“In Singapore, the percentage of elderly patients affected by cataracts is about 78.6%. The number of people affected increases as they get older (It affects 63.6% of people between 60 and 64 years, and 94.6% of people 75 years and older.)”*
A cataract is the clouding of the crystalline lens in the eye. This natural lens is usually clear and therefore enables light to pass through into the eye for clear vision.
The most common cause of cataracts is age-related changes in the eye. Types of cataracts include subcapsular, posterior subcapsular, nuclear and cortical. As the eye ages, the lens material hardens and yellows. If not removed, it will continue to become more and more opaque and may cause blindness eventually. Cataracts can be treated through cataract surgery.
Common symptoms include one or more of the following:
These symptoms can adversely affect vision. Due to these changes, a person who has developed cataract may find daily activities inconvenient. Reading the newspaper and watching the television may become chores rather than pleasures. Night driving becomes difficult as visibility drops and the eye sees glare from street lamps and oncoming car headlights. When a cataract causes inconvenience to a person, we would recommend a cataract surgery.
A cataract may develop in one eye first, then the other. The onset of a cataract is usually due to ageing. An eye with high myopia, acute angle closure glaucoma and chronic anterior uveitis may also develop cataract prematurely.
Some other factors which can cause a cataract are:
More uncommon causes include concussion, exposure to ionizing irradiation for ocular tumours and long-term intake of certain medications.
The single most effective method to restore vision due to a cataract is to undergo a surgery. This involves the removal of the opaque lens and replacing it with an artificial intraocular lens implant (IOL).
The surgery typically takes 15-20 minutes per eye and is done as a day surgery. The eye is able to see clearly as soon as the next day after surgery. After resting for 5-7 days, the patient is able to return to work. Most daily activities can be resumed after 1-2 weeks’ rest.
The newer method for surgery is called phacoemulsification with IOL implantation. Compared to older methods of surgery, the corneal incision made is smaller of 1.8-2.2mm in length and does not require stitching. This translates to faster wound recovery and less discomfort to the patient after surgery. In addition, the doctor is also able to better correct myopia, hyperopia, astigmatism and presbyopia with various types of IOL. Learn more about cataract surgery.
When a cataract begins to affect daily activity, one can consider having a surgery to remove it. Do not wait too long to have a cataract removed. In advanced stages of cataract, the lens may begin to harden, which makes it more difficult to remove via surgery.
In recent years, more patients and surgeons agree that surgery can be done even in the early to moderate stages. As a guide, one should consider undergoing surgery if the symptoms of cataracts begin to affect the quality of vision adversely such that day-to-day activities can no longer be done with ease.
Greater reliance on technology and later retirement ages has increased the need for good vision in our daily lives. Undergoing a cataract surgery earlier also means restoring good vision sooner. With the availability of various types of lens implants, surgeons and patients can together make a better decision on the best-suited lens for each individual.
A cataract should not be removed at a hypermature stage also because the lens may start to leak inflammatory materials which can lead to a secondary glaucoma.
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