FAQs - Cataract

What is Cataract?

  • It is clouding (opacification) of the natural lens, which prevents light rays from reaching the retina.
  • Early on, a change in glass power may help.
  • Later on, it progressively affects vision, till finally, only the perception of light remains.

What are the symptoms of cataract?

  • Painless, gradually progressive blurring of vision.
  • Double vision or seeing multiple images.
  • Trouble with seeing in poor light conditions and sometimes in excessive sunlight.
  • Becoming sensitive to glare, making night driving difficult.
  • Difficulty in distance vision and in reading.

What are the causes of cataract?

Ageing is the most common cause of cataract. Every person gets it sooner or later, especially people over 60yrs of age. Other causes include diabetes, injury, usage of certain medications, and secondary to other eye diseases such as uveitis and glaucoma. Cataracts can occur early in diabetes, myopia (short sight) and as a hereditary predisposition.

What are the symptoms of cataract?

  • Painless, gradually progressive blurring of vision.
  • Double vision or seeing multiple images.
  • Trouble with seeing in poor light conditions and sometimes in excessive sunlight.
  • Becoming sensitive to glare, making night driving difficult.
  • Difficulty in distance vision and in reading.

When does one go in for surgery?

  • To a large extent is depends on the person undergoing surgery.
  • Whenever the cataract affects vision to a degree that it hampers the person’s daily activities (reading, driving, playing golf etc.), surgery should be considered.
  • During surgery the normal lens of the eye is removed and replaced with an intra-ocular lens which lasts for the entire lifetime.

What are the surgical options in Cataract?

  • Surgery can be performed manually through 5- 6 mm wounds called SICS (Small Incision Cataract Surgery).
  • Phacoemulsification is at present universally accepted as the standard of care for cataract surgery.
  • Ultrasound energy is used in phacoemulsification to break up the cataract (emulsify) into microscopic fragments which can be sucked out of the eye.

What is MICS?

  • The surgical wounds have progressively become smaller and now the latest technique is "Micro-coaxial Phacoemulsification" or MICS.
  • MICS is phacoemulsification of the cataract through a wound of 2.2 mm or less, with implantation of an intra-ocular lens through the same wound.
  • Wound healing and refractive stabilization is faster in MICS than in traditional phaco.

What are the Options in Intra-ocular Lenses (IOLs)?

  • The majority of the IOLs implanted are mono-focal.
  • They can focus light rays from one particular distance only.
  • Normally distance objects are clear and one needs glasses for reading.
  • Intra ocular lens can be rigid or foldable. Foldable lens will need smaller wounds to insert.

What are the pre-op procedures?

One needs to be in fairly good general health. Diabetes, hypertension, cardiac problems (if any) need to be controlled before surgery. One needs to do a detailed checkup of the eye and a dilated examination of the retina. Specific to the eye ones need to undergo scans of the eye to find out the curvature and the length of the eye to decide on the model and power of the intraocular lens to be implanted.

What happens on the day of surgery?

  • Surgery is a "walk in-walk out" procedure.
  • Surgery is mostly done under topical anesthesia.
  • Anesthetic drops numb the surface of the eye and the surgery can be comfortably and painlessly performed. The eye remains open after surgery.
  • Some patients may require an anesthetic injection before the surgery.
  • A routine surgery lasts approximately 10 minutes with the preparation time being of similar duration.
  • Pre-operatively dilating drops are applied which take between 1 – 1.5 hours to act.
  • One could expect to spend half a day at the hospital on the day of surgery.

Is there much discomfort after surgery?

Cataract surgery is pretty much painless and so is the post-operative period. There is mild irritation (or foreign body) sensation for a few days. There may be mild redness & watering of the eyes which again subside in a few days.

What do I do after surgery?

There is no need for bed rest after surgery. One can walk, eat normally, watch TV and be normal around home on the day of the surgery. One needs some protective glasses only when outdoors.

What about the post-operative treatment?

  • There is a graded schedule for eye drops after surgery.
  • No tablets / injections are used.
  • One would start with 3 types of eye drops, which would be stopped over a period of 6 weeks.

When can I resume my normal work?

  • One can resume work even the day after surgery.
  • One could either work from home or office, but one should remember to apply the drops as advised.
  • Normally till the glass correction is given 4-6 weeks after surgery, reading may be difficult, but this is much better after implantation of a multifocal IOL.
  • Temporary glasses can be given the day after surgery.
  • One could resume routine exercise, yoga & sports like golf 2-3 days after surgery.

What about post-operative restrictions?

  • One should avoid water from directly getting into the eyes for 10 days after surgery.
  • One could sponge the hair and face properly even the day after surgery.
  • Normal bathing (taking precautions for the eye) can be resumed the day after surgery.
  • After 10 days one can be completely normal.
  • Bending down, chewing food or lifting moderate weights are not at all a problem after surgery.
  • One can be pretty much normal after surgery.

When will I see well?

The vision will be bright and pretty much clear the day after surgery. Full vision will be restored gradually in a few days’ time. Objects may appear excessively bright & blue in color for some days. This is because the cataract was not allowing light to reach the retina and most of the blue light was being cut off. The brain gets disused to seeing blue. All these complaints are temporary.

Will I need glasses after surgery?

We use highly specialized equipment (Immersion A-Scan, Optical Biometry, corneal topography etc.) to predict the IOL power to be implanted. Even then, there is a small possibility of a minor error in the IOL power. This leaves a residual spectacle power which would need to be corrected with glasses.

How do I clean my eye after surgery?

One would not normally need to specifically clean the eye after surgery. Mopping the face with a wet towel (with the eyes closed) should suffice. If there are deposits of medicines on the eyelids or lashes one could use Fresh ear buds, moisten them with an antibiotic eye drops and clean the Outer parts of eyelids (and lashes) with them.

Can I travel after surgery?

  • There is no problem in travelling even on the day after the surgery.
  • Any amount of travel is absolutely fine provided one remembers to apply the eye drops.
  • Timings will be given for the application of the eye drops, but an hour this way or that does not cause any problem.