Contrary to popular belief, a cataract is not a “film” over the eye. Rather it is a gradual thickening of the lens that causes the lens to become so clouded that light is either distorted or cannot reach the back of the eye (the retina) for transmission to the brain.

Blurry or dim vision, colours appearing faded, poor night vision, halos appearing around lights, and sensitivity to bright lights can all be symptoms of a cataract. Age-related cataracts develop very slowly and painlessly. In fact, you may not even realize that your vision is changing until you find yourself going to the eye doctor seeking a change in your eyeglass or contact lens prescription.

Many things can cause a cataract to form, the most common being the natural aging process. As the lens of your eye ages, it gradually thickens and yellows, eventually becoming so cloudy that you are said to have a “cataract.” Other diseases, like diabetes and glaucoma, can increase the chances that a person will develop cataracts. Eye injuries and chronic use of corticosteroids can cause cataracts as well. For more information on what causes cataracts, click here.

The lens of the eye can change in multiple ways, all resulting in the condition called a cataract. In general, there are 2 ways a cataract can form—at the nucleus, or center, of the lens, or at the cortex, or shell, of the lens.

Yes, there are several types of cataracts. The different types are defined by which part of the lens they affect. Nuclear cataracts are the most common and usually form as a natural part of the aging process as cells from the lens deposit in the nucleus of the lens. Cortical cataracts are also fairly common and form when the shell, or cortex, of the lens becomes hard.

Cataract surgery is a microscopic surgery usually performed under local or topical anaesthesia. The cloudy lens is removed by Phacoemulsification, which is a micro-incision technique of cataract surgery wherein a probe breaks the cataract into tiny pieces and sucks them out. If a foldable implant is inserted the incision size is smaller (2.8 – 3.0 mm) as compared to an approximately 5 mm incision to accommodate a non-foldable lens. Both incisions are self-sealing and need no stitches. Our eye doctor will help you decide as to which lens should suit you best.

Cataracts are commonly seen in older people over the age of 60 years. They are rarely seen in infants and young adults.

Well, yes and no. There are no well-established proven means of preventing cataract.  None of the vitamins, minerals, herbal or ayurvedic extracts or other supplements have been scientifically proven to prevent cataract in any age group Since developing cataracts is a natural part of the aging process, it is highly unlikely that you can prevent their development. There are things you can do to slow down their development, however, such as:

1. Wear sunglasses. Use of UV blocking (both UVA and UVB rays) sunglasses can reduce exposure to these harmful rays and may delay the development of cataract if used regularly over long term 
2. In diabetic patients tight blood-sugar control can delay the otherwise accelerated development of cataracts.
3. Eat a diet rich in antioxidants

There are multiple types of cataracts, and even within the same type, there are a range of symptoms a person can experience.

Yes. If you live long enough, you will likely develop cataracts.

Yes. Diabetes and glaucoma both predispose a person to developing cataracts.

Because a cataract affects the part of the eye that is responsible for refracting light, it will sometimes cause a refraction error such as near-sightedness or farsightedness. And rarely, if left to mature, a cataract can eventually become so large that it causes a type of glaucoma.

No. As the natural lens of the eye ages, it often hardens and is less able to flex and focus light. This hardening is often accompanied by a loss of flexibility in the surrounding muscles. This hardening and loss of flexibility is commonly called presbyopia. Because presbyopia is a function of aging, many people with cataracts also have presbyopia. In recent years, multifocal intraocular lenses have been developed to correct both cataracts and presbyopia simultaneously.

No. However, a person can develop cataracts in both eyes.

A cataract surgery is usually performed when the cataract interferes significantly with your vision and your daily routine. You need to visit the eye doctor regularly to monitor its progress. 

Many people think that cataract has to develop completely before it can be removed, but this is no longer true. Cataract surgery is a safe and predictable procedure that can be performed at any point of time you feel your reduced vision is impacting your day-to-day life.

No. This is a widely held belief but has no scientific bearing. With modern day procedure of cataract removal and foldable IOL implantation through a micro-incision using Phacoemulsification technique, there is absolutely no scientific reason to wait for any particular weather for cataract removal.

If left untreated, over a period of time, the clouded areas of the lens can become larger and denser, resulting in worsening of the vision. This could take anywhere between a few months to many years. Eventually your entire lens can become clouded, leading to further increase in blurred vision, thus affecting your daily activities.

Most cataracts associated with aging progress slowly. Some patients do not notice the extent of the visual loss because of the slow onset. Other cataracts, especially in younger people and diabetic patients, progress rapidly over a few months. It is not possible to predict exactly how fast cataracts will progress in any given patient.

This is a colloquial way of saying that the cataract affects vision enough that the benefits of removing it outweigh the risks of the surgical procedure

Yes. When left untreated, cataracts may eventually cause blindness.

A medical eye examination, including a check for glasses prescription (refraction), is necessary. In the early stages of cataract development, a change in glasses may be all that is required to improve vision. During the examination, your eye doctor will determine whether there are other causes of vision loss.

The usual test for visual acuity, the letter eye chart, may not reflect the true extent of your visual loss. Other tests that measure glare, sensitivity, night vision, colour vision, and side or central vision may be useful. Some of these tests may help predict the degree of visual recovery that can be expected after cataract surgery.

There are two circumstances in which removal of a cataract by way of cataract surgery should be considered even though improvement in vision may not be expected. A cataract may be so advanced that diagnosis or treatment of other eye diseases cannot be performed properly. In this situation, it may be best to remove the cataract through surgery so that the interior of the eye can be examined. It is also possible for a cataract to become so advanced that the cataract itself causes other eye diseases, particularly inflammation or glaucoma. These rare situations are the only ones in which cataract removal may be considered an emergency necessity.

If you choose not to have an operation, your cataract won’t get better and your sight will gradually get worse. Your cataract will keep growing until the whole lens is white and you can no longer see.

Cataracts may cause problems that can severely damage your sight. And leaving them to grow can make surgery more difficult, which increases the chance that something will go wrong during the operation.
But cataracts usually develop slowly over the years, and many people with cataracts manage well with glasses and contact lenses. If your cataract isn’t interfering with your daily life, you may choose not to have your operation straight away. Unfortunately, your doctor won’t be able to tell you exactly how fast your cataract will grow. There hasn’t been any good research on this.
Older people sometimes put off having an operation and may avoid it altogether.

Having an operation is the only way to remove your cataract and improve your sight. Eye drops and other treatments are available to treat cataracts, but there’s no evidence that they work.

New glasses, brighter lighting, anti-glare sunglasses or magnifying lenses might help with the first signs of a cataract (slight cloudiness at the edges of an image), but these won’t stop the cataract growing and blurring your sight.

The best surgical procedure is one that combines high precision and has the greatest safety margin. As of now Laser Cataract Surgery and selecting a package where all disposable instrumentation is used is probably the best

We perform the most advanced cataract surgery which in lay man terms is called ‘Laser cataract surgery’ although the true medical term is ‘Phaco emulsification’. The common person calls it laser cataract surgery because of ‘no stitches’. YAG lasers are sometimes used to create a clear opening in the lens-containing membrane, if it becomes cloudy after a few months following cataract surgery.

The overall success rate of a cataract surgery is +98%. Continuous innovation in techniques and instruments has made the procedure simpler and safer than before.

Phacoemulsification is a good technique and has the following benefits – micro incision, no stitches, safe and fast visual recovery. 

The cost of cataract surgery can vary depending on a number of factors, including: 
type of intraocular lens (IOL) you want to select 
The technology involved in the procedure
For more details please visit our institute or call us on 040-30612140 or email us at cataract@lvpei.org

No single lens works for everyone and your ophthalmologist can determine the most appropriate option for you. However, in general if you would like to depend less on glasses, ask about our range of multifocal lenses. A variety of foldable lenses are available and vary according to the material and the optics. The lenses can be made of either Hydrophobic acrylic, Hydrophilic acrylic or Silicone. There are distinct advantages and disadvantages of each material and the suitability of each type for a patient needs to be discussed with the eye surgeon.  Read the section on Premium IOL for more details

Although this is highly unlikely for it not to work, the lens implant or IOL can be replaced with a different one, if needed. Overall, lens implants are intended to be permanent and never need to be replaced under normal circumstances. The first lens implants were used starting shortly after World War II, so there is considerable data supporting the long-term safety of lens implants.

The artificial lenses implanted inside the eye during cataract surgery are intended to remain permanently in place and require no maintenance or handling. They are neither felt by the patient nor noticed by others.

The procedure typically lasts between 15 and 30 minutes, though it may be two to three hours from when you check in until you leave (Operation Theatre) the hospital.

Yes. Your surgeon will offer you medication to help you relax and take steps to make sure you don’t feel any pain.

Contact our centre immediately if you have any problem, especially if you experience decreased vision or pain. (give link to contact us in detail)

Minimum of seven days rest is recommended before you resume your day-to-day activities. This may vary based on your eye condition and your working environment. Polluted and stressful environment should be avoided.

In most of the cases a small refractive error is present after cataract surgery and wearing glasses will make your vision sharper.

This would depend on the type of intraocular lenses (IOLs) used for you. The advanced intra ocular lenses such as multifocal or accommodating IOLs greatly reduce dependency on glasses and in most cases even reading glasses can be avoided. Rarely does anyone have to wear thick eyeglasses now.

As your eyes heal in the days following surgery, you may experience various visual disturbances, such as glare and halos (rings around light sources) in certain lighting conditions. This is normal and usually subsides over time.

Most people notice a significant improvement in their vision and can resume everyday activities within 24 hours after cataract surgery with precautions that have been informed to you after surgery. However, depending on which intraocular lens you have implanted, it can take between two weeks to six months to completely adjust and for you to achieve your optimal vision.

No, once a cataract has been removed, a new cataract cannot develop. Lens implants do not cloud over like human lenses do. However, over time many patients may notice that their vision has once again become cloudy. This fairly common condition, which may occur with any type of lens implant, is known as posterior capsular opacification or “PCO.” Some doctors refer to it as a “secondary cataract” because the visual symptoms are similar to those of a cataract. If the PCO becomes bothersome, your surgeon can clear it away with a relatively simple laser procedure, known as a Yag Laser Capsulotomy.

No. Though it is possible for patients to notice some changes to their floaters when they have gone through cataract surgery, you should not expect for cataract surgery to get rid of your floaters. For more information on floaters, click here.

Negative dysphotopsias are the appearance of a dark line or parenthesis out of the corner of your peripheral vision that may described as a dark shadow. Others describe this as what a horse might see with blinders over the sides of its vision. This visual effect may occur in patients who have had otherwise perfect surgery with any type of intraocular lens implant. Though it is not well understood why this phenomenon occurs, it is believed to be related to changes in the optical system of the eye with the introduction of the lens implant. This temporarily creates an arc-shaped shadow over the peripheral retina when light enters and reflects within the lens implant. Fortunately, this effect generally goes away over 6 to 12 months after cataract surgery in most patients.

The natural lens is a major factor that causes us to need eyeglass prescription changes during our adult life. When you go through cataract surgery, the implantation of a synthetic lens creates added stability in your eyeglass prescription. While your prescription will be more stable, the average lifespan of a pair of eyeglasses is approximately two years due to scratching, breakdown of lens coatings, and other wear and tear. For this reason, if you have opted for a lens implant still requiring you to wear eyeglasses, then you will still find a need to change your eyeglasses approximately every two years.

If you should experience changes whereby you develop nearsightedness, farsightedness, or astigmatism, then you may be a candidate for a vision correction procedure or “enhancement” such as Photorefractive Keratectomy.

Like eyeglasses or contact lenses, every artificial lens implant model (both monofocal and multifocal) is manufactured in more than 60 different “powers” so as to match the appropriate power to your eye. When “refracting” or measuring you for eyeglass or contact lens prescription, we use a trial and error method to preview various lens powers in front of your eye. You are asked, “which is better, lens one or two?” as a way for you to select the lens power that you see best with. However, because the artificial lens implant is inserted inside the eye, and only after your natural lens (cataract) has been removed, it is impossible for you to preview or “try out” different lens powers before surgery. There is not a way to simply insert more than one lens implant and then let you select which one gives you the best distance focus. Lastly, once it is implanted, we cannot easily exchange the lens implant the way we could with eyeglasses or contact lenses.

Fortunately, the appropriate power of the lens implant can be estimated using mathematical formulas that utilize preoperative measurements of your eye’s dimensions. Although the measurements are very accurate, a number of variables prevent this process from being 100% perfect. One variable is the final precise position where the implant will end up inside your eye. Another variable is your amount of astigmatism, the naturally occurring imperfection in the optical shape of your cornea. Astigmatism generally is not corrected by the lens implant placed inside the eye and is another variable that may reduce your ability to see without glasses. The entire process is accurate enough so that most patients will see quite well without glasses in the distance when that was the planned goal. However, that distance vision might not be “perfect” and you might choose to wear glasses with a mild prescription for those times when a sharper distance focus is required.

For a multifocal lens implant to work well, it is very important for the selected lens power to match your individual eye. Despite flawless surgery, some patients with multifocal lens implants are still not able to see as well without glasses as they would like. If this is due to the lens power being “off”, then there are different options available. One option would be to wear glasses or contact lenses. A theoretical solution might be to exchange the multifocal lens implant for another with a different power. However, because of the risks involved with removing a lens implant, it is usually safer to “enhance” or fine-tune any residual prescription with an external laser vision correction procedure such as PRK on the cornea instead. PRK can also correct any remaining astigmatism of your cornea.

Every type of eye procedure intending to reduce a person’s need for eyeglasses may need to be “enhanced” with additional surgery. For example, nearsighted or farsighted people choosing to have laser vision correction such as LASIK or PRK may need a second treatment if the first one does not fully correct their prescription. This unpredictability is understandable because we are not machining plastic or metal, but are working instead with human tissue.

At the same time, it is possible that either the standard or multifocal lens implant that has been selected may not adequately correct your distance prescription. Depending upon how far off your prescription is from our intended goal, laser enhancement may be a good option. The odds that this would need to be done with a multifocal lens are usually less than 10%. The chances are greater in patients with high astigmatism or those requiring very strong prescription glasses to begin with. The need will also depend upon how much better one wants to see without glasses. Unlike some doctors who specialize in only cataract surgery, at Angel Eyes we are able to offer laser vision correction enhancements when they may be needed. Owing to the fact that an additional procedure is involved, there may be added cost implications should you need a laser vision correction.

Not surprisingly, the additional charge for implanting these special lenses is not covered and must be paid out-of-pocket by the patient. Because these lenses have nothing to do with improving the health of your eye, insurance companies and Medicare do not view them as “medically necessary.”

Most patients will notice some amount of a ring or halo effect around point sources of light at night, especially in the first few days after surgery while the pupil is dilated. These are different from and less problematic than halos caused by cataracts. Fortunately, this effect is usually mild, generally does not interfere with your visual function, and tends to decrease with time. The process through which these halos become less noticeable by the brain selectively ignoring them is known as neuroadaptation. It is the same process that allows us to ignore background noise such as traffic noise or the sound of an air conditioner or to become less aware of certain simulation such as the feeling of wearing jewelry or a seatbelt. How quickly this adjustment happens will vary for different individuals. Experience has shown this to continue to improve throughout the course of the first year. Earlier generations of multifocal lenses had a more pronounced effect that was more difficult to adapt. Fortunately, subsequent design changes have enabled subsequent generations of multifocal lenses to be re-engineered so as to significantly reduce the halo effect compared to the earlier model. During the first couple weeks after surgery, some patients describe differences in the crispness of their near or intermediate vision when compared with their distance vision. With time, healing, and adaptation to the lens implant optics, the crispness of each of these zones of vision tends to become more equal.

Typically, we wait a minimum of 3 months after cataract and lens replacement surgery to give your eye adequate time to heal before performing any additional surgery on it. Your eye doctor will be able to determine when you are ready for Laser Vision Correction.