What is a Cataract?

A cataract occurs when there is a progressive clouding of the eye’s natural lens, causing a decrease in vision. This decrease in vision will only get worse and over an extended period of time, if left undetected or untreated, it can lead to blindness.

What is an eye lens?

The lens is the part of our eye which helps focus light rays onto the retina. The retina and more specifically the macula (responsible for our central vision) are structures at the back of the eye which are light-sensitive and help form our central vision. This is where it converts the light rays to nerve signals which is then sent to the brain to form an image for our eyes to see.

The lens needs to be clear for the brain to receive an image. If the lens is cloudy or no longer transparent, it will form a blurred image.

What are the different types of Cataracts?

Age-related Cataract

As we age, the protein within our lens may clump together and start to cloud a small area of the lens. This is a cataract, and over time, it may grow larger and cloud more of the lens, making it harder to see.

Common types of Age-related Cataract include:

Subcapsular cataract occurs at the back of the lens, Nuclear cataract forms deep in the central zone (nucleus) of the lens and Cortical cataract is characterized by white, wedge-like opacities that start in the periphery of the lens and work their way to the centre in a spoke-like fashion.

Congenital Cataract

Cataracts can sometimes be present at birth as a result of infection during pregnancy, injury, delayed development or birth defect. Cataract can also be developed during the early stages of childhood. Congenital cataracts may be so small that no treatment is required. If it does affect the vision, then immediate removal of the cataract is required.

Traumatic Cataract

Cataracts can occur following a direct penetration or blunt trauma to the lens. The cataract can develop immediately or years later.

Secondary Cataract

These cataracts are often a result of other medical conditions such diabetes or glaucoma. Excessive use of steroids and exposure to radiation and UV light is also linked to cataract development.

Who is at risk of developing a Cataract?

The risk of developing a cataract increases with age.

Other risk factors include:

  • Prolonged health behaviours such as smoking and alcohol intake
  • High Myopia (short sightedness)
  • Patient who has had previous trauma to the eye(s)
  • Diabetes
  • Glaucoma
  • Long term UV light exposure
  • Obesity
  • Prolonged use of and high doses of steroid medications.

What are the symptoms of having a Cataract?

The main symptom people report is blurry or cloudy vision. This is due to the cataract inside the lens scattering the light entering the eye. Other common symptoms include:

  • Colours appearing washed out or faded
  • Glare – headlights, street lights or sunlight may appear too bright and halos may appear around lights.
  • Poor night vision – less able to read and drive at night
  • Double or multiple vision
  • Frequent need for spectacle prescription change.
How to prevent a Cataract from developing?

Cataract is a progressive eye condition which can eventually cause blindness if not detected or treated. There are many ways you can help prevent cataract development or slow its progression. These include:

  • Quit smoking
  • Reduce alcohol consumption
  • Wear sunglasses and hat when outdoors on a sunny day
  • Manage health problems such a keeping your blood sugar levels in check if you are Diabetic.
  • Maintain a healthy lifestyle – eat plenty of fruit and vegetables and exercise regularly
  • Have a regular eye examination – if you are age 50 or older, it is highly recommended that you visit an Ophthalmologist once every 2 years for an eye assessment.
How is a Cataract detected?

Cataract is detected through an eye examination by the Orthoptist and Ophthalmologist. During the examination a few tests will be performed, including:

Visual acuity test

This eye test will measure how well each of your eyes can see at near and distance

Slit-lamp exam

Your Ophthalmologist will closely examine your eyes through a special microscope. He or she will be able to see in detail your cornea, iris and lens, and will be able to pick up any abnormalities present. It is here that any signs of a cataract will be detected.

Retinal exam

Drops will be put in your eyes to dilate your pupils so the doctor can have a good view of the back of the eye. Your doctor will also look for signs of any other underlying eye conditions such as glaucoma and macular degeneration.

Cataract Surgery

When the cataract matures and interferes with your daily lifestyle, surgery may be the only effective treatment. Cataract surgery involves removing your eye’s cloudy natural lens and replacing it with a clear artificial intra-ocular lens (IOL). It is a day procedure which means there is no requirement to stay overnight.

Pre-operative tests for Cataract surgery

Before surgery, various measurements will be taken of your eye to help the Ophthalmologist choose the correct intra-ocular lens to implant in your eye. These measurements include your refractions, the length of your eye, and the curvature of your cornea.

Types of Intra-ocular Lens (IOLs)

We provide a range of refractive IOLs such as spherical, toric and multifocal IOLs which are tailored to your individual needs. Your ophthalmologist will discuss with you which is the most suitable IOL for you.

Cataract Surgery Procedure
  1. Anaesthetic

Prior to the procedure, the anaesthetist will put local anaesthetic in your operating eye and sedation to help you feel calm during the procedure.

  1. Phacoemulsification

The Ophthalmologist makes a small incision in the cornea and inserts a tiny probe that transmits high frequency ultrasound waves to break up the lens and removes it by suction. An IOL is then carefully inserted into the eye. The incision site is so small that no stitches are required.

  1. Laser-assisted Cataract Extraction

At iVision Clinic, we offer the latest cataract surgery technique – laser-assisted cataract removal. Femto laser is used to precisely cut open the anterior capsule and break up the cataract.

Advantages of laser assisted cataract surgery include:

  • Bladeless
  • Reduced energy to fragment the lens
  • More precise incisions
  • Centred and circular capsulotomy
After the Cataract Surgery

After the surgery, you will go home with a patch over the operated eye and eye drops to use for the next month. It is very important that you use the eye drops as prescribed by the Ophthalmologist to promote healing, attend post-operative appointments and follow post-operative instructions.

Risks and complications of Cataract Surgery

As with any type of surgery, there are risks associated with cataract surgery such as:

  • Bleeding in the eye
  • Infection
  • Glaucoma
  • Retinal detachment
  • Swelling of the cornea
  • Macular Oedema
  • Loss of vision
  • Ruptured lens – vitrectomy