Is Cataract an Age-Related Disease? Can It Be Seen in Young People?

Cataracts can occur in individuals of any age, including infants. It’s uncommon in middle age but increases in prevalence with age. Roughly half of those aged 50-59 and almost all over the age of 80 have some degree of cloudiness. However, this cloudiness may not always significantly affect vision.

What Causes Cataracts?

In adults, the primary cause of cataracts is changes in the lens associated with aging. In children, metabolic diseases, consanguineous marriages, diseases contracted in utero, drug use during pregnancy, microbial conditions, and injuries play a significant role. Also, eye trauma, diabetes, intraocular inflammation (uveitis), kidney disease, glaucoma, radiation, high blood pressure (hypertension), and long-term corticosteroid use can cause cataracts.

Can Cataracts Be Treated With Medication?

There are no known treatments for cataracts other than surgery. Although some drugs are currently being tested, no successful results have been reported yet. Therefore, we can say that cataracts can be treated surgically.

What Are the Symptoms of Cataracts?

• Painless and gradual blurring of vision
• Glare or reduced sensitivity to light
• Frequent changes in eyeglass prescription
• Need to clean glasses frequently
• Difficulty driving
• Decreased night vision and dispersion in lights
• Need for strong light to read
• Double vision with one eye
• Fading or yellowing of colors

When Is Cataract Surgery Inevitable?

• Patient is recommended to have surgery if they encounter any of the following conditions.
• If the amount of vision does not meet the patient’s daily needs
• If an eye condition such as inflammation has created a cataract and disrupts treatment and monitoring
• If the cataract is raising the patient’s eye pressure
• In congenital cataracts that can cause vision loss and strabismus

What Are the Cataract Surgery Methods?

The surgery is divided into two types depending on the removal of the lens.

1. Intracapsular Cataract Extraction (ICCE): The lens is removed in its entirety along with its capsule. This is an old method.
2. Extracapsular Cataract Extraction: A portion of the lens’s anterior capsule is removed, and the remaining parts are cleared by methods such as phacoemulsification (PHACO). Then an intraocular lens can be implanted into the lens capsule.

The type of surgery to be applied can vary depending on the patient’s age, the condition of their eye, and the surgeon’s preference.

Can Cataracts Be Treated With Laser?

It is commonly known in society that cataract surgery is performed with a laser, but this operation is the PHACO method. Cataract surgery can be performed with a laser. However, it is not commonly preferred as it has no difference in surgical technique compared to PHACO. Laser cataract surgery is still experimental. It is not possible to correct cataracts only with a laser without surgery. In cataract surgery, an artificial (synthetic) lens (IOL) is implanted into the eye after cleaning the cataract, which is now performed in almost all patients. Unless there are special circumstances for the patient (children under one year old, those with intraocular inflammation, etc.), an intraocular lens should be implanted. Whether to implant a lens will be a decision made by the eye doctor depending on the patient’s condition. If a lens is not used, the patient will need to use thick glasses.

What Is the Best Method for Cataract Treatment?

The method can differ depending on the patient’s age, the condition of the eye, the surgeon’s preference, and the type of lens to be used. Currently, extracapsular methods where the lens’s own capsules are preserved are preferred. Depending on the patient’s condition or the course of surgery, the other method may be required.

What Should Be the Features of the Intraocular Lenses Implanted During Surgery?

The lenses to be used are generally produced as single focus, which can clearly show either distance or near. After such a lens is implanted, the patient may need to use glasses or contact lenses to clearly see both far and near. In recent years, “multifocal lenses” aimed at allowing the patient to see both far and near clearly after surgery and lenses with special color coatings that block harmful light entering the eye have started to be used. These types of lenses are used in cases where the patient and the doctor decide together.

What Is Done Before Cataract Surgery?

Before surgery, various tests may be performed depending on the patient’s age, other diseases, medications used, and the type of surgery to be performed. Especially inform your doctor about all the medicines you use and follow the recommendations they will make according to the types of medicines. Some drugs can be administered orally, intravenously, or intramuscularly before or after being taken to the operating room. You should not eat or drink anything for at least 6 hours before coming to the surgery. Having an attendant with you may be helpful. You will need to remove your makeup and jewelry. Your pupil may enlarge and your eye may become red due to the drops to be applied to your eye.

Is Anesthesia Applied During Surgery?

In cataract surgery, general anesthesia (being completely put to sleep) is generally preferred in children. Another option is to apply local anesthesia by injection around the eye. Surgery is also possible by numbing the eye with only drops (topical anesthesia). This anesthesia is applied in situations where the patient’s cooperation is good.

How Is Cataract Surgery Performed?

After the eye is numbed for surgery, the surgeon enters the eye and first opens the front capsule of the lens. Then, the cataractous part inside is removed either entirely or in pieces. Only the lens capsule is left inside. Depending on the patient’s age, the condition of the eye, and the type of surgery, a lens implantation procedure can be done. In some cases (for instance, in children under 1 year of age), a lens may not be implanted. Sometimes, due to the course of the surgery and the condition of the eye, the lens may not be implanted or it may be postponed to a second surgery. In some cases, different types of lenses (requiring sutures to the eye wall, attached to the colored part) may need to be used. The surgeon will make the decision based on what is most suitable when these situations arise.

Is Postoperative Care Necessary?

After surgery, the eye is usually covered with a bandage. This bandage should remain on the eye for the period recommended by your doctor. After the operation, you should not apply pressure to the eye or rub it. The clinical nurse and doctors will inform you of your hospital stay. If you are to be discharged from the hospital, do not drive yourself. You can start eating and taking medication according to the recommendations of the clinical nurse and doctors. Do things like washing your face, taking a bath, carrying items, praying, doing sports, going back to work, and going into the sea and swimming pool after consulting with your doctor. Postoperative medications (drops, ointments, tablets, syrups, etc.) should be used as and when recommended by your doctor. Do not change, decrease, or stop your medications without consulting your doctor. Before using the prescribed drops and ointments, the person applying them to the eye must definitely wash their hands with soap. When applying the medications, the tip of the dropper or ointment tube should not touch places like the eyelid, eyelashes, skin, hand, paper, or tissue. The 1st day, 1st week, and 1st month after the operation are checked. During this time, eye drops are used to ensure the eye heals and is protected from infection. Pay careful attention to the warnings from your doctor about follow-up and what to do after the operation.

Does Reading After Surgery Harm the Eye?

Reading does not harm the eye. You can utilize your old glasses for reading if you have them and they help. However, there may be discomfort and fatigue in the eye immediately after the operation. Watching television is less tiring and does not harm the eye. The full-distance and reading glasses are adjusted after the operation when your doctor sees fit.

What Changes Occur in the Lives of People Who Have Undergone Cataract Surgery?

It is often wondered whether cataract surgery causes restrictions on certain matters. After surgery, those who achieve the level of vision specified by law can obtain a driver’s license and drive a car. They can participate in non-contact sports. They can only not become police officers or soldiers.

Does Cataract Recur?

Cataracts do not recur in those who have had cataract surgery. In those who have undergone surgery, the capsule in which the lens is implanted can become cloudy over time. This is referred to as “secondary cataract” in society, but it is not actually a cataract. This formation can generally be easily treated with a laser. In children or in rare cases where the capsule has become very thick, it may need to be cleaned surgically.