The lens is made mostly of water and protein. Specific proteins within the lens are responsible for maintaining its clarity. Over many years, the structures of these lens proteins are altered, ultimately leading to a gradual clouding of the lens. Rarely, cataracts can present at birth or in early childhood as a result of hereditary enzyme defects, and severe trauma to the eye, eye surgery, or intraocular inflammation can also cause cataracts to occur earlier in life. Other factors that may lead to development of cataracts at an earlier age include excessive ultraviolet-light exposure, diabetes, smoking, or the use of certain medications, such as oral, topical, or inhaled steroids. Other medications that are more weakly associated with cataracts include the long-term use of statins and phenothiazines
At first, the cloudiness in your vision caused by a cataract may affect only a small part of the eye's lens and you may be unaware of any vision loss. As the cataract grows larger, it clouds more of your lens and distorts the light passing through the lens. This may lead to signs and symptoms you're more likely to notice.
All cataracts are fundamentally a change in the clarity of the overall lens structure; however, cataracts may result either early in life or as a result of aging, and different portions of the lens may be more affected than others. Cataracts that occur at birth or present very early in life (during the first year of life) are termed congenital or infantile cataracts. These cataracts require prompt surgical correction or they may prevent the vision in the affected eye from developing normally. When the central portion of the lens is most affected, which is the most common situation, these are termed nuclear cataracts. The outside of the lens is called the lens cortex, and when opacities are most visible in this region, the cataracts are called cortical cataracts. There is an even more specific change that occasionally happens, when the opacity develops immediately next to the lens capsule, either by the anterior, or more commonly the posterior, portion of the capsule; these are called subcapsular cataracts. Unlike most cataracts, posterior subcapsular cataracts can develop rather quickly and affect vision more suddenly than either nuclear or cortical cataracts.
To detect a cataract, the eye-care provider examines your lens. A comprehensive eye examination usually includes the following:
Surgery - The standard cataract surgical procedure is typically performed in either a hospital or in an ambulatory surgery center. The most common form of cataract surgery today is a process called phacoemulsification. With the use of an operating microscope, your surgeon will make a very small incision in the surface of the eye in or near the cornea. A thin ultrasound probe is inserted into the eye that uses ultrasonic vibrations to dissolve (phacoemulsify) the clouded lens. These tiny fragmented pieces are then suctioned out through the same ultrasound probe. Once the cataract is removed, an artificial lens is placed into the same thin capsular bag that the cataract occupied. This intraocular lens is essential to help your eye focus after surgery.
Gourav Kataria
AmSure Delhi (Jasola)
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