Cataracts are an ocular condition involving the opacity of the lens. It is one of the most common reversible blindness in the world. But can it come back? We will learn about it in detail today.
Cataracts are gradual and progressive; even the chances of impacts in both and female populations are roughly equal here.
Despite the efficacy of the surgical intervention, around 20 million people are blind with bilateral cataracts says Bruce Allan. As per the data, Caucasians are mostly affected while the Nepalese population here is no exception.
So, how does it happen?
Our crystalline lens is composed of modified epithelial cells and enclosed by a membranous structure, within a lens capsule. But in the case of cataracts, denaturation and coagulation of lens proteins cause it to lose the transparency of the eyes.
As per Mr Vincenzo Maurino a leading London ophthalmologist, full cataracts will never come back. However, when we remove the cataract we leave the original natural container of the crystalline lens. Its therapy is used to wrap and support IOLs
Since the lens is made of fibers new cells can proliferate on the back of the container. And back of the container can become opaque. This phenomenon is quite common in people who have a strong wound-healing response. It is common in children and less viable in older age populations to happen.
Only 10% of people who have undergone cataract surgery can have this. Even some cases are reported in Nepal as well. The good news is that no re-operation is required.
To treat this mishap you need to take an office-based procedure called YAG-laser capsulotomy, which takes 5 to 60 seconds max to open the back of the container. Your vision recovers quickly and you have no limitations on what not to do after the YAG laser.
Shockingly, you can go swimming a day after YAG laser so it's a quick process. Your vision can quietly dim off a few months or years from the surgery so you can still take YAG laser for that case as well.
Dr Michele Lee, in a survey 42% of people reported dry eye symptoms after cataract surgery. The very common cause of dry eye post-surgery can be your recovery phase. And things may get even worse after you stop using anti-inflammatory drops for your eyes.
Some corneal nerves are cut during surgery which results in loss of corneal sensation. It is responsible for tear production, blink reflex, and producing growth factors for healing.
Patients can have positive dysphotophsias, which look like an arc of light on the side of the vision. Negative Dysphotopsias is a shadow or darkness on the side of the vision. These are related to the design of the lens that is put in the eye to replace your cataract. Though lens designs are improving, many patients still complain about the issues they are facing.
These symptoms can disappear from week to month after the surgery but cannot be guaranteed. These bothersome phenomena are still adopted by individuals. They consider using pupil-constricting eye drops or glasses as per the advice of the eye doctors.
If things get worse your doctor can even consider changing the lens to a different type of lens. This type of surgery is further called intraocular lens exchange, which is extremely risky and must be approached cautiously.
Droopy eyelids (Ptosis) is an overlooked side effect of cataract surgery. It can occur in 21% of patients post-surgery. It can simply be a reaction to the dry eye. But when the eyes go normal, things improve.
But sometimes the droopy eyelids become persistent. The permanent ptosis is due to the eyelid speculum used during surgery. While necessary, it can stretch out your eyelids. If you already have droopy eyelids the condition can get more worse.
Floaters are extremely common. More often after cataract surgery, they occur. If you don't have the detachment of vitreous (jelly that fills the inner part of the eye to the retina). Eye inflammation inside the post-surgical eye is also quite common so patients use anti-inflammatory eye drops. It also causes temporary spots in the eyes.
(Scar Tissue behind the lens) 30 to 50% of the eyes end up requiring laser to get rid of the tissues. It can happen as early as the day of surgery or many years later. This scar tissue is also called a “secondary cataract” because symptoms are very similar to that. We have discussed it earlier in the blog as well.
Apart from age-related complications, which are most common, there are other common causes/risk factors of cataracts, which we will discuss today.
Early cataracts are like the little smudges on the glasses says Dr. Sarbjit Hundal, MD Ophthalmology. While the dense cataracts are like whitish/yellowish paint on your glasses.
Diabetes is the most common high blood sugar level disease which causes osmotic stress in the lens (fibers). This happens when there is more glucose in the blood and sorbitol is induced in the body. It damages lens cell death and cataract formation. Diabetic patients are more likely to develop specific types of cataracts, with poor blood sugar (glycemic) control and longer disease duration, like
Galactosemia is a metabolic disorder (often genetic) that is identified risk factor for oil droplet opacities in the lens i,e bilateral cataracts. It happens because our body cannot process galactose (C6H12O6) under this condition. In particular, dairy products, and fruits like avocados, and sugar beets, cannot be processed as regular.
Homocystinuria is a rare genetic disorder that causes homocysteine levels to rise in our body. When this happens cells cannot function properly, epithelial cells are damaged and lose coordination, and then our body is at prime risk of developing issues like cataracts.
Hypoparathyroidism and hypocalcemia are two conditions that happen side by side. When a healthy body starts experiencing low calcium levels, our body cannot function properly. It can also impact eyes with structural changes and opacities in the subcapsular region of the lens.
Wilson's disease is a condition when Copper is accumulated in our tissues. It thereby results in oxidative stress and inflammation, which contribute to cataract development. Although there is no direct links between Wilson's disease and cataracts, it is certainly associated with metabolic disturbances that are conducive to lens opacification.
When your body does not receive what it ideally needs to function, then you suffer. In such a case our body experiences biochemical abnormalities that increase the risk of cataracts. If we do not drink adequate water in our body, then there are chances of Additionally, conditions such as dehydration and acidosis leading to cellular homeostasis in the lens.
Atopic dermatitis is a long-term skin inflammation. The doctor suggests steroid cream on a regular basis to treat this case, which can increase the side effect of cataract formation in the eyes. It is scientifically proven that individuals with severe or persistent dermatitis develop cataracts more frequently than with normal skin.
Myotonic dystrophy is a genetic disorder that results in muscle weakness in the body. When such happens our eye muscles also lose their flexibility, giving rise to other serious complications like posterior subcapsular opacities.
Besides, the accumulation of abnormal proteins under this condition can also cause changes in lens metabolism. 90% of individuals with myotonic dystrophy experience lens fiber degeneration and cataracts often before they reach their mid-forties.
Neurofibromatosis type 2 is a genetic condition that dispairs our body's abilities to fight tumors and foreign bodies. In inturns causes tumors to spread and grow in our body. Also, it has been categorized as one of the risk factors of cataracts, with a growing number of people reported with this condition complaining about cataracts. Last time the data was between 60% to 80% where individuals reported cloudiness at the back part of their eye lens.
HIV/AIDS makes our body prone to various inflammation and opportunistic infections. Even the medicines used to help ease patients with AIDS can increase the risk factors of cataracts.
Retinitis pigmentosa (RP) is a genetic condition when the retina of our body loses its functions and even degenerates. One with such a condition can also suffer from another condition like cataracts as the body struggles to receive retinal support, and visual information, and experiences oxidative stress in the eyes.
Chronic anterior uveitis is a persistent eye condition when the inflammation of the uveal tract of the eyes occurs. Long-term use of steroid medications to treat the inflammation out of misfortune damages the lens of the eyes and increases opacities.
Stickler syndrome is a hereditary disorder that has something to do with the connective tissues of the body. When one has this body is more inclined toward defective collagen formation. Such a product makes the lens more susceptible to damage. To be precise, people with this condition develop cataracts, especially in the center of the lens, at a younger age.
Studies indicate that individuals with high myopia may develop cataracts earlier than those with normal vision. Under this condition, one experiences alterations in lens biochemistry. Also, they report increased oxidative stress on the eyes due to the anatomical changes in the eye.
Glucocorticoids are a type of medication often used to treat conditions like arthritis, lupus, and asthma. While effective, these medicines can unfortunately increase the risk of developing cataracts. More specifically, they can cause posterior subcapsular cataract that impacts the center portion of the eyes.
If we have Alzheimer's disease, doctors use Acetylcholinesterase inhibitors but often the medical use comes with unexpected risks. Quite a surprise but prolonged use of this medicine also has been linked to lens health. It can result in cataracts like any other medications at risk of inflammation.
Heavy alcohol users are at more risk of developing posterior subcapsular cataracts. Those users who take more than two standard drinks per day have a 26% more likely chance of developing age-related cataracts than general users or populations.
The intensity and duration of smoking always have to do with the likelihood of cataract formation in an individual. According to a recent survey, there are 19% increased risk of cataracts in smokers. And the risk directly increases with the number of cigarettes smoked particularly nuclear cataracts, with odds ratios.
Trauma in the eyes can come in any form like blunt and penetrating eye injuries. Both of these can equally increase the risks of cataract formation. A blunt injury can directly damage the lens directly while a penetrating injury can induce inflammation through the introduction of foreign elements in the eyes. Thereby one needs to get their eyes checked no matter how small is the injury around the eye.
When our eyes are constantly exposed to UV rays, there are chances of chemical changes in lens proteins. This can trigger a reaction involving amino acid derivatives called kynurenines, which further increases the risk of cataracts.
Radiation from the breakdown of an electron has the ability to change the chemical composition of the DNA if it interacts with it. It induces oxidative stress in the lens cell because of which there are chances of cataracts.
It is a matter of concern for those who have had corrective and curative eye surgery, as they are at prolonged risk of cataracts.
Congenital infections in an individual impact normal fetal development. It has a list of complications, out of which chances of eye diseases including cataracts are also one. The most notable congenital infections include:
These congenital infections can affect the developing lens in utero. By birth, one can have impact structural changes which in the future result in early cataract formation.
The ToRCH acronym represents a group of infectious agents that cause serious health issues in newborns. The infections included in this group are,
These common congenital infections are more fatal than we think. It results in various complications including cataracts, hearing loss, and neurological issues.
Cataracts once removed surgically do not come back, but there are chances of forming “secondary cataracts” at the back of the eyes, for those with strong healing. Stay tuned for more such interesting topics and top advice from the doctors themselves. For additional eye health and vision products, you can directly talk to the Vision Concern Eye Clinic.
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