Cataracts are changes in clarity of the natural lens inside the eye that gradually degrade visual quality. The natural lens sits behind the coloured part of the eye (iris) in the area of the pupil, and cannot be directly seen with the naked eye unless it becomes extremely cloudy. The lens plays a crucial role in focusing unimpeded light on the retina at the back of the eye. The retina transforms light to a neurologic signal that the brain interprets as vision. Significant cataracts block and distort light passing through the lens, causing visual symptoms and complaints.

Cataract development is usually a very gradual process of normal aging but can occasionally occur rapidly. Many people are in fact unaware that they have cataracts because the changes in their vision have been so gradual. Cataracts commonly affect both eyes, but it is not uncommon for cataracts in one eye to advance more rapidly. Cataracts are very common, affecting roughly 60% of people over the age of 60.


Why does Cataract occur?

The lens is made mostly of water and protein. Specific proteins within the lens are responsible for maintaining its clarity. Over the years, the structures of these lens proteins are altered, ultimately leading to a gradual clouding of the lens.

Uncommonly, cataracts can present at birth or in early childhood as a result of hereditary enzyme defects, and severe trauma to the eye, eye surgery, or intraocular inflammation can also cause cataract to occur earlier in life. Other factors that may lead to development of cataracts at an earlier age include excessive ultraviolet-light exposure, diabetes, smoking, or the use of certain medications, such as oral, topical, or inhaled steroids.

How do I know that I have Cataract?

Having cataract is often compared to looking through a foggy windshield of a car or through the dirty lens of a camera. Cataracts may cause a variety of complaints and visual changes, including: blurred vision, difficulty with glare (often with bright sun or automobile headlights while driving at night), dulled color vision.

Symptoms can be increased near sightedness accompanied by frequent changes in eyeglass prescription, and occasionally double vision in one eye. A change in glasses may help initially once vision begins to change from cataract; however, as cataract continue to progress and opacity increases, vision becomes cloudy and stronger glasses or contact lenses will no longer improve sight.

Cataract is usually gradual and not painful or associated with any eye redness or other symptoms unless they become extremely advanced. Rapid and/or painful changes in vision are suspicious for other eye diseases and should be evaluated by an eye-care professional.

How will my ophthalmologist decide whether I need surgery?

To detect a cataract, the eye-care provider examines your lens. A comprehensive eye examination usually includes the following:

  • Visual acuity test: An eye chart test is used to measure your reading and distance vision.
  • Refraction: Your eye doctor should determine if glasses would improve your vision.
  • Non-Contact Tonometry: a standard test to measure fluid pressure inside the eye (Increased pressure may be a sign of glaucoma.)
  • Pupil dilation: The pupil is enlarged with eye drops so that the ophthalmologist can further examine the lens and retina. This is important to determine if there are other conditions which may ultimately limit your vision besides cataracts. After dilation your ophthalmologist will do a slit lamp examination, grade your cataract and decide as when is laser (phaco) surgery advisable for you.

What are the surgical options for Cataract Removal?

With recent advances in techniques of Cataract surgery, it is not advisable to allow cataract to mature or harden. The harder the cataract, more phaco energy is needed, which causes more stress on cornea. Conventional Intra capsular and Extra Capsular techniques were for a very long time the preferred techniques for cataract removal, but the use of these techniques require large incision (Cuts) and stiches.

Currently Phacoemulsification is the procedure of choice for cataract removal. It is a very precise procedure which gives excellent results in expert hands. All the centres of ASG are equipped with the state of art Phaco machine from Alcon Lab., USA with advance Everest Software and Neo sonic hand piece. ASG Eye hospitals have now stepped into MICS technique which has made implantation of Toric, multifocal and Toric multifocal IOLs more comfortable for patient with highest precision of results.

Operating microscopes are from Carl Zeiss, Germany, which have excellent optical visualisation system and aid in tracking the minutest of the changes while operating.

What is an Intra Ocular Lens?

After removal of cataract with phacoemulsification technique, the surgeon implants an artificial lens in the eye which enables us to see after cataract surgery.

Does the quality of intra ocular lens make a difference?

Yes, it does. There are four basic types of lens:

  • Silicon material
  • PMMA material
  • Hydrophilic Acrylic
  • Hydrophobic Acrylic

Hydrophobic acrylic lenses are supposed to be the best.

Is freedom from glasses possible after cataract surgery?

  • Multifocal IOL have made it possible for one to be spectacle/ glass free after cataract surgery. Multifocal IOL can be Hydrophilic acrylic or Hydrophobic acrylic material.
  • Recent advances have made it possible for any person to have high cylinders to go for toric multifocal IOL.

These lenses enable both distance and near vision without glasses, so patient practically need not use any glass after surgery even if he is using glasses before surgery. Of course not everyone is eligible for such kind of lenses, your ophthalmologists can suggest you whether you are a candidate for such lenses.

ASG is a pioneer in the country regarding use of such kind of lenses.

Is the buzz regarding TORIC lenses true?

Yes, Alcon Lab. have come up with TORIC intraocular lenses which can take of your astigmatism also.

ASG and Cataract Surgery?

ASG specializes in suture less cataract surgery by phacoemulsification and phaconit, which uses minimal local anesthesia, even injection can be avoided. Patient returns to his/her routine activities the very next day, with no requirement of dark glasses. The patient is discharged after 2 hrs of surgery without a bandage. ASG uses state of the art phaco machine by Alcon Labs and microscope manufactured by Carl Zeiss at all its centers.  Most important, all the phaco surgeons have been extensively trained at best institutes in the country like All India Institute of Medical Sciences.

What are the precautions to be taken after surgery ?

  • Use the eye drops and medicines as prescribed.
  • Avoid rubbing or squeezing your eye
  • Protection: As advised by your doctor, you may wear the protective eye shield at night for first week. Dark eyeglasses may be worn during the daytime, especially outdoors, to avoid any discomfort that you may have from bright light and also to prevent any injury to eye.
  • Face wash: For the first few days, avoid splashing water directly into the eye. You may use a clean, soft, wet towel to wipe your face.
  • Shaving: Shaving of the beard is permitted after the operation.
  • Bathing: Body bath (below the neck) may be resumed after the first day, but avoid taking a shower or a bath in the bathtub for the first week after surgery.
  • Head bath: One may wash the hair with the head tilted backwards to avoid any water splashing into the eye.
  • Games: Normal daily activities including walking, reading and watching television may be resumed soon after the operation. However avoid strenuous activities like jogging, lifting weights, swimming, gardening, aerobics, contact sports etc. for 1-2 months.
  • Sex: You can resume your sex life a week or two after the operation after consulting your doctor.
  • Makeup: Avoid eye makeup for 6 weeks.
  • Diet: There are no dietary restrictions and you may take your routine diet. However, the restrictions as per you pre-existing medical problems, if any, are to continue. Avoid constipation by taking high fiber diet and plenty of fluids.
  • Driving: Avoid driving unless the surgeon permits you.
  • Job: You may get back to your job in 1-4 weeks after surgery depending on your profession. Ask your surgeon about this.
  • Normal symptoms: The following symptoms are normal and are not a cause for alarm. These are slight redness, mild watering, mild irritation, glare and slight drooping of upper eyelid. These will remain to some extent for 6-8 weeks.
  • Alarming symptoms: In case of any pain, injury, decrease in vision or flashes of light in the operated eye, contact your surgeon immediately.