What is Cataract?

A cataract is a clouding of the normally clear lens of your eye. There is a lens (lens) in the eye that we all have from birth. Lens and lens are known by different names among the people and in medical language, but both express the same tissue. The lens inside our eye changes its shape, allowing the eye to see clearly over distances. In other words, it ensures that the visual cells are sent clearly to the retina, to create clear images of objects at various distances. As long as the image from the lens is blurred, the image carried from the retina will also be blurry. Although the other layers of the eye are completely healthy, only the cloudy lens prevents the person from seeing.

For people with cataracts, the world they see is a bit like looking through a frosted or misted window. Blurred vision caused by cataracts can make it difficult to read, drive (especially at night), or see the expression on a friend’s face.

Most cataracts develop slowly and do not impair your early vision. But over time, cataracts eventually affect your vision, changing your quality of life.

Factors that increase your risk of kata include:

CAUSES OF CATARACT

There are a number of building blocks inside our lens, the most important of which are proteins and water. Cataracts start when proteins in the eye form clumps or undergo structural changes that prevent the lens from sending clear images to the retina. As the water content of the lens decreases with age or for medical reasons, which I will list below, the amount of water-insoluble proteins increases. The lens hardens, its flexibility and transparency decrease. The decrease in the transparency of the lens with age is actually part of the normal aging process.

As the cataract continues to develop, the clouding intensifies and includes a larger portion of the lens. A cataract disintegrates as the image passes through the lens, preventing the image from reaching your retina. As a result, your vision becomes blurred.

Cataracts usually develop in both eyes, but not equally. The cataract in one eye may be more advanced than the other and cause a difference in vision between the eyes.

Factors that increase your risk of cataracts include:

  • advancing age

  • Trauma

  • Diabetes

  • overexposure to sunlight

  • To smoke

  • Obesity

  • Hypertension

  • Previous eye injury or inflammation

  • previous eye surgery

  • Long-term use of corticosteroid drugs

  • Radiotherapy

  • drinking excessive amounts of alcohol

  • The cause of senile cataract is complex and still not fully elucidated. The weight and thickness of the lens increase with age and its adaptability decreases.

SYMPTOMS OF CATARACT

  • The development of cataract and its symptoms is usually a slow process.

  • blurred vision; At first, you may not be aware of any vision loss as the blurring of your vision caused by a cataract affects only a small part of the lens of the eye. As the cataract progresses, it causes your lens to become more cloudy and distorts the image passing through the lens. This can lead to more specific complaints. First of all, your far vision and then your near vision deteriorate. Here, there is a situation that generally misleads patients; With the development of cataract, myopia increases and the patient may begin to see his relatives better for a short time than before. However, with the progression of the cataract, both distance and near vision deteriorate significantly.

  • Changes in color vision: patients generally see colors as paler and yellowish, and the first thing patients describe after surgery is that the colors come alive.

  • For reading and other activities, the person needs brighter light. Since the light passes through the lens with cataracts is less, the person needs more light than before.

  • Problems seeing in bright light (car lights at night). Cataract areas inside the lens are not the same throughout the lens and undergo different refraction as light passes through blurred and transparent areas, causing glare and scattering of lights. Also, the person complains of seeing “halos” around lights

  • No pain. The lens inside our eye has a veinless and nerveless structure, so there is no pain during the development of cataract.

  • Frequent changes in eyeglass or contact lens prescription

  • Double vision in one eye

When to see a doctor

  • Make an appointment for an eye exam if you notice any changes in your vision, double vision or scattering of lights.

TYPES OF CATARACT

Cataracts are examined under 3 headings depending on age.

Childhood Cataracts: These are cataracts that can occur in children of any age from birth. It occurs with the deterioration of the balance of water and proteins in the above-mentioned lens from birth. These cataracts may be due to an infection or trauma in the womb, or they may be genetic.

Midlife Cataract: These are early-stage cataracts that occur due to intraocular infections, trauma, drugs used or some systemic diseases.

Old age cataract: It is the most common type of cataract. Occurs as a natural process of aging

DIAGNOSIS OF CATARACT

Your doctor will do a comprehensive eye exam to check for cataracts and evaluate your vision.

The first stage is a vision test to check your vision at different distances. This test evaluates the acuity and clarity of your vision. Each eye is individually tested for the ability to see letters of different sizes.

Biomicroscopic examination: Your ophthalmologist will examine the cornea, iris, lens, and other areas in the front and back of the eye. The biomicroscope, which is a special microscope, makes it easy to detect abnormalities in all layers of the eye.

Your intraocular pressure will be measured, and it will also be tested for other abnormalities, such as glaucoma, apart from cataracts. Your doctor will also put drops in your eyes to dilate your pupils to examine your retina and optic nerve. This makes it easy to check for damage to the optic nerve and retina at the back of your eye.

Other tests your doctor may do include checking your sensitivity to glare and your perception of colors. It can also include different tests if necessary.

CATARACT TREATMENT

According to the clinic and the patient’s expectations (social status, occupation, age) in all patients diagnosed with cataract, the only treatment is surgery. There is no drug treatment to prevent cataracts. The progress of the cataract and the time it takes to reach the surgical level depend on the personal structural characteristics of each person.

CATARACT SURGERY

During cataract surgery, your eye surgeon will remove the cloudy natural lens of your eye. As I explained at the beginning, since the natural lens of the person allows the objects to be seen clearly and the objects at different distances to be focused, an artificial lens will need to be replaced when the blurred lens that has lost its function is removed. This new lens is called the intraocular lens (or IOL). When you decide to have cataract surgery, your doctor will talk to you about IOLs and how they work.

Cataracts are a very common cause of people losing their sight, but it is treatable. You and your eye doctor should discuss your cataract complaints. You can decide together whether you are ready for cataract surgery.

However, there is one exception that surgery is urgent in congenital cataracts. Because if congenital cataracts are not removed between the first 0-7 years of age when the visual system develops, the visual system will get used to seeing as blurred, this will cause lazy eye and even if cataracts are removed in the future, the child’s vision will not improve.

People who have had cataract surgery may have blurred vision again years later. Patients may perceive this as cataract has developed again, but because the intraocular lens is removed and cataract is a disease of the lens, cataract will never develop again. This is usually due to the clouding of the eye capsule, the membrane surrounding the cataract. It is very important for this membrane to stay in place and hold the lens in the first 6 months, but within 6 months, this membrane is no longer needed as the intraocular lens sticks to its location. Your eye doctor may use a yag-laser to open the cloudy capsule and provide clear vision. This is called a capsulotomy. After capsulotomy, the person can regain clear vision.

PREVENTION OF CATARACT;

Nothing is guaranteed to stop cataract formation. Most often, they occur as we age.

However, if you can limit some of the risk factors listed below, you can slow the rate of cataract development.

• Wearing sunglasses during the day to reduce your eyes’ exposure to the sun’s UV radiation.

• Quitting smoking.

• Maintaining a healthy diet and exercise regimen, even with light physical activity such as walking.

• Managing and controlling the effects of co-existing conditions such as diabetes or hypertension.

• To ensure that the developing cataract is diagnosed as early as possible and to have frequent eye examinations in order not to delay the timing of the surgery.

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