Senile Cataract-Procedures, Side effects, Recovery time, Costs and alternatives

It is a vision impairing disease that occurs due to aging, and mainly affects elderly patients or people above the age of 50. This condition causes clouding in the eye lens or thickening of the lens, which leads to decrease in vision that gradually worsens with time. Senile cataract has high probability of causing partial or total blindness if left untreated.In fact, it is one of the leading causes of blindness worldwide. The main symptom for this condition is loss of vision or blurriness. Another common symptom is glare, i.e., difficulty to see in bright light. Patients may also observe the presence of black spots in the eye lens.

Aging is the primary cause ofthis visual disorder, as the lens thickens gradually with age. However, there are a lot of other factors that influence the risk of senile cataracts in individuals. Regular smokers have high chances of suffering from this condition. Exposure to radiation or UV rays is another factor. Some other causes are eye injury or trauma, nutrient deficiency and drug ingestion. Diabetic and obese individuals are also at greater risk. The cause can be hereditary in some cases, where infants are born with the presence of cataracts.

Surgery is the only effective treatment for cataracts, where the defective eye lens is surgically removed and replaced with an artificial lens. A diagnosis will first be performed by the doctor/ophthalmologist toexamine the symptoms and confirm the presence of cataract. Generally, surgery is not suggested for early stages of cataract when loss of vision is not significant.

During the diagnosis process, ocular tests are conducted to measure visual acuity and analyse the severity of the condition. Need for surgery will be decided after considering factors like the stage of cataract and the patient’s visual needs. The most commonly used surgical method is called ‘phacoemulsification’, which is conducted under the influence of local anaesthesia. The steps involved in this procedure are listed below.

1. Anaesthesia is administered to the patient, either by injecting it near the affected eye or by using anaesthetic eye drops.
2. Small incisions are made in the cornea to facilitate the insertion of other required instruments in the eye,
3. Using specific surgical instruments, a small hole is made in the lens capsule, which is the membrane that holds the lens.
4. Ultrasonic device is then used to emulsify the lens into liquid. The emulsified liquid is sucked out from the hole in the lens capsule.
5. An artificial lens is finally implanted into the lens capsule.
6. Salt water is applied to the incision wounds in the cornea, as this leads to swelling and helps the incision to be sealed.

The surgery takes less than an hour, and the patient can be discharged on the same day if no complication arises. There are other surgical methods, such as Intracapsular cataract extraction (ICCE) andExtracapsular cataract extraction (ECCE). But these are not commonly used as compared to phacoemulsification because these methods require large incisions to be cut in the eye, while phacoemulsification can be carried out by making much smaller incisions.

This condition hardly affects youths and adults, so it is more prevalent among people above 50 years of age. Anyone who has been diagnosed with senile cataract can opt for surgical treatment. But unlike many other diseases or disorders, there are no specific signs or stages for the surgery to be conducted. As such, the patient and doctor need to mutually decide if surgery is required or not. Two factors play an important role in deciding if surgery is required or not. The first factor is severity of loss of vision and the second factor is how badly the patient’s everyday life is affected by the visual impairment.

Anyone suffering from cataracts is certainly eligible for treatment. But people who are suffering from some other health and medical conditions such as diabetes, or those who are under certain medications, may need to consult their doctor and sit through some extra tests before preparing for surgery. The doctor may also choose to compensate a patient’s visual impairment with glasses or contact lenses instead of opting to perform surgery on them.

Patients who undergo surgery for cataract extraction may experience some side effects afterwards, such as,

• General anaesthetic side effects like dizziness, nausea and shortness of breath.
• Mild edema (swelling of the eye)
• Slight pain or discomfort in the eye
• Teary eyes and itching sensation
• Sensitivity to bright lights
• Accumulation of fluid in the eye

These side effects do not last for more than a week or two after the surgery. If any side effect persists longer than it should, consult the doctor or surgeon immediately.

Like with any other surgical procedure, there is also a minor chance of infection if proper post-treatment care is not taken

Patients will usually be advised to follow these guidelines after surgery:

• Wear an eye shield for about a week after the surgery, specially while sleeping
• Do not engage in activities that may exert pressure on the eye, such as bending over or lifting heavy objects.
• Apply prescribed eye drops to prevent infection as per the doctor’s instructions.
• Refrain from outdoor activities for the first few days after surgery. If you must go out, keep the eye covered properly to prevent infection.
• Maintain regular follow ups with the doctor until the surgical wounds heal completely.
• Do not rub the eye, and be careful not to let shampoo or soap enter the eyes while bathing or washing face.
• Wear sunglasses in brightly lit conditions to lessen the sensitivity.
• Refrain from driving until the doctor declares you fit to do so. It’s important to adhere to these guidelines for a timely recovery and to avoid possible complications.

Complete recovery after the cataract surgery takes about 6 to 8 weeks. But patients can resume their daily activities after just a few days as long as they keep the eye well-protected and do not exert any pressure on the eye.

Cost of cataract surgery varies all over India, depending on the type of hospital or institution, equipments used, and other extra services that may be required. If an average is to be estimated, then the cost usually ranges from Rs. 30000 – Rs. 60000.

The treatment of cataract with surgery leads to significantly improved visions in more than 90% of cases. Sometimes, contact lenses or glasses may further be prescribed after the surgery to ensure the patient enjoys almost normal vision. There are a minority of cases where some problems exist even after surgery, but this is mostly due to other pre-existing eye defects or some external factors. It’s best to consult with a medical professional in such cases to discuss further treatment.

FDA approved and scientifically proven measures for the prevention of senile cataracts do not exist as of yet. Study and research is being conducted regarding this matter.

Avoiding any and all factors that increase the risk of cataracts still does not provide guaranteed protection from this disorder.

Since the exact pathophysiology of this disorder is still being studied by the medical community, there aren’t much alternatives for its treatment other than surgery. The only alternate option worth mentioning is homeopathic treatment, but its effectiveness is debatable. Herbal treatment and nutrition therapy are also considered by some people, but both these methods focus on the prevention of cataracts in healthy individuals and not on the cure or treatment of those already diagnosed with this condition. Thus, these methods serve as preventive measures, and not treatment. Both herbal treatment and nutritional therapy are not scientifically approved measures. So surgery, specifically phacoemulsification, remains the most effective treatment for senile cataracts.