August 2022 - Armadale Eye Clinic

what does a cataract look like

What Does a Cataract Look Like?

August 30, 2022/0 Comments/in Cataract Surgery /by armadaleeye

With cataract surgery being the top most commonly performed eye surgery in the world, it’s not unexpected that you would be familiar with the age-related condition that is cataracts. However, for many people, the finer details of common cataract symptoms and how they’re diagnosed can be a little less well-known. So, what does a cataract look like?

What Does a Cataract Look Like to You: Symptoms of a Cataract

Cataracts refer to opacities or haziness that form in the crystalline lens behind the coloured iris. Usually, this lens is transparent, allowing the free transmission of light into the eye. So, as this lens becomes hazier or cloudier with progressing age, it naturally will interfere with your sight.

It’s not typically possible to see your own cataracts in a mirror as they’re hidden behind the iris. However, if viewing someone else with a cataract from the right angle, you may notice a whitish glint in their pupil. This is a sign known as leukocoria. When it comes to yourself, suspecting you’re developing cataracts is more likely to arise from some common visual symptoms.

Deteriorating clarity of vision. Some people don’t identify an actual change in the quality of their sight. Instead, they may be more likely to notice certain activities are becoming more difficult. For example, where you once were able to easily read the scrolling news headlines at the bottom of the TV screen, you now find yourself squinting.

Another commonly reported concern is when people with cataracts feel they need to get much closer to street signs than previously before being able to read them when driving.

In other cases, a person may be able to describe the deterioration of their sight as blurry, cloudy, hazy, or filmy.

It’s this aspect of cataract symptoms that often drives people to look into cataract surgery.

Increased discomfort with bright lights. This is also known as glare sensitivity or photophobia. As the opacities of a cataract can scatter light, you may find you become increasingly sensitive to glare and lights. This may manifest as feeling particularly uncomfortable when driving at night, as you are often faced with oncoming car headlights or street lamps. The impact of cataracts on glare sensitivity may also be apparent when backlight signage or LED signs also become more difficult and uncomfortable to read, especially when the ambient lighting is low.

Poorer vision in dim lighting. In addition to discomfort in bright lighting, dim lighting can also present a problem when cataracts begin developing. This aspect of cataracts is known as contrast sensitivity. The most common manifestation of decreasing contrast sensitivity is finding it more challenging to read in poorer lighting. Many patients will report finding that they now need to bring their newspaper right to the window to read the print, or they realise they need a bright lamp shining right on the page when reading indoors.

Altered colour perception. This is not often noticed, but some people with occupations or hobbies requiring fine colour discrimination may be aware of this change in their sight. A common form of age-related cataract known as nuclear sclerosis develops as a yellowish-brown haze. This has the effect of absorbing certain wavelengths of light, which alters the colour of the world seen through the cataract.

The impact of these symptoms on a person’s lifestyle and daily tasks is often what guides the timing of cataract surgery. If you’re still getting along quite comfortably despite these changes to your sight, cataract surgery can be safely deferred (and this is often what’s recommended). Alternatively, if you have another condition that would benefit from eye surgery and can be combined with your cataract surgery, you may be advised to go ahead with the cataract surgery earlier. An example of this is certain glaucoma eye surgery procedures that are often performed at the same time as cataract surgery.

What Does a Cataract Look Like to Your Eyecare Professional: Diagnosis of a Cataract

Diagnosing a cataract is often done during a routine eye exam, even before you notice any changes to your sight. Both optometrists and ophthalmologists (eye specialists) are capable of diagnosing a cataract. However, only ophthalmologists are qualified to perform eye surgery to remove it.

When assessing cataracts, your eye care professional will perform a couple of common tests.

Visual acuity testing. This is done by asking you to read black letters against a white background, set at a certain distance. The result is recorded as the smallest size of letters you’re able to read accurately.
Slit lamp examination. The slit lamp is a useful piece of equipment comprising a microscope system and a light source. Through the slit lamp, your eye care professional is able to view your cataracts directly. What does a cataract look like behind the slit lamp? Through this microscope, your eye care professional will be able to see any alterations to the transparency of your crystalline lens. Depending on the type of cataract, this may typically look like discolouration of the centre of the lens (nuclear sclerosis), white or grey spoke-like opacities radiating from the edge of your lens (cortical cataracts), or a dense plaque on the back surface of the lens (posterior subcapsular cataract). There are also a number of other cataract presentations, including bluish flecks, snowflake-like opacities, and white spots.

The appearance of a cataract is not usually a cause for alarm, as they’re considered to be a normal part of ageing. By being attentive to your vision and keeping to your scheduled eye check-ups, your eye care professional will be able to monitor the development of any cataracts and advise you when cataract surgery may be recommended.

Note: Any surgical or invasive procedure carries risks. Before proceeding, you should seek a second opinion from an appropriately qualified health practitioner.

References

Cataracts.

https://www.mayoclinic.org/diseases-conditions/cataracts/symptoms-causes/syc-20353790#:~:text=A%20cataract%20is%20a%20clouding,frosty%20or%20fogged%2Dup%20window.

Cataracts.

https://www.healthdirect.gov.au/cataracts

procedure for cataract surgery

Procedure for Cataract Surgery — All You Need to Know

August 16, 2022/0 Comments/in Cataract Surgery /by armadaleeye

Every year, over a quarter of a million people undergo cataract surgery in Australia. Considering that the development of cataract is closely linked to older age, it’s no surprise that your local cataract surgeon is kept busy with our ageing population. As preparing for upcoming cataract surgery can be a nerve-wracking experience, it may help you to read about what you should expect from the procedure for cataract surgery.

The Procedure for Cataract Surgery

The procedure for cataract surgery is actually relatively simple. That being said, your cataract surgeon would have gone through about a decade of medical and specialist training to perfect their technique. The aim of the surgery is to remove the hazy, cloudy crystalline lens from your eye and replace it with a clear implant. By removing the opaque lens, light can enter the eye correctly, allowing you to see with better clarity.

Cataract surgery is a day procedure performed either through the public or the private system. The calibre of the surgeon is the same no matter which system you choose, as many surgeons operate in both.

Before your cataract surgery, your surgeon and clinical team will have gone through a few pre-operative necessities. These include:

Assessing your cataracts and your vision to ensure cataract surgery is an appropriate course of action at this time for you.
Examining your eye for other conditions or abnormalities that may pose a risk during your operation or during the post-operative recovery.
Discussing your visual needs with you and what sort of intraocular lens implant you would like to replace your natural lens once it’s been removed.
Taking a complete medical history, including any medications or other health conditions that have the potential to affect the outcome of your cataract operation.
Taking precise biometric measurements of your eye to calculate the power of the intraocular lens.
Recommending pre-operative preparation as necessary, such as avoiding contact lens wear or using certain prescribed eyedrops leading up to your surgery.

On the day of your cataract surgery, you will be asked to ensure you’ve organised transport home as you won’t be able to drive after your operation. Your cataract surgeon may offer you a light sedative if you’re feeling particularly uncomfortable or anxious, but general anaesthesia is usually avoided as it increases the risks of the surgery. Your eye area will be numbed with either a topical anaesthetic or a local nerve block injection, and your pupil will have been dilated with pharmaceutical eye drops. If the eye drops aren’t sufficient to widen the pupil, the surgeon can also use other tools to achieve this.

Once you’re comfortable, your surgeon will ask you to fixate on an overhead light to help keep your eye steady. A small incision is made in the cornea, the eye’s front surface. The surgeon can insert the other tools necessary to extract the cataract through this incision. This includes gently opening the membrane bag that holds the cataract, fragmenting the cataract into smaller pieces, and then suctioning these pieces out of the eye. The intraocular lens is also inserted through this corneal incision. Your surgeon places the implant into the membrane bag and gently manipulates it into place. The procedure for cataract surgery takes, on average, 10-20 minutes per eye.

There are two popular methods of cataract surgery – conventional phacoemulsification and femtosecond laser-assisted cataract surgery. Femtosecond laser-assisted surgery replaces most steps performed manually in conventional surgery, with a laser tool. Advocates for femtosecond laser-assisted cataract surgery find that the steps of the operation are more precise and predictable than during phacoemulsification cataract surgery. However, the cost of the femtosecond laser equipment is significantly higher, and this method is not available through the public healthcare system. Ultimately, research tends to find that the visual outcomes between femtosecond laser-assisted surgery and conventional cataract surgery are not significantly different. The final result is often largely dependent on the skill of the surgeon.

Cataract Surgery Post-Op

After your cataracts have been removed, your surgeon will provide you with a prescription for various eyedrop medications and some post-operative guidelines. You will have a protective shield placed over your eye and a few review appointments booked, typically for a day or two after your operation, a week later, and a month later.

Your specific post-op instructions may vary slightly, but in general, they will include recommendations to:

Get enough rest to allow your body to heal.
Avoid any heavy lifting.
Use your eye drops as instructed, even if the eye feels better before the end of the prescribed course.
Avoid swimming pools, the beach, jacuzzis, spas, and saunas.
Keep the eye protected from dirt, dust, soaps, and other foreign substances.
Take a break from high-risk activities that have the potential to result in an eye injury.

Most people can return to driving within a few days once they’ve had their eyesight assessed and cleared as passing the local road authority’s vision requirements. Depending on your vocation, you may return to work after a week. Alternatively, high-risk occupations may be recommended to take a more extended leave period.

If you think you may be developing a cataract that requires an operation, see your local optometrist or ophthalmologist for an assessment by calling on (03) 9070 5753.

Note: Any surgical or invasive procedure carries risks. Before proceeding, you should seek a second opinion from an appropriately qualified health practitioner.

References

New standard to improve care for Australians with cataract.
https://www.safetyandquality.gov.au/about-us/latest-news/media-releases/new-standard-improve-care-australians-cataract#:~:text=Each%20year%20more%20than%20250%2C000,in%20private%20hospitals%5Biii%5D.

Cataract surgery and nonsteroidal anti-inflammatory drugs.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5531861/#:~:text=This%20has%20been%20widely%20accepted,an%20increased%20risk%20for%20complications.&text=Another%20and%20arguably%20the%20most,is%20for%20prevention%20of%20CME.