~~April 15, 2014~~
Cataracts are cloudy areas in the lens inside the eye – which is normally clear.
Cataracts can develop in one or both eyes. If they develop in both eyes, one will be more severely affected than the other. A normally clear lens allows light to pass through to the back of the eye, so that the patient can see well-defined images.
If a part of the lens becomes opaque light does not pass through easily and the patient’s vision becomes blurry – like looking through cloudy water or a fogged-up window. The more opaque (cloudier) the lens becomes, the worse the person’s vision will be.
~~There are two types of cataracts~~
Age related cataracts – they appear later in life; the most common form.
Congenital cataracts (childhood cataracts) – these may be present when the baby is born, or shortly after birth. Cataracts may also be diagnosed in older babies and children – these are sometimes referred to as developmental, infantile or juvenile cataracts. Researchers from the University Zurich were the first to identify the chromosomal location and exact molecular defect in the coding region of the gene responsible for a childhood cataract.
A cataract is a clouding of the lens inside the eye which leads to a decrease in vision. It is the most common cause of blindness and is conventionally treated with surgery. Visual loss occurs because opacification of the lens obstructs light from passing and being focused on to the retina at the back of the eye.
It is most commonly due to biological aging, but there are a wide variety of other causes. Over time, yellow-brown pigment is deposited within the lens and this, together with disruption of the normal architecture of the lens fibers, leads to reduced transmission of light, which in turn leads to visual problems.
Those with cataracts commonly experience difficulty in appreciating colors and changes in contrast, driving, reading, recognizing faces, and coping with glare from bright lights.
~~Signs and symptoms~~
The only way to know if you have cataracts for certain is when your ophthalmologist does a dilated eye exam. Get a baseline exam at age 40, when early signs of disease and changes in vision may start to occur. Your ophthalmologist will let you know how often you should return for follow-up exams. At any point, if you have symptoms or risks for eye disease, see your ophthalmologist. Because your risk for cataracts and other eye diseases increases as you get older, starting at age 65 you should see your ophthalmologist every year. A complete eye examination will rule out any other condition that may be causing blurred vision or eye problems.
Most age-related cataracts develop gradually. As a result, you may not immediately notice changes in your vision when cataracts first develop.
Painless clouded, blurry or dim vision;
Increasing difficulty seeing at night or in low light;
Sensitivity to light and glare, seeing halos around lights;
Colors seem faded or yellowed;
The need for brighter light for reading and other activities;
Frequent changes in eyeglass or contact lens prescription; or
Double vision within one eye.
~~Cross-sectional view, showing the position of the human lens~~
Cataracts may be partial or complete, stationary or progressive, or hard or soft. The main types of age-related cataracts are nuclear sclerosis, cortical, and posterior subcapsular.
Nuclear sclerosis is the most common type of cataract and involves the central or ‘nuclear’ part of the lens. Over time, this becomes hard or ‘sclerotic’ due to condensation of lens nucleus and deposition of brown pigment within the lens. In advanced stages it is called brunescent cataract. This type of cataract can present with a shift to nearsightedness and causes problems with distance vision while reading is less affected.
Cortical cataracts are due to opacification of the lens cortex (outer layer). They occur when changes in the water content of the periphery of the lens causes fissuring. When these cataracts are viewed through anophthalmoscope or other magnification system, the appearance is similar to white spokes of a wheel pointing inwards. Symptoms often include problems with glare and light scatter at night.
Posterior subcapsular cataracts are cloudy at back of the lens adjacent to the capsule (or bag) in which the lens sits. Because light becomes more focused toward the back of the lens, they can cause disproportionate symptoms for their size.
A mature cataract is one in which all of the lens protein is opaque while the immature cataract has some transparent protein. In the hypermature cataract, also known as Morgagnian cataract the lens proteins have become liquid.
Congenital cataract, which may be detected in adults, has a different classification and includes lamellar, polar, and sutural cataract.
Cataract surgery, using a temporal approach phacoemulsification probe (in right hand) and “chopper” (in left hand) being done under operating microscope at a Navy medical center. Slit lamp photo of posterior capsular opacification visible a few months after implantation of intraocular lens in eye, seen on retroillumination
Cataract removal can be performed at any stage and no longer requires ripening of the lens. Surgery is usually ‘outpatient’ and performed using local anesthesia. Approximately 90% of patients can achieve a corrected vision of 20/40 or better after surgery.
Several recent evaluations found that surgery can only meet expectations when there is significant functional impairment from poor vision prior to surgery. Visual function estimates such as VF-14 have been found to give more realistic estimates than visual acuity testing alone. In some developed countries a trend to overuse cataract surgery has been noted which may lead to disappointing results.
~~Cataract Surgery 3D Animation O. Findl, MD, Vienna~~
~~Uploaded on Jan 30, 2009~~
Cataract surgery 3D computer animation explained by Oliver Findl, MD.
~~Eye News TV-Watch live surgery using the laser cataract system~~
How does it work?
~~Uploaded on Jul 8, 2011~~
“Laser refractive cataract surgery is without a doubt the most technologically advanced option for cataract patients,” explains Dr. Eric Donnenfeld from Opthalmic Consultants of Long Island.
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