Cataract, which occurs most often with advancing age and the effect of sun rays, is among the leading causes of blindness and visual impairment in the world. Specialists working for the prevention and treatment of this disease, the treatment of which is surgery, continue to develop new methods. One of these experts, Prof. Dr. Rıfat Rasier, Lecturer, Faculty of Medicine, Istinye University, years ago, developed a new method for converting single-focal lenses inserted into the eye to multifocal. Informing on this new method, Prof. Dr. Rasier made explanations about the causes, symptoms and treatment methods of cataract.
Cataract is one of the most common causes of vision loss and vision loss in the world. According to the World Health Organization (WHO), cataracts are among the leading causes of blindness and visual impairment in the world, with 51 percent. Prof. Dr. Rıfat Rasier, Lecturer, Faculty of Medicine, Istinye University made the single focus lenses used in cataract surgery multifocal with a new laser method he applied. The method received the best project award from ESCRS, one of the most respected scientific associations in the world’s eye field. Giving information about this new method, Prof. Dr. Rasier also made statements about the causes, symptoms and treatment methods of cataracts.
A white image can be noticed in the pupil of a person with cataracts
Prof. Dr. Rıfat Rasier gave the following information about cataract, “Cataract is the most common cause of vision loss in the world. In order for the image to be formed, the light must first pass through the frontmost transparent layer of the eye, which we call the cornea. Then this light passes through another transparent tissue, the lens in the eye, and reaches the retina. The lens is a transparent, convex structure on both sides. It allows the light coming into the eye to be refracted and focused on the visual center of the image. The lens should be transparent for life, if it loses its transparency at any time, this situation is called cataract. It causes difficulty in seeing the person by causing problems in reaching the retina and reducing the contrast. The lens in the eye loses its transparency and takes on the structure of frosted glass. Just as a person looks through a frosted glass, he sees the image as hazy, and in a person with cataracts, the image he normally sees becomes hazy, icy, foggy. In advanced stages, a mature cataract can reduce the person’s appearance to a level where only light can be noticed. The person looking at the person with such advanced cataract may notice a white image instead of blackness in the pupil.”
Sunlight exposure and increasing age are some important factors
Stating that there are many reasons that may cause the lens in the eye to lose its transparency, Rasier continued his words as follows,
“The most important of these is the progression of our age. As we age, the water content of the lens decreases and the amount of lens proteins increases. In this case, the lens becomes rigid, its flexibility decreases, and as a result, the transparency of the lens gradually decreases. Another important reason is exposure to sunlight with increasing age. The eye, which is exposed to the ultraviolet rays of the sun without wearing sunglasses, actually turns its lens from transparent to frosted glass as a defense mechanism so that more damaging light does not come to the retina. Because these harmful rays coming to the retina cause yellow spot disease, which we will explain later. Trauma is one of the causes of cataracts. When a blunt or sharp object hits the eye from the outside, the lens inside the eye may lose its transparency, either by displacing or not moving at all. Among the rarer causes that can lead to the formation of cataracts are the use of drugs containing cortisone. When cortisone medication is used in the form of drops, it causes cataracts, and when it is used orally in the form of pills, it can lead to cataract formation. While hereditary metabolic diseases cause congenital cataracts in newborn babies, many systemic diseases such as diabetes and thyroid disease can cause cataracts in adults. If the sugar level is kept within normal limits in systemic diseases, especially diabetes, cataract development slows down.”
There are many different types of cataract!
Prof. Dr. Rasier listed the many different types of cataracts as follows:
- Age-related cataract: It is a type of cataract that occurs with the loss of water content of the lens as age increases, and the increase in the protein ratio in the lens. After the age of 40, the probability of developing age-related cataracts doubles in every 10-year period. While the probability of developing cataract is 5 percent around the age of 65, this rate increases to 50 percent at the age of 75.
- Congenital cataract: Newborn babies may develop congenital cataracts due to infection, blows they received during birth, or the inability of the baby’s lens to fully develop.
- Traumatic (injury) cataract: It is a type of cataract that develops as a result of penetrating or blunt blows.
- Cataracts developing due to a systemic cause: It is the type of cataract that develops due to a disease such as diabetes, thyroid disease, develops as a result of exposure to a toxic substance, develops as a result of exposure to ultraviolet, or develops as a result of the use of drugs such as cortisone and diuretics.
- In addition, smoking, air pollution and excessive alcohol consumption are also causes that can accelerate the development of cataracts.
Symptoms of cataract:
Prof. Dr. Rasier states that the diagnosis of cataract is made by detecting a decrease in your vision level with the examination performed by your ophthalmologist, and when the lens is examined with a microscope, the opacity of the lens and the decrease of the transparent parts are observed. “Due to the loss of transparency of the cataracted lens, the vision-related symptoms become more and more pronounced and progress to a situation that is more disturbing and interferes with daily activities,” Rasier summarizes the symptoms of cataracts as follows:
- Foggy, hazy, dirty appearance as if looking through a frosted glass
- Rapid change of glasses numbers due to change in lens
- Changes in color vision
- Myopia shift of the eye with the development of cataract and therefore the decrease in the need for near glasses. In general, patients who have started cataracts express themselves that they have started to see their relatives better.
- Scattering of lights especially at night
- Scattering in images during the day
- Double vision as if images are superimposed
Cataract treatment is surgery
Prof. Dr. Rasier said, “The treatment of cataract is surgery. If the person’s vision level is very low, if the visual level is affecting the person’s quality of life, or if the lens is very hard during the examination, cataract surgery should be performed. The first thing to do is to determine the level of vision of the person with the correction of eyeglasses numbers. If the image is low despite the glasses, surgery is required to remove the lens that has lost its transparency. The name of cataract surgery is phacoemulsification surgery. For this surgery, the opaque lens is broken up with sound waves called ultrasound. After the lens is removed, an artificial lens is put into the eye. The lenses placed in the eye can be single-focal (only near or only far view) or multifocal (far-mid-near view) lenses in today’s technology. The benefit of multifocal lenses for the patient is that they provide intermediate and near vision without distorting the distant view. Thus, the need to use glasses is eliminated while the cataract is surgically removed, causing a blurry image. The number of people who need this treatment, anyone over the age of 40-42 who wears eyeglasses may need this lens. However, multifocal lenses are not recommended for those who have no problems with distance vision, as they cause a slight loss of contrast at distance.”
