Cataract: a sentence or a blessing?

Impossible to treat with medicines. It will happen to everybody who lives long enough. According to the World Health Organization it is the most common cause of blindness in the world. But a cataract removal surgery is a fast and very effective ophtalmological treatment with almost 100% chances of success. There’s nothing to be scared of! Moreover, a new synthetic lens can be better than the one we’ve got since birth.

Cataract is an opacification of the lens which prevents the light to penetrate the inner eye and as a result causes a loss of vision. In antiquity people believed it was caused by a blockage of a special fluid flowing from the brain to the eye – like in famous cataracts on the Nile. Cataract is an inevitable part of growing old. Why do some people contract it earlier than others? Because of the biological clock which makes different body parts grow older with a varied speed. There is also congenital cataract, present in 1 in 250 newborns.

The most advanced form of cataract is mature cataract – a person suffering from it hardly sees any light.

How to treat cataract?

Surgically only. Eyedrops that slightly supress a development of cataract exist on the market but they don’t revert already existing changes. Despite the fact that the cataract removal surgery is the most common ophtalmological treatment in the world, according to the WHO over 20 million people can’t see due to untreated cataract. This number will grow because the society is getting older.

How does a cataract removal surgery look like?

Firstly, the eye is anaesthetized locally. Then the surgeon makes a 2 mm cut in the cornea and cuts a round opening in the frontal capsule of the lens, through which the cloudy lens will be removed. Before removal the lens will be divided into smaller parts using a procedure called phacoemulsification. The device used in this procedure can be compared to a vacuum cleaner which simultaneously grinds down and sucks out parts of the lens. The aim of this treatment is to remove the content, i.e. the cloudy lens, while retaining its packaging – the capsule.
After removing the old lens, a new synthetic rolled up lens is being implanted in its place and uncurled. This way a new content is being placed in the old packaging. A patient is fully conscious while the treatment is carried out but the surgery is entirely painless.

Lenses that work miracles

New synthetic lenses try to meet our eyes’ needs as much as possible and equal nature. All of them, like our natural lens, have filters which protect the retina from harmful effects of UV rays.

It happens though that synthetic lenses outclass our natural ones. For example those equipped in additional UV filters – useful in case of age-related macular degeneration and for people with retinal or choroidal nevi.
Lenses which correct significant sight defects are also very popular. Thanks to modern lenses we can now correct a sight defect of -20 dioptres! Complicated defects, such as astigmatism, also don’t constitute a problem. They can be corrected thanks to special toric lenses. Can we then say that artificial lenses are better than natural ones? Yes and no. Yes, because they can work miracles in case of significant sight defects and no, because they are not able to accommodate.

Accommodation is a unique feature of our own lens. It allows us to see at varied distances because our lens changes its thickness accordingly. Unfortunately this ability doesn’t last forever. It starts deteriorating when we are about 40 years old and from then on it gets worse. This is when we start having problems with reading or working on a computer. But even then new opportunities arise – we can use pseudo-accommodative lenses. They will not bring back our youth but they will allow us to see from two or even three different distances, like bifocal glasses.

But that’s not the end of miracles. In some clinics, such as the Retina Ophthalmological Outpatient Clinic and Hospital, we implant lenses facilitating laser therapy for patients with lattice degeneration and diabetes. Sometimes we choose special lenses that magnify the picture and facilitate reading for people with macular degeneration.

National Health Service-funded treatments use the most basic lenses and you need to pay for the more complex ones. It’s better to implant them in private clinics where ophtalmologists match them to your needs.