The lens in the eye is like a camera lens and is located behind the iris and pupil. Its mission is to focus images on the retina. Opacification or clouding of the lens is known as a cataract.
The reasons why this happens are not always well known although it is in most cases part of the natural ageing process. Cataracts are usually progressive; as the lens becomes more opaque, the first cataract symptoms appear.
- Metabolic illnesses: Diabetes, hyperparathyroidism, hypocalcaemia and Albright syndrome and Wilson’s disease, among others.
- Trauma: Eye contusions, perforating injuries, radiation, electric shock, intraocular foreign bodies, etc.
- Medicine for prolonged use: Corticosteroids and miotics.
- Systemic diseases: Myotonic dystrophy, atopic dermatitis, Rothmund syndrome, Werner syndrome, Takayasu’s disease, Buerger’s disease, etc.
- Eye diseases: Uveitis, Fuchs heterochromia, intraocular neoplasms, retinal detachment, absolute glaucoma, essential iris atrophy, retinal dystrophies, acute glaucoma and vitreo-retinal surgery.
Initially it can be seen a slight decrease in vision or a slight haze, which often goes unnoticed. Sometimes the first symptom of a cataract is, paradoxically, an improvement in near vision because the eye is becomes more myopic.
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As the process progresses, the symptoms of the cataract intensifies, colours appear more muted and glares and light reflections become more bothersome. Sometimes the strength of glasses needs to be changed very regularly.
When symptoms increase, vision loss due to the cataract becomes significant, hampering daily activities. This is when cataract surgery should be undertaken. Surgery is the only effective treatment.
Delaying the operation as long as possible (as was done in the past) makes no sense. The patient will simply suffer the symptoms of the cataracts longer, seeing increasingly worse and further complicating the surgery, with slower visual recovery.
According to the moment they appear:
- Congenital Cataract: Lens opacity is present upon birth or within the first three months after birth.
- Childhood cataract: These manifest during childhood or adolescence. Its etiology and morphology follows the pattern of congenital cataracts. They progress very slowly and do not usually reduce vision very much.
- Senile Cataract: They appear after the age of 60 and are regarded as a physiological change of ageing. They are usually progressive. If diagnosed before the age of 60, they are called presenile cataracts.
According to anatomical location of opacity:
- Nuclear cataract: Affecting the nucleus of the lens.
- Cortical cataract: Opacification of the cortex (or lens cortex).
- Posterior Subcapsular Cataract: opacity takes the form of granular deposits on the posterior surface of the lens
The treatment for cataracts is performed when the symptoms intensify and vision loss becomes significant, hindering everyday activities.
Before cataract surgery, a thorough eye exam is carried out to rule out other eye diseases and to assess cataract symptoms that the patient presents.
Treatment of cataracts is always surgical. In cataract surgery using lasers the cloudy part of the lens is aspirated and replaced by a multifocal premium intraocular lens. Intraocular lenses are currently also used to correct other refractive errors such as eye strain. Find out more information about the operation of intraocular lens presbyopia operation