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Cataracts - what to ask your doctor

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You are having a procedure to remove a cataract, a cloudy area in the lens of your eye. This should help improve your vision.

Below are some questions you may want to ask your doctor or nurse to help you take care of your eye (or eyes, if you need to have two cataracts removed).

Questions

Q-1:What is a cataract?

Answer: A cataract is a clouding of the lens in your eye. It affects your vision. Cataracts are very common in older people. By age 80, more than half of all people in the United States either have a cataract or have had cataract surgery.

Q-2:How will cataract surgery help my vision?

Answer: It will remove your cataractous/opaque lens & replace it with artificial lens through surgical procedure " Intra Ocular Lens Transplantation", thus allowing light to pass into eye unaffected which help you to regain your vision.

Q-3:If I have two cataracts, can I have surgery on both of them at the same time? 

Answer: No, at least a gap of 4-6 weeks should be there to undertake cataract surgery in second eye.

Q-4:How long after surgery before I notice my vision is better?

Answer: Modern surgical techniques allow you to see better after few hours of surgery in majority of cases.

Q-5: Will I still need glasses after surgery? For distance? For reading?

Answer: It depends on total outcome of surgery, surgical procedure adopted & type of IOL implanted. Most don't require glasses for distance. However, a near correction is necessity to see fine prints.

Q-6: How do I get ready for surgery?

Answer: Ask your doctor to specify after going through all your medical past records & examination of your body. You should  not be suffering from active infections, uncontrolled diabetes,hypertension,asthma,dyspnoea, bleeding disorders,arrythmia or any serious heart diseases.

Q-7:When do I need to stop eating and drinking before surgery? 

Answer: Usually before 3 hours of proposed eye surgery under local or topical anesthesia.

Q-8: Do I need to stop taking or change any of my medicines?

Answer: Use of Aspirin or related medicines should be stopped before a week of surgery. However, all medications related to hypertension,diabetes,asthma,heart problems should be continued as per schedule including on day of surgery.

Q-9:What else do I need to bring with me on the day of surgery?

Answer:Bring one active assistant & money to pay charges incurred.

Q-10:What happens during cataract surgery?

Answer:

The normal lens of the eye is transparent (clear). As a cataract develops, the lens becomes cloudy and blocks light from entering your eye. Without enough light, you cannot see as clearly.

Cataracts are painless. Mostly, they develop in the elderly. But sometimes children are born with clouded lenses that are caused by infections or other problems before birth. These are called congenital cataracts.

Surgery is usually recommended for people who cannot see well because of their cataracts. The surgery is performed in a hospital or surgery center in an outpatient clinic.

  • Adults are usually awake for the procedure. You will receive local anesthesia (numbing medicine) to block pain and a sedative to relax you.
  • Children usually receive general anesthesia to make them unconscious and unable to feel pain.

Looking through a microscope, the doctor will make a small incision (cut) in the eye. The surgeon then removes the lens. It can be removed in several ways, depending upon the type of cataract you have. Two ways to remove it are:

  • With surgical instruments and suction
  • With an instrument and machine that uses sound waves (ultrasonic energy) to break up the lens and suction it out. This is called phacoemulsification.

A man-made lens, called an artificial intraocular lens (IOL), is usually placed next. It will help improve your vision.

The doctor will close the incision with very small sutures (stitches) or use a self-sealing (sutureless) method. If sutures are placed, they may need to be removed later.

The surgery usually lasts less than an hour. Most times, just one eye is done. If both eyes need it, your surgeon may recommend waiting 1 to 2 months before having cataract surgery on the other eye.

View this video for more information:

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Q-11: What type of anesthesia will I have?

Answer: Surgery could be performed under topical,local,regional or general anesthesia depending on age of patients,level of cooperation from patients side,types of cataract, comfort level of surgery etc. Most of the surgery performed either under topical anesthesia or local anesthesia.

Q-12: Will I feel any pain during the surgery? How do you make sure I won't move during cataract surgery?

Answer:Although pain is very subjective in nature,  majority have just feeling about something being done on eye without any discomfort or pain.

Q-13:Will I need a lens implant?

Answer: Yes, in vast majority of cases.

Q-14:What are the risks of cataract surgery?

Answer: Complications of cataract surgery are rare.

Rarely, the surgeon is not able to remove the entire lens. If this happens, a procedure to remove all of the lens fragments will be needed at a later time. Most patients who need this procedure still do very well.

In other very rare cases, infection can occur after cataract surgery. This can lead to permanent vision problems.

Q-15: Will I have to spend the night in the hospital? 

Answer: No, unless necessitated by attendant medical problems or emergency.

Q-16: How long will I need to spend at the surgical facility?

Answer: Apart from time taken to prepare O.T., machines,preparation of patients, actual surgical procedures takes 20 minutes on average.

Q-17: What happens after cataract surgery?

Answer: You will probably return home after surgery and then have a follow-up exam with your doctor the next day. Your doctor may ask you to wear a patch over your operated eye until your exam the next day. After this, you may want to wear dark sunglasses outside.

Your doctor may prescribe antibiotic and anti-inflammatory eye drops to use for 1 or more weeks to help with healing.

Make sure your hands are clean before touching your eye. Try not to get soap and water in your eye when you are bathing or showering for the first few days.

If your doctor closed your incision with sutures, you may need to schedule a visit to have them removed.

Take it easy. Light activities are best as you recover. Check with your doctor before doing any strenuous activity, resuming sexual activity, or driving.

Expect complete healing in about 10 weeks. If you need new glasses or contact lenses, have them fitted after your wound have healed completely. It is important to have a follow-up visit with your doctor.

Q-18: Will I have to wear an eye patch?

Answer: Yes, for one day.

Q-19: Can I shower or bathe at home? 

Answer: Shower or bathe is not prohibited below neck. However no bathe or shower for at least 3 days in face & head areas. Instead, you can have sponge in face & head areas. The purpose is not to allow access of normal water to the wound.

Q-20: What activities can I do while I recover?

Answer: You are prohibited to rub eyes, weight lifting or strenuous exercise including sex for three weeks. However, you are free to watch T.V.,computers or read or drive As & when you feel comfortable to do so.

Q-21: When will I be able to drive? 

Answer: As soon as you feel comfortable to do so.

Q-22: When can I be sexually active?

Answer: Wait for three weeks for wound to have adequate strength.

Q-23: When I will have first cup of tea after surgery?

Answer: Within 20 minutes of surgery. You can have normal diet devoid of heavy fats, protein & spices for one more day.



Update Date: 30/05/2011



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BewiseHealthwise



Cataract is defined as an opacity of the crystalline lens of the eye or its capsule, resulting in changes of the transparency and refractive index of the lens (1).
person’s vision may become blurred or cloudy and may experience problems with glare from the sun or other bright lights (2)
variations in the refractive index can be due to changes in lens cell structure or changes in lens protein constituents (high-molecular-weight protein aggregates) or both (1)

Immature cataracts are defined as cataracts through which a red reflex can still be seen.

Mature cataract have obscured red reflex and often are associated with weakness of the suspensory ligament of the lens.

Hypermature cataracts have leaked protein as a result of the action of endopeptidases, resulting in a wrinkled lens. This sort of lens ought to be removed before it causes a lens-induced uveitis or glaucoma.

Cataracts can be divided according to the segment of the lens that is affected:


nuclear cataract
cortical cataract 
subcapsular cataract (3)
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