Cataract is a disease that while being treated with a simple operation does not always happen to be properly treated, because on the one hand it may not be perceived by the sufferer and on the other hand, even when it is perceived, no immediate decision is made to treat it, as there is a belief that he must be at a certain stage (to be “mature”) to undergo surgery. The truth is, however, that once the cataract is diagnosed, surgery must be performed to restore the sufferer’s vision.
How the eye works
“Before analyzing cataract disease, its effects on vision, and how to treat it, some information about the normal eye will be given. The human eye could be compared to a camera, both in its construction and in its principles of operation. The eye has two lenses on its front, the cornea and the crystalline lens. At the back, it has the “film”, where the images are focused, which is the retina. The lenses must be clear and have the right curvature to focus the light passing through the eye to the retina to form a clear image.
“When there are pathological conditions, where the lenses are cloudy or have an abnormal curvature, the result is that the image in the retina is not formed properly and the patients’ vision is not good”, says Mr. Vassilios F. Diakonis, MD, PhD, Anterior Hemisphere Director – Ophthalmic Surgeon B’s Ophthalmology Clinic of Metropolitan Hospital.
What is a waterfall?
Cataract is the clouding of the crystalline lens of the eye and has the effect of reducing patients’ vision. Decreased vision creates problems in patients’ daily functions and activities such as night driving, reading and watching television. Cataracts are caused by a variety of causes: the most common cause is normal (in the elderly) aging of the crystalline lens (senile cataract), while other causes are the use of drugs such as cortisone (pharmacological cataracts), the presence of systemic head injuries (traumatic cataract) and some genetic abnormality (congenital cataract).
It is worth noting that in senile cataracts the reduction of vision occurs gradually and at a slow pace, with the result that patients do not perceive it, thinking that they have normal vision.
Diagnosis
When cataracts become significant, they reduce patients’ vision both quantitatively and qualitatively. During the examination at the ophthalmologist, visual acuity is found below 5/10, while, during the clinical examination, the opacity of the crystalline lens is perceived by the ophthalmologist. If there is no other pathological cause that reduces the patient’s vision, the final diagnosis for cataracts is made and surgery is recommended.
Treatment & treatment
“Cataracts can not be improved with eye drops or medication, as its treatment requires surgical removal of the cloudy crystalline lens. “Cataract surgery is the most common surgery performed on the human body worldwide: about 1% of the general population undergoes cataract surgery every year,” adds the doctor.
Before the start of cataract surgery, the patient receives local anesthesia in the eye using eye drops and mydriasis (dilation of the pupil). General anesthesia is not necessary, but intoxication is given. The duration of the surgery is about 15 minutes and the patient is lying under a microscope with bright light. The eye is kept open with the help of an eyelid dilator and during the operation the patient does not feel pain or other discomfort. After the crystal lens is removed, a new artificial lens is placed, which remains there for the rest of the patient’s life.
After cataract surgery, the patient does not need hospitalization and goes home, without the need for ocular bandaging. Vision is restored after a few days, while the patient uses eye drops for 4 weeks after surgery. Finally, there are some restrictions for 7 days after surgery, which are: to avoid rubbing the eye, to avoid eye contact with soap and water during personal hygiene, and to avoid lifting heavy weights.
The term “mature” waterfall
A common question patients ask ophthalmologists is: “Is my cataract mature enough to have surgery?” The concept of “mature” waterfall is not a test, because what is perceived (and described) as the “maturity” of the waterfall is related to the vision requirements of the average person. For example, a man who lived 60 years ago did not use a car as often, did not watch much TV, did not use a computer or cell phone, and probably read less often, so he did not need sharp eyesight. However, the vision requirements of modern man have increased significantly due to lifestyle changes, which is why the same waterfall that is now considered “mature” would not be considered “mature” 60 years ago.
Intraocular lenses
“After removing the natural crystalline lens, we place an artificial (plastic) lens in its place. There are 3 main categories of intraocular lenses: unifocal lenses, which correct pre-existing myopia and hyperopia, toric lenses, which correct astigmatism, and finally, multifocal intraocular lenses, which partially correct preposition. The desired refractive results are a complex process that requires close cooperation between an ophthalmologist and a patient, in order to achieve a satisfactory result that will meet the needs of the latter “, adds Mr. Diakonis.
Laser in cataract surgery
Another misunderstood concept for cataract surgery is the use of lasers. The classic cataract surgery, for the last 40 years, is performed using ultrasound, which shreds and crushes the crystalline lens. This ultrasonic phacoemulsification has been misinterpreted as laser. However, in recent years there are lasers available for cataract surgery, which before the start of the main operation, perform part of the surgery with extremely high accuracy. The use of this laser aims to reduce human error and possible complications as well as to reduce surgical time and surgical trauma.
Writes:
Mr. Vassilios F. Diakonis, MD, PhD,
Anterior Hemisphere Director – Ophthalmic Surgeon B’s Ophthalmology Clinic of Metropolitan Hospital
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