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Diagnosis,Prevention and Management

Diagnosis of Cataract is done after a thorough assessment of symptoms and comprehensive examination of the eye on  annual/biannual visit to the eye doctor. The Ophthalmologist examines the patient’s eye for any kind of changes in the lens. The initial examination is followed by some specific tests that can more precisely evaluate the eye condition:

  • Visual acuity test is done to measure the reading vision and distance vision of the patient. It is generally poor in cataract patients.
  • Refraction to determine if glasses can improve vision and quality of life of the patient.
  • Slit Lamp Examination is done to verify the type of cataract, and the health of rest of the eye.
  • Glare sensitivity test is done to check the glare symptoms, with and without bright lights. A Cataract patient will notice strong glare in bright light.
  • Macular function test to evaluate the eye’s acute vision center to define expected improvement after surgery.
  • Contrast sensitivity test to check patient’s ability to differentiate between different shades of grey.
  • Tonometry to measure fluid pressure inside the eye.
  • Pupil dilation is done using eye drops to thoroughly examine the lens and retina and also to rule out other eye conditions.
  • Certain advanced tests like an OCT or a topography may be advised and done especially so if you opt for premium lenses and if the eye doctor finds the need to do so after a comprehensive test to rule out certain co existing eye conditions that might hamper the visual outcome after a cataract surgery.

Cataract is not a preventable eye condition. However, the chances of developing a cataract may be delayed by the following:

  • Wearing UV protection sunglasses during day time/when out in snow/on altitudes.
  • Eating diet high in antioxidants, carotenoids, vitamins (especially C and E) and minerals (like citrus fruits and green leafy vegetables)
  • Following a healthy lifestyle
  • Doing regular eye exercises
  • Avoid smoking
  • Avoiding excessive amounts of alcohol (nutritional deficiencies)
  • Monitoring eye health in case of long term use of certain medications like corticosteroids and statins.
  • Controlling blood-sugar and blood pressure levels either through medication or by following healthy diet and lifestyle

Non Surgical treatment of Cataract:

When diagnosed in its early stages, you may have cataract symptoms like blurry /cloudy vision ,poor night vision, increased requirement of light for reading, light sensitivity, frequent change of eyeglass prescription,etc.

Although surgery is the only cure for cataract, it can be delayed till the time it does not cause gross vision loss or disturbs daily routine activity. In such cases there is a need of regular follow up and eye examination to track the progress of cataract. This is required to avoid any kind of sudden or unnoticed vision loss due to cataract.

Based on the level of discomfort or the degree it affects your quality of life, your eye doctor would suggest:

  • Change of eyeglasses or contact lenses
  • Better brighter lights for reading/working
  • Use of sunglasses/wide brimmed hats
  • Pupil dilating medications

 Surgical treatment of Cataract: 

The only way of managing a cataract and regaining the lost vision is by surgery.The surgical procedure has evolved over the years from a basic surgical incision (involving almost half the circumference of the cornea,with no IOL(Intra Ocular Lens) implantation,to the most advanced Minimal incision surgeries with advanced precision high end premium IOLs.

The various procedures that are done are:

  • SICS: Small Incision Cataract Surgery: this is a manual procedure with an incision size of 5-7 mm

 

  • Phacoemulsification: Here Ultrasound energy is used to breakdown the cataract into small pieces and emulsify (breaking into micro pieces) it and then wash and suck it out of the eye.

  • FLACS: Femto Laser Assisted Cataract Surgery: In this procedure,all the incisions and cuts that are required are made with the help of a femto laser,and then the cataract is removed with the help of the ultrasound/phacoemulsification technique.

The various IOLs that can be implanted are classified as:

  1. I) Rigid (these need larger incisions) or foldable ( they require smaller incisions )
  2. II) Focusing ability

Monofocal: are single focus lenses and correct either distance or near vision

Multifocal: These are lenses that correct both distance ,intermediate and near vision.

Trifocal:The intermediate distance specially used for computer usage is sharper.

EDoF: The technology used in making these lenses helps the patient see an extended range of intermediate vision,thereby adding better depth of focus.

III) Astigmatism Correcting/Toric IOLs : these IOLs correct the preexisting Astigmatism.They are either Monofocal,Multifocal EDoFs or Trifocals.

 

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