Cataract (The Disease Of Aging)

The Ancient Greeks believed that there is a fountain of water inside the eye in front of the lens responsible for the whitish discoloration of the eyes of elderly people, so they called it “Cataract”; cataract means waterfall. In this article we will discuss all aspects related to cataracts, so you can better understand this eye disorder.

What Is a Cataract?

A cataract is a pathological condition of the crystalline lens of the eye. Normally the crystalline lens is transparent, but with aging, certain chemical changes occur in the composition of the transparent fibers of the lens making it opaque. This leads to gradual diminution of vision.

What Causes a Cataract?

eyeAs we grow, the normal lens in our eyes, acquire new layers of fibers. With aging, certain biochemical changes in the protein composition of the lens fibers occur, rendering it opaque and cloudy instead of being transparent.

Also, the lens fibers acquire pigmentation leading to the yellowish brown hue with advancing age.

What Are The Risk Factors That Predispose The Development Of Cataracts?

The risk factors include:

  1. Intake of drugs for long periods such as: corticosteroids, psychotic medications like phenothiazines, miotics in treatment of accommodative esotropia (a type of squint).
  2. Smoking, as studies have proven that there is an increased frequency of lens opacity in smokers than in non-smokers.
  3. Mechanical trauma; whether blunt as if someone is hit strongly in his face or eyes, or perforating and penetrating traumas as in cases of gun shots penetrating the eye or foreign bodies perforating the eye, like glass particles in cases of car accidents.
  4. Chemical injury, such as alkali injuries to ocular structures.
  5. Exposure or excessive exposure to ionizing radiation, ultraviolet waves, infrared waves or micro waves.
  6. Electrical injuries as injuries caused by high voltage sources.
  7. Metabolic diseases as diabetes mellitus and galactosemia (a hereditary disorder in which the body is unable to convert galactose which is a type of sugar found in cow’s milk, into glucose).
  8. There is an increased risk of having cataract in patients suffering from some ocular disease such as: uveitis, glaucoma.

A Lot Of My Family Members Were Diagnosed As Having Cataract, What About Me?

Studies have shown that there is an intimate relation between cataracts and genetics as a large proportion of the risk of age-related cataracts is inherited.

Inherited genetics account for more than 50% of the risk of developing cortical cataract.

What Are The Symptoms Of Cataract (When To Seek An Ophthalmology Consultation)?

If you are complaining of one of the following symptoms, then you may need to visit an ophthalmologist to have your eyes examined. The symptoms are:

  1. Gradual diminution of vision
  2. Seeing glare, especially in daytime or with oncoming car headlights.
  3. Decreased contrast sensitivity (Contrast sensitivity is the ability to detect subtle variations in shading).
  4. Diplopia and seeing two or more images of the same object.

Can Cataract Be Treated By Medication?

There are no medications available commercially, that are capable of reversing the biochemical changes of the cataractous lens to restore its transparency. The only curative treatment is surgical removal of the cataractous lens and insertion of an IOL (intraocular lens).

Are There Options Other Than Surgery?

Yes. Certain types of cataract can be managed by careful refraction and spectacle prescription, and the vision of the patient can be improved for near as well as far vision.

What Happens During Cataract Surgery?

The normal lens is surrounded by a layer of tissues forming a bag. During the cataract surgery the surgeon may either:

  1. Make a corneal incision, then an opening in the anterior surface of the lens bag, then delivers the cataractous lens from that opening and replaces it by an IOL made of certain types of plastic polymers, and finally closes the wound by microscopic sutures. This surgical technique is used when the lens is too hard to be fragmented inside the eye and then aspirated outside the eye.
  2. Make a much smaller incision, then an opening in the anterior surface of the lens bag, and then introducing a phaco probe through the corneal incision.

The phaco probe emits ultrasonic power allowing the surgeon to fragment the lens into small pieces, then aspirate them outside the eye; finally he replaces the lens by an IOL. There is no need to suture the wounds in this technique, in most of the cases.

For a more indepth view of cataract, please browse the other pages here, or the Cataract FAQ.