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eyes
eyeball

Treat cataracts for clear vision

When we look at something, light rays travel into our eye through the pupil and are focused through the lens onto the retina, a layer of light-sensitive cells at the back of the eye.

The lens inside the eye works much like a camera lens, focusing light onto the retina for clear vision. It also adjusts the eye’s focus, letting us see things clearly both up close and far away. The lens is mostly made of water and protein.

The protein is arranged in a precise way that keeps the lens clear and lets light pass through it. The lens must be clear in order to focus light properly onto the retina. As we age, some o f the protein in the lens may clump together and start to cloud areas of the lens. This is a cataract, and over time, it may cloud more of the lens, making it harder to see. Figures find approximately 91 per cent of those between the ages of 75 and 85 have some cataract forming in their eye.

The lens of a human eye is shaped similar to an M&M’s lolly (not the peanut ones!). It has a front (anterior) part and a back (posterior) part. The central portion of the lens is called the lens nucleus, and the outer portion is called the lens capsule. Between the inner nucleus and the outer capsule is a portion of the lens called the cortex.

TYPES OF CATARACT

  • A subcapsular cataract occurs at the back of the lens. People with diabetes or those taking high doses of steroid medications have a greater risk of developing a subcapsular cataract.
  • A nuclear cataract forms deep in the central zone (nucleus) of the lens. Nuclear cataracts are usually associated with aging.
  • A cortical cataract is characterized by white, wedge-like opacities that start in the periphery of the lens and work their way to the center in a spoke-like fashion. This type of cataract occurs in the lens cortex, which is the part of the lens that surrounds the central nucleus.

The location of the clouding can also be defined as being anterior or posterior, central, or peripheral. Often the clouding of the lens may affect multiple portions of the lens. The most common type of cataract that is related to age is sometimes termed a “senile cataract.” This type of cataract primarily involves the nucleus of the lens. Cataracts that develop in the posterior subcapsular area (in the rear region of the lens capsule) are more common in a younger age group.

RISK FACTORS
Besides advancing age, cataract risk factors include:

  • Diabetes
  • A family history of cataracts
  • Extensive exposure to sunlight
  • Smoking
  • Obesity
  • High blood pressure
  • Previous eye injury or inflammation (swelling) in the eye
  • Long-term use of steroid medication (especially combined use of oral and inhaled steroids)

VISION PROBLEMS
If your vision has become blurry, cloudy or dim, or things you see are not as bright or colorful as they used to be, a cataract may have developed in one or both of your eyes. Many people say that their vision with cataracts is similar to the effect of looking through a dirty car windshield.

As a cataract begins to develop, you may not initially notice any changes in your vision. Gradually, as cataracts progress, you may begin to find that it interferes with your daily activities and you may experience symptoms such as:

  • Painless cloudy, blurry or dim vision
  • More difficulty seeing at night or in low light
  • Sensitivity to light and glare
  • Seeing halos around lights
  • Faded or yellowed colors
  • The need for brighter light for reading and other activities
  • Frequent changes in eyeglass or contact lens prescription
  • Double vision within one eye

Performing a complete eye exam, your ophthalmologist can tell you whether cataract or another problem is the cause of your vision loss.
No studies have proved how to prevent cataracts or slow the progression of cataracts. However, doctors think several strategies may be helpful, including:

  • Have regular eye examinations. Eye examinations can help detect cataracts and other eye problems at their earliest stages. Ask your doctor how often you should have an eye examination.
  • Quit smoking. Ask your doctor for suggestions about how to stop smoking. Medications, counseling and other strategies are available to help you.
  • Reduce alcohol use. Excessive alcohol use can increase the risk of cataracts.
  • Wear sunglasses. Ultraviolet light from the sun may contribute to the development of cataracts. Wear sunglasses that block ultraviolet B (UVB) rays when you’re outdoors.
  • Manage other health problems. Follow your treatment plan if you have diabetes or other medical conditions that can increase your risk of cataracts.
  • Maintain a healthy weight. If you currently have a healthy weight, work to maintain it by exercising most days of the week. If you’re overweight or obese, work to lose weight slowly by reducing your calorie intake and increasing the amount of exercise you get each day.
  • Choose a healthy diet that includes plenty of fruits and vegetables. Adding a variety of colourful fruits and vegetables to your diet ensures that you’re getting many vitamins and nutrients. Fruits and vegetables have many antioxidants, which help maintain the health of your eyes.

SURGERY
There are no medications or eye drops that will make cataracts go away—surgery is the only treatment.
A cataract may not need to be removed right away if your lifestyle isn’t significantly affected. In some cases, simply changing your eyeglass prescription may help to improve your vision. Once you are diagnosed with a cataract, your ophthalmologist needs to monitor your vision regularly for any changes.

When a cataract causes bothersome vision problems that interfere with your daily activities, your ophthalmologist may recommend surgery to remove the cataract. With cataract surgery, your eye’s cloudy natural lens is removed and replaced with a clear artificial lens implant (called an intraocular lens or IOL). This is usually done as a day stay procedure. If the eye is healthy, the likelihood is that cataract surgery will restore good vision.

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