Cataract
Summary/Definition
Cataract is a phenomenon in which objects appear blurred, as if they are in a fog. The lens of the eye plays a key role in the process of focusing on visible objects, but over time, it can become cloudy due to aging, inflammation of the eye or injury. In total, 70% of people aged 60 and older, as well as 90% of people aged 70 and older, experience cataract symptoms.
There are two types of cataracts: senile cataract, which occurs naturally with age, and congenital cataract, which may occur due to the mother’s rubella disease in early pregnancy or due to genetic factors. Acquired cataracts, for example, senile, are much more common than congenital. Other causes of cataracts include trauma, diabetes, uveitis, prolonged exposure to ultraviolet rays and overdose of certain medications, such as adrenal cortex hormone.
Symptoms
In most cases, cataracts do not cause any pain, except for visual impairment. Persons who previously needed glasses for farsightedness to read small print may suddenly begin to see small objects up close, as the refractive index increases with the development of cataracts, which can lead to myopia. However, as the cataract gradually progresses, the turbidity becomes more noticeable, and vision deteriorates.
Cataract is a disease characterized by visual impairment due to clouding of the lens, and, as a rule, any pain, except for visual impairment, does not accompany it. Usually cataracts develop slowly, over several months or even years, and in the early stages of the disease there are often no obvious symptoms. However, as the clouding of the lens increases, the following signs may appear: cataracts can cause blurred vision and glare during the day. Depending on the severity of the cataract, visibility in dark places or at night may be difficult, and monocular double vision may occur, in which one object is perceived as two, even if one eye is closed.
Diagnostics
Cataracts are diagnosed by checking visual acuity, ophthalmoscopy, biomicroscopy of the eye using a slit lamp and measuring intraocular pressure. After dilating the pupil with a special test, the degree of opacity of the lens and its location are determined using biomicroscopy of the eye using a slit lamp. Depending on where the opacity is located in the lens, cataracts are divided into anterior polar, nuclear and posterior polar. Anterior polar cataract develops under the capsule in the area of the anterior pole of the lens, that is, it forms in front of the lens. Nuclear cataract is characterized by compaction and clouding of the central nucleus of the lens, that is, it develops in the very center of the lens. The posterior polar cataract is formed under the capsule of the posterior pole of the lens, that is, behind the lens. Posterior polar cataract occurs more often with prolonged use of steroids after transplantation surgery or prolonged use of eye drops containing steroids.
Tests are also carried out to identify diseases that can cause vision loss, and to assess other eye structures. In addition, urine and blood tests are performed to identify other pathological conditions that may be associated with vision loss, for example, hypertension and diabetes.
Treatment and course of the disease
When using eye drops or oral medications in the early stages of cataract, you can expect a slowdown in the process of its development. Among the additional preparations, eye drops containing antioxidants are used, as well as eye drops with potassium iodide. However, it is important to understand that the complete restoration of the transparency of the lens only with the help of drug therapy is impossible. The safest and most effective method of treating advanced cataracts is surgery. Cataract surgery is performed by creating a small hole in the iris or sclera of the eye, introducing an ultrasound machine, aspiration of clouded lens masses and installing an artificial lens with a similar structure in their place. After surgery, it is recommended to use eye drops, for example, antibiotics or anti-inflammatory drugs, for 1-4 weeks, as well as to observe a rest regime and refrain from heavy physical exertion, exercise or actions that can damage the eyes, for about a week after surgery. In addition, it is recommended to use a protective blindfold before going to bed for 4 weeks after surgery.
Complications
After surgery, various complications may occur, for example, astigmatism, myopia, hyperopia, etc. In some cases, it may be necessary to wear glasses for vision correction. In addition, symptoms such as redness of the eyes, subconjunctival hemorrhage and dry eyes may occur after surgery. In rare cases, after surgery, a rupture of the posterior capsule of the lens may occur and endophthalmitis develops, which is an inflammatory disease inside the eyeball caused by the penetration of bacteria or fungi.
