Category: Cataract

Normally cataracts are seen more frequently in adults due to advancing age. Some cataracts are seen in children and adults are non age-related.

Non age-related cataracts could be either unilateral or bilateral. (Unilateral cataract is when it affects one eye and bilateral cataracts are when both the eyes are affected).

Types of non age- related cataracts are:

• Congenital cataracts:

Congenital cataracts are cataracts that occur at birth. It could be hereditary or genetic. Congenital cataracts if untreated can cause permanent vision loss.The exact causes of cataracts are still unknown in most of the cases. Cataract surgery is most effective in the first month after birth.

• Other diseases and medication:
  • Previous eye surgery can cause cataracts earlier.
  • Metabolic disorders likeDiabetes and Galactosaemia – Those suffering from Diabeteshave high blood sugar which makes the lens of the eye swell and obstructs vision. Further posterior subcapsular cataracts and post operative inflammation are common in those having diabetes.
  • Excessive use of steroids
  • Ocular inflammation
• Traumatic cataracts:

Traumatic cataracts occur when the eye gets damaged due to trauma, accidents, punch causing corneal abrasions and orbital fractures.

Signs of cataracts in children:

• Inability to look directly.
• Inability to see smaller toys or objects.
• Glares make the child to squid or cover the eyes.
• Strabismus (unable to focus on the same point at the same time).
• White spot in the pupil.

Problems due to cataract in children:

• Eye wiggling (nystagmus)
• Amblyopia (lazy vision)
• Strabismus
• Glaucoma (high eye pressure)

Treatment:

The first few months of an infant after birth is most critical stage in the development of vision. The deformities in the visual cortical connections can give rise to lazy eye (amblyopia) in children.

Early eye check up after birth helps in diagnosing Pediatric vision issues and enables children to get treatment and correction. Eye examinations with tests can detect cataract in children. Not all pediatric cataracts require surgery as vision develops normally nevertheless cataract surgery with general anesthesia is normally conducted wherein the natural lens are replaced with IOL on case to case basis .In some glasses or contact lens are prescribed.Post operative follow up and preoperative evaluation are essential. The kind of Pediatric cataract determines the urgency of the treatment. Long term follow up is essential for Pediatric cataracts than compared to adults.

Ensure children have adequate protection of eyeswith UV protected sun glasses while outin the sun.Pregnant women are advisable to take precautions against infectious diseases.

In case your child is a new born infant pre-screening eye test after birth isof paramount importance. Moreover tiny babies can’t say if they can see well or not.

In case of older children or adults any symptoms of cataract or difficulties in vision, do consult us early fordiagnosis and appropriate choice for treatment. With advances in treatment, your child can have an enhanced visual outcomeand safe treatment.

 

Cataracts are a part of aging. They are generally considered to be associated with advancing age and the most commonly known type of cataract is the age related cataract or senile cataracts. Age related cataracts are seen in some as early in their 40’s and 50’s although normally seen in people in their 60’s and 70’s. In reality this is not the only type of cataract. Cataract can occur at any age even as early as birth. The deterioration of vision may be gradual and progressive. Many times it is quite unnoticeable in the initial stages.

Some of the most common types of non age- related cataracts are:

• Congenital cataracts:

As the name suggests congenital cataract occur at birth. The exact causes are not known. It could be hereditary or genetic.

• Traumatic cataracts:

These mainly occur due to damage in the eye caused by trauma or accidents leading to corneal abrasions. The development of traumatic cataract is normally accelerated faster after the accident. Eye trauma could be caused by chemical burns, radiation etc. It is advisable to use protective eye wear while working in hazardous environment.

• Metabolic cataracts:

Studies show patients with diabetes and Galactosaemia could cause progression of cataract at a faster rate and could occur at an earlier age.

• Secondary cataracts:

These are caused due to other factors like eye surgeries. Certain eye surgeries could cause cataracts before aging. Use of certain medications can trigger an early onset of cataract particularly the excessive use of steroids.

Other factors that accelerate the growth of non age related cataracts:

• Ocular inflammation. e.g. Uveitis.
• Excessive Smoking & Alcohol.
• Environmental factors like effect of ultra violet rays, radiation. Use of UV protected sun glasses help to safeguard while going out in sunlight.
• Uncontrolled Blood sugar and Blood Pressure: These could trigger an early onset of cataract hence it is advisable to keep them under control through diet and exercise.
• Radiation and work conditions as in welding and glass blowing could cause cataracts at an earlier age.

Treating non age related cataracts: In case of congenital cataract, early treatment for babies at birth is most effective in such cases and a delayed treatment could result in permanent vision loss. Often any retinal scarring from macular degeneration, floaters and other eye disease unrelated to cataract needs to be diagnosed to rule out other causes for decreased vision other than cataract. Timely check up and complete eye examination can detect cataracts early and hence facilitate a quick surgical correction and treatment. Treatment varies depending on the eye condition and best suitability after through eye examination and assessment. The outcome of an early treatment is more beneficial irrespective of the type of non age related cataracts.

A focus on the factors that are controllable and preventable could reduce the risks of cataracts to some extent. Latest advancement in technology and techniques has resulted in better visual outcome with advanced lens as suitable to one’s needs.

Do get in touch with us for appointment and for more details.

The evolution of cataract treatment from couching to Intra Capsular Cataract Extraction without IOL, further to Micro incision cataract surgery has revolutionized cataract treatment tremendously. Earlier cataracts were awaited to mature for surgery. With technological advancement, one need not wait for cataracts to mature for cataract surgery. American Academy of Ophthalmology had reported a study on how people with cataract related vision loss who undergo cataract surgery tend to live longer compared to others who have visual impairment and do not undergo surgery (40% lower long-term mortality risk in those who have undergone the surgery).

The main purpose of cataract surgical treatment is to restore vision. Presently, cataract surgery is the most effective treatment for cataract removal. Other alternative treatments which do not require surgery are been widely researched like activating protective proteins to keep lens in the eye clear from clouding etc.

In cataract surgery, the diseased natural lens is replaced with artificial intraocular lenses. If IOL replacement is ruled out then other options like contact lens or glasses could be recommended. Symptoms of cataract could be resolved temporarily by increasing the prescription in glasses. Pre-operative consultation and thorough eye examination is performed at first. The most suitable procedure, preparation, benefits, risks and complications are discussed during the consultation ensuring you are the right candidate for the procedure. The treatment plan is chalked out based on the type of cataract, degree of loss of vision, severity of the condition, presence of other illnesses, age etc.

Phacoemulsification: During Phacoemulsification an ultrasonic probe is used to emulsify the cataract by breaking it into small pieces and further aspirated using the same probe.

It is a widely accepted procedure using small incisions, and does not require overnight hospitalization. Topical anesthetic (eye drops) are administered and procedure is completed within few minutes. In Shroff Eye, your family has an option to view this cataract surgery live, which is performed with the latest technology and best expertise.

Uses of lens in cataract surgery: Prior to surgery the most suitable lenses are opted for, depending not only on measurements in terms of the shape, size and power of the eye, but also the lifestyle of the person. Today availability of a varied array of lenses, the selection of the right choice of lens is vital. We, at Shroff Eye, assist in choosing the best suitable lens for your eyes after your examination and discussion with our surgeon.

Benefits of Cataract Treatment:                                                                                                                  

• Prevents blindness.
• Prevents accidents due to decreased vision.
• Enhances vision.

·         Cataract removal is essential as a part of treatment for other eye conditions such as diabetic-retinopathy or Age – Related Macular Degeneration.

Cataract Treatment in children: Early treatment is beneficial in case of congenital cataract as development of the brain needs correct visual stimulation, hence learning disabilities are avoided. The earlier it is done, also the results are better. Delays could result in some visual impairment. Moreover it prevents irreversible amblyopia [lazy eye]. Just like symptoms of cataract vary among individuals, the response to treatment also may vary.

A detailed eye examination ensures an appropriate line of treatment.

The pre-operative counseling helps you to have clarity on the process and understand the protocol to be followed.

The follow up and post-operative medication and care helps expedite recovery.

Early diagnosis and cataract treatment restores vision.

Do get in touch with us to help you achieve your vision goals.

Over the years we would have possibly heard about some myths on cataract surgery and doubted the reality. These myths are not the real truth and could cause delay in getting the right treatment at the right time. Today cataract surgery is safer and has better outcome. Moreover with advances in technology and changes in the cataract surgery these prevailing misconceptions have a better revelation.

Let us debunk the common myths and learn the reality for better understanding.

MYTH #1: The need of cataract surgery arises only after cataract is allowed to ripen or mature.

FACT: In the initial stages of cataract, the surgery is more beneficial and has less risk of complications. There is not advisable to wait for the cataracts to mature. Thanks to the advances in cataract surgical procedures, we can diagnose cataract as soon as the vision issues crop up. Early diagnosis and treatment will help to rule out other eye disorders as well.

MYTH# 2: Is cataract is a cloudy filmy layer forming on the outermost layer of the eye?

FACT: Cataract in fact does not form on the outermost layer of the eye (conjunctiva). In fact, cataract is the clouding of the natural lens of the eye and develops within the eye lens itself. This prevents light passing through the lens and causing blurred vision making us unable to see clearly. When the opaque lens is replaced with an artificial lens during the cataract surgery, the vision becomes clear.

MYTH #3: Cataract is an eye problem occurring with the aged.

FACT: Cataract can occur at any age. Some occur at birth (congenital cataracts) and can form at any age although generally seen in older people. Those with diabetes, smokers, eye trauma etc. can develop cataracts earlier.

MYTH # 4: After cataract surgery complete rest for months is essential.

FACT: Cataract surgery is an outpatient procedure and modern cataract surgery can be completed in minutes and recovery time is very fast unlike surgeries that had larger incisions and longer healing time.

MYTH #5: Eye drops can prevent cataract.

FACT: Eye drops or ointments cannot prevent cataract and surgery is the most effective treatment. A surgical opening is required to replace the lens. Vision researchers are working on prevention of cataract through eye drops has been widely researched.

MYTH# 6: Straining one’s eyes on detailed and fine vision like sewing deteriorates cataract.

FACT: Fine vision activities do cause stain for the eyes. It does not impact the growth of cataract.

Fears of undergoing cataract surgery.

• Some feel cataract surgery is a dangerous process and may lose sight. Presently surgery being the solution to treat cataract effectively. As cataract destroys your vision and could lead not only blindness but also lead to reasons for other accidents.
• Some feel it’s a painful procedure. With advanced cataract treatments the surgical experience is quite painless.
• Some fear that they will have to wear glasses even if cataracts are removed. Correction could be made by using suitable lens during the cataract surgery and could help you to get rid of your glasses.

In case of any clarification or for more details, do get in touch with us.

Cataracts are normally associated with aging. Congenital cataract is the clouding or blurring of the natural lens of the eyes that occurs at birth. An undetected congenital cataract could result in permanent visual loss.

Screening of the baby’s eye after birth is mandatory. Certain congenital cataracts need immediate surgery whereas certain types which block vision at the peripheral portion of the lens may not need cataract removal. Unlike adults where a delayed cataract surgery may have a lesser impact on the visual outcome but in case of children affected with congenital cataract a delay in surgery may result in never regaining vision thereafter.

Studies have noted that children treated for bilateral dense congenital cataracts, surgery prior 3 months of age is paramount to decrease the risk of visual acuity loss. The anatomical features in baby’s eye e.g. small lenses, soft cataract and developing size of the lens makes cataract surgery different and challenging. In certain cases it is conducted when the baby is just few weeks old.

Types of Congenital cataract

• Anterior polar cataracts: These are located in the front part of the eye’s lens and surgical intervention may not be required.
• Posterior polar cataracts: These are well defined and appear in the back portion of the lens.
• Nuclear cataracts: These are located in the central part of the lens and comparatively more common form.
• Cerulean cataracts: These affect both eyes of infants and normally do not cause vision problems.

Causes:

• Genetic
• Diabetes
• Trauma
• Inflammation
• Drug Reactions
• Infections
• Metabolic issues
• Certain illnesses that affect the pregnant mother like measles or rubella.

Symptoms

• Cloudiness of the pupil.
• Blurring in vision when cataracts are in both eyes.
• Nystagmus -rapid eye movements.

Treatment: Our pediatric ophthalmologist would advise the best time to conduct the surgery after detailed examination if surgery is recommended.

Too early surgery could risk the eye from getting secondary glaucoma and too late would result in blindness. If the occurrence is small in size may not require surgery. Prenatal and family history are closely noted and recorded. Parent’s illnesses or drugs used during pregnancy are noted.

Comprehensive examination and Tests: The eye screening examination in the new born mainly consists of the evaluation of the red reflexes, Retinoscopy and Laboratory Tests.

Surgery: Unlike adults wherein local anesthesia or tropical drops are used, the pediatric cataract surgery would require general anesthesia. In some cases the posterior capsule is removed during the surgical procedure.

The treatment begins with cataract surgery and the process may take years of accurate optical rehabilitation, other related therapies and postoperative supervision

• Lumpectomy: During this procedure the lens (including the posterior capsule) and anterior vitreous are removed.
• IOL implantation: IOL implantation is safe and effective in the treatment of congenital cataract specifically at a suitable age. Secondary intraocular lens implantation is normally conducted after a certain gap as required. Spectaclesare prescribed according to the vision requirement and the age the child can wear them. IOL implantation may sometimes need spectacles at the later stage.

Post Operative Complications:

• Glaucoma -Early diagnosis of Glaucoma can delay the onset.
• Posteriorcapsule opacification (PCO) – Nd: YAG laser capsulotomy in children is done to overcome PCO.
• Uveitis – Uveitis is a chronic inflammation in the eye could also occur.
• Pupillary Capture
• Decentration of IOL
• Secondary Membrane Formation
• Retinal complications- Retinal detachment is most common surgically treated eye.
• Amblyopia (Lazy eye) – Most commonly occurred in children where one eye becomes a weaker in focus and subsequently the stronger eye becomes the preferred eye. This makes the weaker eye amblyopic.
• Strabismus(Crossed eyes)

Do report us if you observe any kind of swelling, bleeding, redness, pain that requires prompt medical attention.

In case of congenital cataract in the family it is advisable to have genetic counseling. The success of congenital surgery would require co-operation from the parents. The treatment is most effective when parents partner with us to symphonise in the overall management and treatment in congenital cataract.

Do get in touch with us for more details for an effective congential cataract management for your child’s visual development.

Cataract progression is gradual and can impair daily functioning. Earlier when technology was not advanced the cataract was awaited to ripen or mature leading to complications and visual impediments. Normally the age related cataracts are progressive and is predictable once detected. In case of delay it worsens vision and could result in permanent loss of vision. Hence timely treatment and regular eye checkups are vital.

Advantages of timely treatment for cataract:

• It improves the quality of life.
• Better visual outcome.
• Delay could increase the risk of complications during the surgery
• Spectacle independence.
• Prevents accidents due to poor vision.

BEFORE CATARACT

Battling with blurred images, depth perception or struggle to gauge distance becomes an obstacle to lead a normal life although at initial stage it may not be a hindrance. Sometimes cataracts are accompanied with other eye disorders like glaucoma, muscular degeneration etc. These could be determined in advance and are easily treatable.

Instrumentation to measure the power of Lens to be inserted are now more accurate. The best and most suitable artificial lens [IOL or Intra Ocular Lens implant] for each eye is prescribed and replaces the diseased natural lens during the surgery. The line of treatment is performed in accordance to achieve the best results.

AFTER CATARACT

After a cataract surgery, vision not only improves but is enhanced in most cases. In some cases, part of the lens capsule gets cloudy causing blurred vision. This condition is called ‘PCO or Posterior Capsule Opacity’ and can be corrected very easily by a YAG laser capsulotomy.

Prognosis of pediatric cataracts: Unlike cataracts in adults, in children the progression is variable, unpredictable and complex. If left untreated it could cause amblyopia.

Factors for good prognosis for cataracts:

• Prompt diagnosis and effective treatment– Avoid delays in treatment to have a better prognosis.
• Patient’s co-operation, age and health condition– Co-operation from patient’s side is a supporting factor. Advancing age could deteriorate overall health and your ocular conditions too.
• Good control of diseases such as Diabetes and Hypertension are necessary for reducing risks and also healing well.
• Expertise of treating ophthalmologist utilizing the latest technology advancement in ophthalmology is significant in your healing process.
• Type and severity of the cataract– Treatment at initial stages favors better prognosis hence advisable to undergo timely diagnosis.
• Type of cataract surgery- Cataract surgeries with smaller incisions and advanced IOLs not only result in better visual outcome but also increase the recovery rate.
• Sterile conditions and prevention from other infection- Treatment before and after surgery in non-sterile conditions could lead to infections and delay the recovery.
• Medications and speed of recovery- Effective medications and timely administration improves the recovery at the faster rate.
• Existence of other illnesses like diabetes could delay the recovery time.
• Post-operative complications- Lesser the post-operative complication better the cataract prognosis.

Cataract prognosis varies from eye to eye and person to person. Moreover most of the factors are controllable and results are achievable.

Our expert team at Shroff Eye is well equipped with the latest technology and expertise to tackle any type of cataract to optimize the best visual prognosis and care for your eyes.

Cataract clouds the natural lens of the eye causing loss of vision. Let’s note the factors that increase your risk of cataracts.

Risk factors

• Aging- Aging is major cause of age related cataract most commonly known.
• Genetics- Some having a family history of cataracts may inherit from parents genetically.
• Congenital cataract- Some children are born with cataract.
• Ethnicity-Evidence suggests that our ethnic ancestry influences the likelihood of developing cataracts.
• Female gender-Studies have reported that women are more likely to develop cataracts than men.
• Medical conditions
  • Diabetes- Diabetes type 1 or 2 has a high risk factor for cataract at a younger age. The accumulation of certain sugars in the blood leads to formation of sugar alcohols in the lens which causes swelling and rupturing of the lens cells causing cataract due to diabetes. Managing blood glucose at normal or near normal levels is hence important.
  • Hypertension- High blood pressure is seen as a risk factor.
  • Obesity- Studies shows the effect of diet high in saturated fat and occurrence of cataract. Obesity boosts blood sugar levels which in turn increase risk of cataracts.
  • Eye Trauma- Blunt trauma, penetrating trauma, chemical injuries and electrical injuries. It is advisable to wear protective eye gear as per requirement.
  • Previous eye surgery- Eye surgeries such as surgery for a retinal detachment can increase the risk of developing a cataract.
  • Prolonged use of corticosteroid medications (commonly called steroids) pose a particularly high risk.g. Steroids are used to treat autoimmune diseases such as asthma and Crohn’s disease, rheumatoid arthritis, and lupusetc resulting in cataract as a side effect.
  • Statin medicines used to reduce cholesterol- Studies suggest that the risk for cataract is high among Statin users as compared with nonusers.
• Life style risk factors
  • Drinking excessive alcohol– Chronic drinkers under high risk for cataract. Avoid excessive use of alcohol.
  • Smoking– Smoking can increase your risk of developing cataract Avoid smoking.
• Environmental risk factors
  • Excessive exposure to sunlight – Over exposure to ultraviolet (UV)radiation is risk factor for nuclear cataract. It is advisable for people whose jobs are exposed them to sunlight for prolonged periods to use sunglasses with 100% UV protection.
  • Exposure to ionizing radiation- Exposure used in X-rays and cancer radiation therapy may cause cataract.
  • Poor nutrition-Vision researchers believe that a diet high in saturated fat and refined carbohydrates may be linked to the development of cataracts. Healthy diet rich in antioxidants helps in risk reduction of cataract.

Regular eye exams can detect early occurrence of cataracts. Further research is in progress to develop interventions that will have an impact on their prevalence. Sometimes in some persons one or more risk factors never develop the disease, while in some persons it develops having no known risk factors. Nevertheless the understanding of the risk factors aids in the management of cataract.

Let’s discuss… We guide you to a better vision.

Cataract is world’s leading cause of blindness currently affecting nearly 20 million people. We do understand that age is the most common risk factor for cataract. Aging cannot be prevented and so is cataract. The alternate prevention mode that we focus attention on is how the risk of developing cataract can be minimized by slowing down its development.

The lens in the human eye consists of unique cells known as lens fibers that contain water and proteins called crystallins. These let light pass through the lens. Aging causes abnormal development in the lens causing cataract.

Eye drops and eye exercise do not prevent cataract formation and there is no sufficient evidence supporting that it may slow down progress either.

Let’s learn how to prevent cataract to some extent or to slow down its development.                  

• Nutrition and Diet strategies:

Information supports that having a rich nutritional diet with dark coloured fruits, vegetables (rich in lutein and zeaxanthin), fish with in omega 3 helps in decreasing the progression of cataracts.

• Wellness management strategies:

Regular check on the potentially interrelated personal factors such as:

• Regular check up and control on blood pressure is important. Stress being a risk factor need to be kept in control.
• Diabetes: Maintenance of healthy blood glucose levelscould prevent the onset of cataract.
• Obesity: Maintenance of healthy weight through exercise etc.
  • Other external conditions :
• Radiation exposure like X rays and gamma irradiation to be minimized.
• Protection of eyes from eye injury to avoid Traumatic cataracts.
• Sunlight: Moderate sunlight exposure at the right time is required for Vitamin D in the body and helps in controlling Myopia but exposure to intense sunlight without sufficient protective measures like sunglasses with UV protection can be a risk factor for cataracts.
• Medicines / Drug strategies:
• Use of steroid medicines– It has been observed that higher doses of steroid (prednisone and cortisone) along with longer usage could be a risk factor for posterior subcapsular cataracts.
• Uses of statin– Certain studies have associated the link between long term statin usage and cataracts.
• Homeopathy eye drops (Cineraria Maritima) is used by some to delay progress
• Lifestyle management strategies
• Smoking- Avoid smoking to prevent the risk cataract.
• Alcohol – Excessive amount of alcohol could increase the incidence of cataracts.
• Eye care strategies:
• Eye examination and test: Have frequent eye test to keep cataracts in check. Congenital cataract occur at birth can be detected if checked early.
• Neglecting presbyopic conditions could lead to cataracts.

Atomic-scale views of an eye protein aquaporin zero (AQP0) has been recently discovered. This protein maintains transparency of the lens in the eye, which could potentially lead to new methods in cataract treatment and prevention.

Vision researches research progressively on the known and unknown prevention measures. With multiple factors responsible occurrence of cataracts can be minimized by a following a healthier lifestyle.

Do get in touch with us an appointment and more details.

You can prevent cataract occurrence from developing to a great extent nevertheless cataracts cannot be fully prevented but we can treat them effectively.

At the moment surgery is the only effective treatment for cataract. Now you need to get the cataract affected natural lens replaced by a new IOL (intra ocular lenses) by surgery.

Read on for an insight to Femtocataract surgery.

What is Femtocataract surgery?     

Gone are the days where you had to wait in dark glasses in pain for days for clear vision after a cataract surgery. With the advances in ophthalmology procedures like Femtosecond laser-assisted cataract surgery (FLACS) a novel revolution in Cataract Refractive surgery has paved its way. As the name suggests the major difference here is the use of a Femtosecond laser controlled by the surgeon.

The edge over the conventional phacoemulsification lies in major surgical steps as noted below.

The first few steps in a cataract surgery involve the creation of corneal / corneo-scleral incisions (ports of entry) and capsulorhexis – creation of an incision in the front surface of the lens capsule, to enable removal of the cataract affected lens. Both these steps today are under the manual skill of a cataract surgeon. The phacoemulsification steps begin with the ‘chopping’ of the lens, breaking it down into smaller fragments to aid removal through a small incision, thus avoiding the need for stitches.

All above steps can be substituted with a good Femtosecond laser. However, it cannot substitute phacoemulsification in cataract surgery. The aspiration of the lens completely will still require the phacoemulsification equipment.

Thus it serves as a good aid to reduce complications, improve accuracy, safety and precision in cataract surgery.

Clear Corneal Incisions-

It is faster and safer to have incisions (surgical cuts) being computer-controlled with imized precision that can be customizable according to your eyes. Incisions made by the laser have a clear cut edges which results in quick sealing and healing, letting you have a satisfied refractive post operative outcome on day 1 of surgery itself.

Capsulotomy (Capsulorhexis) – Creation of the Opening made on the lens covering is done by dissecting with unmatchable precision which aids in perfectly positioning the implanted IOL.

Lens Fragmentation –Initial fragmenting (breaking up) of the lens to minute parts is done by the Laser thereby reducing the Phaco energy and time making it safer and less traumatic for the eye.

What are the steps in Femtocataract surgery procedure?

After pupillary dilatation and topical anesthesia the applanation (flattening of the cornea) with disposable patient interface cone is done.

• Real time OCT (Optical coherence tomography) along with high resolution video microscope captures images of the anterior segment of your eye which are further analysed.
• Every step is planned and customized according to your eye requirement to enhance vision. After mapping and marking of the size, shape and location of the incisions and surgery is completed with the removal of the capsulorhexis flap, the lens fragmentation and cortical clean up.
• Finally the IOL is implanted.

WHY Femtocataract surgery?

• Less complications- In comparison with phacoemulsification certain risks of injury to the capsule, iris, and cornea.
• Laser Precision and Accuracy
• Decreased Phaco energy
• Better refractive outcome– you can now experience functional visual improvement and spectacle independence
• Safer surgery- The laser wavelength is not absorbed by the corneal tissue.
• Moreover least risk of infections.
• Perfect capsulotomy- Accurate capsulotomies improves the precision of intraocular lenses (IOL)
• Helps to treat astigmatism, complex cataract cases, dense lenses etc.

The challenges

• May not be suitable to every patient.
• Cost and Infrastructure- The challenge of a huge financial investment both in initial cost and maintenance costs for the surgeon and procedure cost for the patient.
• Medical insurance – not covered by insurance.

Laser Systems used in Femtosecond cataract surgery

• VisuMax from Zeiss
• LenSx from Alcon
• Catalys from Optimedica
• LensAR fom LensAR
• Technolas

Other systems (Femto LDV Z6 –FDA cleared, Centurion newly released)

Femtocataract surgery is being adopted worldwide successfully nevertheless the technology is relatively new compared with conventional phacoemulsification cataract surgery. It has been used in complicated cataract cases too. The outcome on a large scale human trials and studies would need more time to justify.

Your eye is precious.

No doubt the best treatment suggested for you will be the one which you are best suited and which will optimise the best overall outcome.

If you have symptoms that suggest a possibility of cataract, get it diagnosed immediately. Identifying the type of cataract helps doctors determine the most appropriate course of treatment. Details on eye movement, pupillary responses, eye pressure and pupils on dilation are recorded.

Your eye is not just a window to the world, but also a window to understand other health conditions. The main purpose of the diagnosis is to determine if vision deterioration is particularly due to cataract and not other eye diseases which have similar conditions. The right diagnosis helps in deciding if the eye is suitable for cataract surgery.

Steps in diagnosing cataracts

Comprehensive Eye Examination is conducted by both Optometrist and Ophthalmologist to determine the type, location and size of the cataract.

Examination by Optometrist

Detailed history and physical examination of the eyes – Review of your medical history helps in determining cataract. Do discuss the existing illness and medications. Ensure that you carry your existing spectacles and stop the use of your contact lens before the appointment.

• Visual Acuity Test– The impairment in the vision can be easily detected by asking you to read an eye chart known as the Snellen eye chart. This is a chart with variation in the size of letters and is read from various distances usually 20 feet. Each eye is tested individually. The normal visual acuity is taken at 20/20.
• Refraction Test– If there is a reduction in visual acuity, a pinhole card is used to exclude short-sightedness as the cause of the vision loss. This determines the need for changes in your eyeglass or contact lens prescription.
• Tonometry test for Glaucoma screening– This is a standard test to measure fluid pressure (Intra Ocular Pressure) inside the eye. This is commonly known as the ‘Puff Test’ as the new method does not need to ‘touch’ your eyes, but uses air to take measurements.
• Pupil Dilation: This is a retinal examination where dilating drops are put in the eyes to enlarge the pupils. It is advisable to wear sunglasses after pupil dilation due to light sensitivity and blurred vision. Due to the dilated eyes, one is not allowed to self-drive after this check for your own safety.

Examination with Ophthalmologist

• Slit Lamp examination for cornea: The structure in front of the eye is magnified using a microscope called the slit lamp. The front parts of your eye – the cornea, iris, lens and the spaces in between are illuminated using a slit lamp to investigate minute abnormalities.
• Fundus Examination for retina: In the fundus examination the pupil is dilated which increases the size of your pupil. The observation on the vitreous, optic nerve, blood vessels, macula and retina is recorded. Here the retina is checked using an ophthalmoscope.

Treatment Plan

The above series of tests help in the management of the cataract progression. Tests like color perception, contrast sensitivity, and reaction to glare are conducted on case to case basis .The only effective treatment for cataracts is to have them surgically removed. In the treatment plan the further course of action is discussed like medications, pre – operative tests, blood tests, an ECG and chest X-ray. Diabetes, hypertension and heart conditions are also checked prior cataract surgery. The only cataract-specific test is the A-Scan. This determines the power of the artificial intra ocular lens which will need to be inserted in your eyes once the cataract affected natural lens is removed during surgery.

Cataract if left untreated, can cause blindness.

Ensure you get the right diagnosis at the right time.