at all ages and even congenitally, it is the senile, age-related, a cataract
that is the commonest in prevalence. People get cataract at different ages depending upon familial trends
and associated systemic illnesses and exposure to certain light frequencies.
Diabetes (and other metabolic afflictions), steroid intake and exposure to Ultra Violet light cause early
cataract formation. Trauma to the eye also causes cataract formation.
Why does vision decrease?
The normally transparent crystalline lens of the eye becomes translucent and some areas turn opaque,
thus causing scattering of light as well as a blockage. Location of opaque areas also matters as central
changes affect vision much earlier than those in the periphery. Opaque areas close to the nodal point of
the lens will affect vision profoundly even if small in size.
Is there a medical cure available?
In spite of tall claims no medical treatment has been established scientifically beyond doubt till now.
Anecdotal claims do not satisfy scientific hypothesis. Use of antioxidants may retard the progression
of cataract as a general anti ageing effect. Avoid using eye drops of unknown composition and dubious
sources in the name of magical cures! They may cause more harm than benefit.
What is the "Right Time" for surgery?
It depends on upon the lifestyle, profession and visual needs of a patient. It is ordinarily an elective
surgery and a patient should discuss all the elements of procedure and care with the surgeon and decide
on the timing of surgery. Surgery is aimed at improving "quality of life". Glare, difficulty in driving
and reading are some of the things that can affect the quality of life of a person and surgery is expected
to alleviate them. A driver, an IT professional, an avid golfer may choose to undergo surgery at an earlier
stage than a person who does not drive and read much.
Gone are the days when patients used to wait for the cataract to mature! Surgery time is decided after a mutual
discussion on outcomes and QOL targets. Surgery should not be postponed for long in case of advanced cataracts
as they turn harder with time and surgery becomes more challenging. There are situations when surgery can not be
postponed such as a swollen lens causing a rise in pressure or a leaky lens causing inflammation.
Cataract surgery is one of the most gratifying surgical procedures and safest as well. Do not get scared, discuss
the goals of surgery and take a cool decision.