Cataract

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Symptoms

Cataract is a painless disorder. The first symptoms include blurred vision and sensitivity to strong light. Drivers can experience glare from oncoming vehicle headlights while driving at night. When looking with one eye, the colors might appear less saturated than when looking with the other eye. In addition, the image of near objects may be doubled. Gradually, myopia develops on the affected eye, i.e. blurred distant vision.

Causes

The principle of this disorder is a cloudy eye lens. Its causes (so-called acquired cataract) are not yet well known. They may be associated with other eye disorders or injuries as well as overall disease - such as diabetes. Long-term usage of certain medications such as corticosteroids is also considered a possible cause, as well as is smoking. The most common type is called senile cataract, cataract occurring in patients over the age of 65. Whether it develops eventually depends on genetic inheritance. Genetics plays a role in congenital cataracts. The cause may be mother’s infection such as rubella during pregnancy.

Examination

In addition to the standard complex eye examination, (see dioptric defects) you will be examined by a slit lamp. This is a special microscope that allows the doctor to look into the eye and examine thoroughly its individual parts. The examination is painless. You will be seated in front of the device, you will rest your forehead and chin on a special construction, and the doctor will examine your eyes one at a time. The doctor will assess the degree of cataract and examine the eye background, to see if the visual disorder is not caused by the retina.

For better visibility, it is sometimes necessary to apply eye medications that dilate the pupil (the so-called artificial mydriasis). Shortly after the examination, maximally a few hours, the artificially dilated pupils might worsen your near vision and this may cause higher sensibility to light. Therefore, activities such as driving, for instance, are not recommended. However, symptoms such as these, which are caused by medication, will wear off within a few hours.

Conservative treatment

For patients with cataract the conservative treatment is not available.

Surgery

Phacoemulsification with artificial intraocular lens implantation

During phacoemulsification, an ultrasonic probe tip is inserted into the eye through a small incision (2.1 - 3 mm). This probe tip emulsifies and aspirates the contents of the clouded lens. The capsule of the lens must be preserved, and so a circular opening is created only in its anterior part. The artificial intraocular lens is then placed into the capsule. The incision through the cornea can be left either without sutures afterwards, or it can be closed with only one stitch. The surgery is performed on an outpatient basis. The eye is anesthetized by drops beforehand.

Initially, artificial, hard (inflexible) intraocular lenses made of plastic (polymethylmethacrylate) were used. The development of delicate surgical methods led to the demand for soft, flexible intraocular lenses, made of biomaterials (silicone, acrylic, collamer etc.) A soft, folded lens is inserted into the eye through a small incision and inside the eye the lens unfolds into the required shape. According to the visual correction needs, it is possible to select monofocal or multifocal lenses. The first provides clear vision of a single focal point in the lens that is either near or far. The latter allows sharp vision at multiple distances.

Equipment/Devices used

Phacoemulsifier

This device is designed for anterior eye segment surgery. It enables clouded lenses to be emulsified by the means of ultrasound. The remains of the lenses are then aspirated and replaced by a special solution. It guarantees the preservation of a stable volume of the eye during surgery. Our clinic uses phacoemulsifiers from the Alcon Company, which belong to the best and most advanced devices of its kind.

Contactless barometer

This device uses a laser beam to determine the correct dioptre values of the intraocular lens (it is implanted instead of the original cloudy lens). As eye contact with the device is not needed, measurement accuracy is higher. Anesthesia of the eye is not required and the risk of transmitted infection is reduced. Our clinic uses a biometer from the Carl Zeiss Company.

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