cataract surgery spectacle freedom

What is cataract?

Cataract is the opacification of the natural lens inside the eye

What is lens ?

Lens is a transparent structure present within the eye which helps to focus the image of what we are seeing onto the retina. It is similar to a camera lens which helps to focus images on the camera film.

What are the symptoms of cataract?

  • Blurring of vision
  • Frequent change of spectacle number
  • Night glare especially while seeing headlights while driving at night time
  • Altered colour perception - can be appreciated by artists and ladies while choosin sarees
  • Double images while seeing with one eye

Does cataract develop only in old age? Who is at risk of developing cataract?

The most common cause of cataract is old age. However there are many other causes which can lead to cataract. Abnormal development of lens can lead to cataract in newborns and children. Any injury to the eye or inflammation of the eye can also lead to cataract at young age. Uncontrolled diabetes can lead to early development and faster progression of cataract.

We have heard that once cataract starts developing the vision improves initially. Is that true?

In certain types of cataract like nuclear sclerosis , the refractive index of the natural lens increases which leads to improved vision for near.As a result the patient maybe able to read without spectacles. This is known as 'second sight' phenomenon. However as the cataract progresses this vision will also reduce and it will be difficult to improve even with spectacles.

Will cataract cause pricking or redness of eyes?
Cataract most commonly presents with gradual, painless blurring of vision not associated with redness or pricking of the eyes. If the cataract becomes over ripe ( hypermature cataract) then it can cause rise in eye pressure which can cause redness and pain. Also if the cataract is not due to old age but due to injury to the eye or following some inflammation of the eye then it maybe associated with redness.

How long can I wait to get my cataract surgery done?
The presence of cataract does not always mean surgery is needed immediately. Surgery is warranted if there is blurring of vision due to cataract which is hampering or limiting your daily activities. The rate of progression of cataract varies from person to person, so if you have been diagnosed with cataract but are not having any visual complaints then you can follow up with your doctor every 6-12 months so that the progression of cataract will be monitored. If anytime you feel that your vision is unsatisfactory then surgery maybe needed at that time.

Should we have to wait for ripening/maturing of the cataract until surgery?
Until about 5 decades ago, cataract was removed manually hence we needed to wait for it to ripen to perform cataract surgery. With the technology that we have today, we can perform cataract surgery at any stage of cataract. In fact for patients above 40-45 years of age who have a high spectacle power, we can perform cataract surgery even in the very early stage of cataract to give them freedom from spectacles.

What are the types of cataract surgery?
The various types of surgical procedures for cataract are :
Manual procedures with large wound -

  • ICCE (obsolete)
  • ECCE
  • SICS

Machine based procedure -
Phacoemulsification - This is the latest technique which involves dissolving the cataract using ultrasound energy into fine particles which are absorbed into the machine.

In our practice we are doing all surgeries with by Phacoemulsification with a micro incision. These surgeries are painless & suture-less with fast recovery. It is performed under topical anaesthesia that is with drops hence there is no need for injection near the eye.

What is ZEPTO cataract surgery?
One of the most important surgical steps in cataract surgery by phacoemulsification is to achieve a perfectly centred, round ,smooth opening in the anterior capsule of the lens. This is known as CCC (continuous curvilinear capsulorhexis)This can be done manually however newer technologies have been developed to increase the precision of making this opening.

The Zepto precision pulse capsulotomy (PPC) technology creates a circular anterior capsulotomy of a precise diameter using a disposable handpiece and tip. Zepto PPC holds promise for complicated eyes such as those with intumescent or brunescent lenses, zonulopathy, or small pupils. A disposable handpiece and nano-engineered capsulotomy tip are powered by a small console to automatically and instantaneously create a perfectly circular capsulotomy of a precise predesigned diameter.

What is the procedure for undergoing cataract surgery at Bhaskar Eyecare?
After we evaluate the patient clinically and feel the need for cataract surgery, we take measurements of the patients’ eyes to know which Intraocular lens (IOL) is suitable for them. Thereafter we give you a list of investigations to be done preoperatively . We also explain the various options of lenses and guide the patient what would be appropriate for them based on their eye measurements, medical insurance cover etc. Once the patient or relative shows us the reports along with a physician fitness certificate , we schedule the surgery date. The patient is explained medications which are to be started prior to surgery day.

What is IOL? Is it necessary to put lens in the eye after removal of cataract?
In the olden days when intraocular lenses were not yet invented , the cataract surgery involved only removal of cataract. Hence these patients needed to wear thick glasses or soda glasses which had a very high power (about +10 Dioptres) to compensate for the power of the natural lens which is removed. With today's surgical technique, we remove the cataract and place an artificial lens i.e. intraocular lens (IOL) in place of the natural lens. The power of this IOL is chosen based on the patient's eye measurements to minimise spectacle need after surgery.

What are the types of IOLs?
Broadly there are 2 categories of IOLs , Monofocal and Multifocal. Monofocal lenses have only 1 power so with them, the distance vision is clear and one will need spectacles for near work like reading, seeing mobile , stitching etc. Multifocal lenses have both distance and near power hence most of the activities can be done without spectacles. However for fine print spectacles may still be needed. For patients who have a cylindrical power in their eye we also have toric lenses. These lenses have an inbuilt cylindrical power which is customised for the patient’s eyes. This further reduces the need for spectacles in these patients.

Will my spectacle number go completely after cataract surgery?
We take measurements of the patients' eyes preoperatively and calculate the power of the lens required for the patient. If patient opts for monofocal lens then we aim for a near zero power for distance so that the patient can do most of their activities without glasses. However for near work he or she will need glasses. If patient opts for multifocal lenses then most of their distance and near work will be possible without spectacles but for very fine print they may still need spectacles occasionally.

cataract surgery spectacle freedom

What is cataract?

Cataract is the opacification of the natural lens inside the eye

What is lens ?

Lens is a transparent structure present within the eye which helps to focus the image of what we are seeing onto the retina. It is similar to a camera lens which helps to focus images on the camera film.

What are the symptoms of cataract?

  • Blurring of vision
  • Frequent change of spectacle number
  • Night glare especially while seeing headlights while driving at night time
  • Altered colour perception - can be appreciated by artists and ladies while choosin sarees
  • Double images while seeing with one eye

Does cataract develop only in old age? Who is at risk of developing cataract?

The most common cause of cataract is old age. However there are many other causes which can lead to cataract. Abnormal development of lens can lead to cataract in newborns and children. Any injury to the eye or inflammation of the eye can also lead to cataract at young age. Uncontrolled diabetes can lead to early development and faster progression of cataract.

We have heard that once cataract starts developing the vision improves initially. Is that true?

In certain types of cataract like nuclear sclerosis , the refractive index of the natural lens increases which leads to improved vision for near.As a result the patient maybe able to read without spectacles. This is known as 'second sight' phenomenon. However as the cataract progresses this vision will also reduce and it will be difficult to improve even with spectacles.

Will cataract cause pricking or redness of eyes?
Cataract most commonly presents with gradual, painless blurring of vision not associated with redness or pricking of the eyes. If the cataract becomes over ripe ( hypermature cataract) then it can cause rise in eye pressure which can cause redness and pain. Also if the cataract is not due to old age but due to injury to the eye or following some inflammation of the eye then it maybe associated with redness.

How long can I wait to get my cataract surgery done?
The presence of cataract does not always mean surgery is needed immediately. Surgery is warranted if there is blurring of vision due to cataract which is hampering or limiting your daily activities. The rate of progression of cataract varies from person to person, so if you have been diagnosed with cataract but are not having any visual complaints then you can follow up with your doctor every 6-12 months so that the progression of cataract will be monitored. If anytime you feel that your vision is unsatisfactory then surgery maybe needed at that time.

Should we have to wait for ripening/maturing of the cataract until surgery?
Until about 5 decades ago, cataract was removed manually hence we needed to wait for it to ripen to perform cataract surgery. With the technology that we have today, we can perform cataract surgery at any stage of cataract. In fact for patients above 40-45 years of age who have a high spectacle power, we can perform cataract surgery even in the very early stage of cataract to give them freedom from spectacles.

What are the types of cataract surgery?
The various types of surgical procedures for cataract are :
Manual procedures with large wound -

  • ICCE (obsolete)
  • ECCE
  • SICS

Machine based procedure -
Phacoemulsification - This is the latest technique which involves dissolving the cataract using ultrasound energy into fine particles which are absorbed into the machine.

In our practice we are doing all surgeries with by Phacoemulsification with a micro incision. These surgeries are painless & suture-less with fast recovery. It is performed under topical anaesthesia that is with drops hence there is no need for injection near the eye.

What is ZEPTO cataract surgery?
One of the most important surgical steps in cataract surgery by phacoemulsification is to achieve a perfectly centred, round ,smooth opening in the anterior capsule of the lens. This is known as CCC (continuous curvilinear capsulorhexis)This can be done manually however newer technologies have been developed to increase the precision of making this opening.

The Zepto precision pulse capsulotomy (PPC) technology creates a circular anterior capsulotomy of a precise diameter using a disposable handpiece and tip. Zepto PPC holds promise for complicated eyes such as those with intumescent or brunescent lenses, zonulopathy, or small pupils. A disposable handpiece and nano-engineered capsulotomy tip are powered by a small console to automatically and instantaneously create a perfectly circular capsulotomy of a precise predesigned diameter.

What is the procedure for undergoing cataract surgery at Bhaskar Eyecare?
After we evaluate the patient clinically and feel the need for cataract surgery, we take measurements of the patients’ eyes to know which Intraocular lens (IOL) is suitable for them. Thereafter we give you a list of investigations to be done preoperatively . We also explain the various options of lenses and guide the patient what would be appropriate for them based on their eye measurements, medical insurance cover etc. Once the patient or relative shows us the reports along with a physician fitness certificate , we schedule the surgery date. The patient is explained medications which are to be started prior to surgery day.

What is IOL? Is it necessary to put lens in the eye after removal of cataract?
In the olden days when intraocular lenses were not yet invented , the cataract surgery involved only removal of cataract. Hence these patients needed to wear thick glasses or soda glasses which had a very high power (about +10 Dioptres) to compensate for the power of the natural lens which is removed. With today's surgical technique, we remove the cataract and place an artificial lens i.e. intraocular lens (IOL) in place of the natural lens. The power of this IOL is chosen based on the patient's eye measurements to minimise spectacle need after surgery.

What are the types of IOLs?
Broadly there are 2 categories of IOLs , Monofocal and Multifocal. Monofocal lenses have only 1 power so with them, the distance vision is clear and one will need spectacles for near work like reading, seeing mobile , stitching etc. Multifocal lenses have both distance and near power hence most of the activities can be done without spectacles. However for fine print spectacles may still be needed. For patients who have a cylindrical power in their eye we also have toric lenses. These lenses have an inbuilt cylindrical power which is customised for the patient’s eyes. This further reduces the need for spectacles in these patients.

Will my spectacle number go completely after cataract surgery?
We take measurements of the patients' eyes preoperatively and calculate the power of the lens required for the patient. If patient opts for monofocal lens then we aim for a near zero power for distance so that the patient can do most of their activities without glasses. However for near work he or she will need glasses. If patient opts for multifocal lenses then most of their distance and near work will be possible without spectacles but for very fine print they may still need spectacles occasionally.

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