Cataracts and Frequently Asked Questions

Is Cataract a Disease of Old Age? Is It Also Seen in Young People?

It can be seen in people of all ages, including babies. It is rare in middle age. Its frequency increases with advancing age. There is some degree of opacity in about half of those between the ages of 50-59 and in almost all of those over the age of 80. However, this opacity may not always significantly affect vision.

What Are the Causes of Cataract Formation?

The most important cause of cataracts in adults is the changes that occur within the lens with aging. In children, metabolic diseases, consanguineous marriage, diseases experienced in the mother’s womb, medication use during pregnancy, microbial conditions, and injuries are effective. Additionally, blows to the eye (trauma), diabetes, intraocular inflammation (uveitis), kidney disease, glaucoma, radiation, high blood pressure (hypertension), and long-term use of cortisone medications can cause cataracts.

Can Cataract Be Treated with Medication?

There is no form of treatment for cataracts other than surgery. Although there are some medications currently being tested, no successful result has been reported yet. That is to say, the treatment of cataracts can only be done with surgery.

What Are the Symptoms of Cataract?

• Painless, progressively increasing blurred vision

• Glare in the eye or decreased sensitivity to light

• Frequent changes in glasses prescription

• The need to wipe glasses frequently

• Difficulty driving

• Decreased night vision and scattering of lights

• Need for strong light for reading

• Double vision in one eye

• Fading or yellowing of colors

In Which Situations Does Cataract Surgery Become Inevitable?

Surgery is recommended if the patient faces any of the following situations.

• If the amount of vision does not meet the daily needs of the patient

• If a disorder such as inflammation in the eye has caused a cataract and disrupts the treatment and follow-up

• If the cataract raises the patient’s eye pressure

• In congenital cataracts, in situations that can lead to decreased vision and deviation (strabismus)

What Are Cataract Surgery Methods?

Surgery is divided into two according to the removal of the lens.

• Intracapsular Cataract Extraction (ICCE): The lens is removed as a whole with its membranes. It is an old method.

• Extracapsular Cataract Extraction: A part of the anterior capsule of the lens is removed, and the other parts are cleaned with methods like delivery, suction, or fragmentation with ultrasound waves (PHACO). Then, an intraocular lens can be inserted into the lens membranes. The type of surgery to be applied may vary depending on the patient’s age, the condition of the eye, and the surgeon’s preference.

Can Cataract Be Treated with Laser?

It is widely known among the public as laser cataract surgery, but this operation is the PHACO method. Cataract surgery can be performed with a laser. However, it is not widely preferred because there is no difference from PHACO as a surgical technique. Laser cataract surgery is still in the experimental stage. It is not possible to correct a cataract with only a laser without surgery. In cataract surgery, inserting an artificial intraocular lens into the eye after the cataract is cleaned is now performed in almost all patients today. Unless there are special circumstances for the patient (children under one year of age, those with intraocular inflammation, etc.), an intraocular lens must definitely be inserted. Whether an intraocular lens will be inserted or not will be a decision to be made by the ophthalmologist performing the surgery depending on the patient’s condition. When a lens is not used, the patient has to use thick-glass glasses.

What is the Best Method That Can Be Applied in Cataract Treatment?

The method may differ depending on the patient’s age, the condition of the eye, the surgeon’s preference, and the type of lens to be used. Today, extracapsular methods, in which the lens’s own membranes are preserved, are preferred. Depending on the patient’s condition or the course of the surgery, the other method may also be needed.

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

The lenses to be used today are generally single-focus, that is, produced in a way to show either distance or near clearly. After such a lens is inserted, the patient may need to use glasses or contact lenses to see both distance and near clearly. Recently, “multifocal lenses” aimed at enabling the patient to see both distance and near clearly after surgery, and lenses with special color coatings that block harmful lights entering the eye have also started to be used. Such lenses are used in situations where the patient and their physician will decide jointly.

What is Done Before Cataract Surgery?

Before the surgery, various tests may be performed in cases deemed necessary depending on the patient’s age, other diseases, medications used, and the type of surgery to be performed. In particular, inform your physician about all the medications you use and follow their recommendations depending on the type of medications. Some medications can be administered orally, through the arm, or through the hip 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 a companion with you can be good for helping you. You will need to remove your makeup and jewelry. Because some drops will be put in your eye, your pupil may dilate, and your eye may become red.

Is Anesthesia Performed During Surgery?

In cataract surgery, general anesthesia (being completely put to sleep) is generally preferred in children. Another preference is to apply anesthesia (local) by giving an injection around the eye. Surgery is also possible by numbing the eye with only drops without a needle (topical anesthesia). This anesthesia is applied in cases where the patient’s compliance is good.

How is Cataract Surgery Done?

After the eye is numbed for surgery, the eye is entered according to the selected method, first the anterior membrane of the lens is opened, and the cataractous part inside it is removed either as a whole or by being fragmented. Only the membrane of the lens is left inside. Again, depending on the patient’s age, the condition of the eye, and the type of surgery, the lens insertion procedure can be performed. In some cases (such as children under 1 year of age), a lens may not be inserted. Sometimes, due to the course of the surgery and the condition of the eye, a lens may not be placed, or it may be delayed until a second surgery. In some cases, it may be necessary to use different types of lenses (requiring sutures to the eye wall, attached to the colored part) other than the planned type. When these situations occur, the physician performing the surgery will decide according to the most appropriate option for you.

Is Post-Operative Care Required?

After surgery, the eye is generally covered with a bandage. This bandage should remain on the eye for the period recommended by your doctor. You should not put pressure on the eye or rub it after surgery. You will be informed of your stay in the hospital. If you are to be discharged from the hospital, do not drive yourself. You can start food and medication intake according to the recommendations of clinical nurses and doctors. Do things like washing your face, taking a bath, carrying items, praying, doing sports, starting work, entering the sea and pool by consulting your physician.

The medications to be given after surgery (drops, ointments, tablets, syrups, etc.) should be used in the way and for the duration recommended by your doctor. Do not change, reduce, or stop your medications without consulting a physician. Before using the prescribed drops and ointments, the person who will apply them to the eye must wash their hands with soap. When applying medications, the tip of the dropper or ointment tube should not touch places like the eyelid, eyelashes, skin, hands, paper, or napkins.

Check-ups are made on the 1st day, 1st week, and 1st month after the operation. During this time, eye drops are used to ensure both the healing of the eye and its protection against infection. Pay attention to your physician’s warnings regarding the follow-up period and what to do after surgery.

Does Reading After Surgery Harm the Eye?

Reading does not harm the eye. For reading, you can use your old glasses if you have them and if they help you read. But there may be discomfort and fatigue in the eye immediately after the surgery. Watching television is less tiring and is not harmful to the eye. Exact distance and near glasses are adjusted at a time deemed appropriate by your physician after the operation.

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

It is also wondered whether cataract surgery creates limitations in some matters. After surgery, people who achieve the vision specified in the law can get a driver’s license and drive. They can do non-contact sports. Only they cannot be police officers and soldiers.

Does Cataract Recur?

Cataract does not form again in those who have had cataract surgery. The membrane into which the lens is placed during the operation may become opaque over time. Although this is called “secondary cataract” among the public, it is not actually a cataract. This formation can generally be easily treated with a laser. In children or in rare cases where the membrane thickens too much, it may be necessary to clean it surgically.