Cataracts

Do you know that cataracts increase the risk of falls by about 30% in the elderly?

Experiencing Any of These Symptoms?

Light Sensitivity

Those with cataracts may struggle in bright sunlight or find indoor lighting overly intense, often with halos around lights

Blurry Vision

The most common sign of cataracts, leading to progressively impaired vision as the amount of light reaching the retina decreases

Changes in Color Perception

Cataracts can dull the perception of colors, causing them to look faded, or make objects seem to have a brownish or yellowish hue

Increasing Myopia

Worsening myopia (short-sightedness) in adults can be a sign of cataract formation.

Cataracts can make daily activities like driving inconvenient or even dangerous.
Quality of vision is badly affected in presence of cataracts
If these symptoms sound familiar, you may have cataracts
Book an appointment with us for a detailed CATARACT EVALUATION

Understanding Cataracts

A cataract is the development of cloudiness in the eye’s natural lens. In youth, the natural lens of the eye is transparent, allowing light to enter the eye undisturbed. With degeneration as one ages, this lens gradually become cloudy, allowing lesser and lesser light to enter the eye and resulting in visual impairment.

Causes

While aging is the most common cause, other factors such as prolonged exposure to ultraviolet radiation (sunlight), poorly controlled diabetes, certain medications like steroids, and eye injuries can also result in cataract formation. Cataracts can even affect children: some due to inherited genetic defects; others develop cataracts because of abnormalities during development.

Symptoms

People with cataracts may suffer from a range of symptoms including:

  • Progressive blurring of vision
  • Worsening night vision
  • Loss of vibrancy of colors
  • Rapid changes in eyeglass prescription
  • Increased glare
  • Halos around lights
  • Double vision

If these symptoms interfere with daily activities or increase the risk of falls or accidents, cataract surgery should be considered.

Types of Cataracts

Age-Related Cataracts

This is the most common type. They develop due to ageing and the gradual breakdown of proteins in the eye's lens as a result of degeneration.

Secondary Cataracts

Develop as a result of other medical conditions, such as poorly controlled diabetes or long term exposure to medications like steroids. A steroid induced posterior subcapular cataract tends to result in intolerable glare and photophobia at a younger age.

Congenital Cataracts

These present at birth or they may develop during early childhood. Cataracts in children are extremely important to treat as they may otherwise lead to irreversible amblyopia (lazy eye).

Complex Cataracts

These are non-routine cataracts that come with increased risks during surgery.  These occur because the cataracts are very dense or hypermature, or because there are concurrent abnormalities like very high myopia or high pressure (acute glaucoma). Some cataracts are complex due to instability (subluxed or dislocated cataracts) and this makes them at higher risk of complications during surgery.

Surgery for complex cataracts often requires additional techniques different from those needed for routine cataract surgery. Individualization of surgical plans is crucial for these cataracts in order to reduce the risk of complications.

Take Your First Step Towards Sharper Vision
Don’t let cataracts affect your life. With more than 20 years of experience, Dr Tan specializes in both routine and complex cataract surgery. Book a consultation for personalized treatment options.

When to Consider Cataract Surgery

Consider cataract surgery when visual impairment affects daily life or when it stops you from enjoying your favorite activities such as reading, playing sports, or driving safely.

Studies have shown that older people with cataracts are more likely to suffer from falls and fractures. Cataract surgery is highly recommended when vision loss affects mobility or safety.

Cataract Treatment Options

Cataract surgery is a common outpatient procedure aimed at restoring vision. During surgery, the cloudy lens is replaced with an artificial lens. 

Modern cataract surgery is routinely done using phacoemulsification (ultrasound energy) but more complex cases may benefit from the addition of the femtosecond laser technology. Surgery is painless and with small incision surgery, recovery is quick and easy.

Lens Implants Options

There is a large variety of lens implants available to cater to different desired postoperative outcomes. Monofocal, multifocal, extended-depth-of-focus (EDOF), and toric lenses are now able to correct pre-existing refractive errors, minimizing the need for glasses after surgery.

Phacoemulsification or the use of an ultrasonic device to emulsify and remove the cataract.
An intraocular lens implant is inserted to replace the cataract (cloudy lens) which has been removed.

Monofocal lens

Single focus lenses provide sharp vision for those who prefer to wear glasses after surgery. It is also used in people who are not suitable for other types of lenses.

Multifocal lens and EDOF lens

These allow a range of distance, intermediate and near vision for those who prefer to minimize the use of glasses after surgery.

Toric lens

Removes astigmatism so images are sharper and not distorted.

FAQs about Cataracts

There is currently no effective treatment for cataracts other than surgery. Eyedrops and oral medication have not been proven to work, and there are no food or vitamin supplements that can make cataracts go away.

If not removed, cataracts will continue to harden and vision will worsen. These hyper mature cataracts will then become more difficult and riskier to remove in the future.

In rare situations, a hypermature cataract may swell up in the eye and cause a sudden rise in eye pressure. This dangerous condition is a type of cataract-induced glaucoma (acute angle closure glaucoma) which can lead to permanent optic nerve damage and irreversible visual loss. Emergency surgery would then be necessary and the outcome could be poor despite treatment.

An overly mature (intumescent) cataract causing angle closure glaucoma. Emergency treatment is needed to prevent permanent loss of vision.

A large range of intraocular lens implants can now be used to correct pre-existing short-sightedness, long sightedness, astigmatism and presbyopia (老花). This means that a patient’s unaided vision (i.e. vision without glasses) after cataract surgery can often be even better than before the cataracts developed. 

You will need to discuss the features of each type of lens with your eye surgeon in order to decide which lens implants are most suitable for you. The decision should be made based on your needs, lifestyle and pre-existing eye condition.

A toric lens with the three alignment dots on opposite sides of the lens is used to reduce pre-existing astigmatism.

 

Multifocal lens implants have rings which correct for distance, near and intermediate vision. This mean that many patients who have this lens are spectacle free or require glasses only for extremes of distances.

 

The extended range of focus (EDOF) lens has fewer rings than the full multifocal lenses and corrects for a smaller range of distances. Some people who are unsuitable for multifocal lenses may be able to use EDOF lenses instead.

Cataracts do not ‘grow back’ after cataract surgery. However, some patients may experience blurring of vision again years after the surgery because the natural partition of the eye (posterior capsule) behind the lens implant can become cloudy again. This posterior capsule opacification (PCO) is easily and painlessly treated with a “YAG laser”.

Cloudiness in the posterior capsule of the eye can cause vision to be blurred again years after a cataract surgery.

 

YAG laser in progress to remove the posterior capsule opacification (PCO) and restore vision.

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