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What is cataract?

There is a normal crystal clear, transparent lens located inside the eye. This crystalline lens gradually starts losing its transparency and become opaque of various grade.

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Why does cataract occur?

Commonly due to old age-(Senile cataract).

Misuse of steroid tablet or steroid eye drops (steroid induced cataract)

Due to injury with blunt or sharp objects (traumatic cataract)

Infection to the mother at the time of pregnancy leading on to cataract to the new born (congenital cataract)

Eye infections caused by bacteria causing tuberculosis, leprosy etc., and other eye infections causing uveitis leads on to a cataract called complicated cataract.

Other conditions like night blindness, detachment of the retina also can cause complicated cataract.

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Are cataracts found only in older people ?

Most cataracts develop slowly over time and affect people over age of 45 . in rare cases ,infants can have congenital cataracts due to infection in mother during pregnancy.

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Why does cataract occurs in younger age?

It could be a pre-senile cataract like premature greying of hair .It could be because of borderline nutritional deficiency in younger individuals.

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What is the reason for cataract progression /development?

Mainly due to aging ,other factors contribute for cataract progression are any kind of vitamin deficiency or malnutrition, prolonged exposure to sunlight(UV rays ) can initiate a cataract formation and also cause progression of cataract from one stage to another .

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Can cataract be treated by applying eye drops or by wearing glasses ?

No ,cataract can be treated only by surgery(replacing the natural lens by IOL ).

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What are the symptoms of cataract ?

Gradual decrease in vision

Cloudy,fuzzy,foggy or filmy vision

Haloes,for example seeing shadows around a bright object like vehicle head lights

Experiencing glare especially in night driving

No clarity in vision even with new prescribed glasses

Sometimes experiences double vision

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Why do cataract patients experience photophobia /flashes/glare ?

There is hydration of lens fibres in cataract and formation of vacuoles through which when light passes there is diffraction causing photophobia or glare.

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How does cataract develop, after any eye injury?

In case of penetrating injury, a sharp object pierces the cornea i.e. the black button of the eye, there is also simultaneous injury to the capsule of lens. This capsule is the protective covering of the normal lens. Once it is injured by a sharp object, the lens material also gets injured. It becomes immediately opaque called Traumatic Cataract.

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How cataract is diagnosed ?

Cataract is diagnosed by dilated comprehensive routine eye check .

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My doctor says I have a cataract, but he wants to wait a while before removing it. Why?

Mild cataracts often cause little or no vision problems. Your doctor is probably monitoring your cataract to see if it worsens and more significantly affects your vision or lifestyle before recommending surgery.

Some cataracts never reach the stage where they need to be removed. But if your cataract worsens and you begin to have trouble seeing clearly for driving and other everyday tasks, it's probably time to consider cataract surgery.

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How cataract development relates with diabetes ?

The normal lens has got lens fibres. These fibres have a tendency to opacify under situations of low blood sugar levels (hypo glycemia ) or high blood sugar levels (hyper glycemia). In diabetic patients there is a rapid progression of cataract from immature to mature stage. Sometimes there is fluctuation in vision whenever there is fluctuation in the blood sugar levels which causes transient cataract.

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OWhen cataract surgery is advised ?

When patient starts to experience cloudy ,foggy ,double vision and glasses no longer provides clear vision ,which lead to difficulty in performing daily activities when the cataract becomes matured ,it’s advisable to undergo cataract surgery .

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How is a cataract removed ?

A small incision is made in the front surface of the eye with a scalpel or a laser. A circular hole is then cut in the front of the thin membrane (anterior capsule) that encloses the eye's natural lens. Typically the lens is then broken into smaller pieces with a laser or an ultrasonic device so it can be more easily removed from the eye.

Once the entire lens is removed, it is replaced with a clear implant called an intraocular lens (IOL) to restore vision. In most cases, the eye heals quickly after surgery.

Today, several steps in cataract surgery can be performed with a computer-controlled laser instead of hand-held instruments.

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How much does cataract surgery cost?

The cost of cataract surgery varies from one doctor to the next; it also depends on the type of procedure and intraocular lens you and your cataract surgery decide is best for your needs.Most of the cataract surgery is covered by insurance.

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What are possible side effects of cataract surgery?

Experience serious cataract surgery complications. In most cases, complications or side effects from the procedure can be successfully managed with medication or a follow-up procedure.

To reduce your risk for problems after cataract surgery, be sure to follow the instructions your surgeon gives you and report any unusual symptoms immediately.

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What are the types of IOL options available ?

High definition lens for high clarity eye sight after cataract surgery

Toric lens for patients with cylindrical power

Multi focal lens for patients with vision at all distances, no need for presbyopic glasses

Toric with multi focal for patients with both the above said benefits.

Ultra –premium cataract procedures are also available

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Why do we need near vision glasses after cataract surgery?

Near vision is due to the accommodation power of natural lens.

Accommodation is a mechanism by which eye changes focus distance to near vision produced by change in lens shape.

After the removal of the natural lens in cataract surgery, the artificial lens placed does not accommodate, hence the patient has to be given near vision glasses.

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Is there any option so that I can avoid wearing glasses after cataract surgery? Will cataract surgery correct my glasses power ?

Cataract surgery is different from lasik ( surgery done to correct power of eyes ) .during cataract surgery ,your ophthalmologist remove the cataract lens and replace it with artificial IOL Where else in lasik the black part of the eyes ( cornea ) is corrected to achieve clear vision without glasses .

Presbyopia is a condition most people over the age of 40 experience that results in difficulty seeing up close without the aid of bifocals, trifocals, or reading glasses.

This age‐related condition is believed to be caused by a hardening of the lens inside the eye, making it difficult for the eye muscles to focus.

This can be corrected during Custom Cataract Surgery using a multifocal or presbyopia-correcting IOL.

Another type of premium lens available is a Toric (monofocal) IOL that can correct astigmatism.

Astigmatism is caused by the cornea being shaped more like a football than a basketball, which results in images focusing at different points in the retina. As everyone’s eyes vary, you will need to meet with your ophthalmologist to determine if one of these premium lenses can help reduce or eliminate your dependency on glasses after your cataract surgery.

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Is cataract surgery is painfull?

No,anesthesia is given during the surgery so that you don’t experience any kind of pain .

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Are you awake during cataract surgery ?

Yes, typically you are awake during cataract surgery. This eliminates risks associated with general anesthesia (being "put to sleep") and enables your cataract surgeon to communicate with you during your procedure.

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we undergo Cataract surgery for both eyes, at the same time/same day/alternate day?

There is no time limit, it can be done even on the same day, especially for special cases like patients with other medical ailments who cannot be frequently mobilized for surgery.

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Does cataract surgery causes dry eyes?

Cataract surgery does not typically cause dry eyes.

Only two very small incisions are made in the cornea during the procedure. These incisions heal quickly after surgery and do not significantly affect how many tears your eyes produce.

Though cataract surgery does not cause dry eyes, a pre-existing dry eye condition can sometimes affect the quality of a cataract surgery outcome.

For this reason, during your eye exam and consultation prior to cataract surgery, your eye doctor or surgeon will evaluate the tear film on your eyes. If it appears you have dry eyes, treatment is given to restore your tear layers prior to surgery.

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Does cataract surgery cures floaters ?

Cataract surgery restores vision that has been diminished due to clouding of the eye's crystalline lens, which is located directly behind the pupil.

Because vitreous floaters occur in the posterior part of the eye (the vitreous body is located in the large cavity in the back of the eyeball, between the lens and the retina), removing a cataract and replacing it with a clear intraocular lens (IOL) will not diminish the appearance of vitreous floaters.

In fact, if you have vitreous floaters, the increased clarity of your vision after cataract surgery may make the floaters even a bit more visible.

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If you see large spots and floaters, treatment may be possible?

Vitreous floaters are common. Most floaters are relatively small and are only a minor annoyance under certain lighting conditions.

If you are bothered by large vitreous floaters after cataract surgery, ask your eye doctor or cataract surgeon to refer you to an ophthalmologist who specializes in the treatment of floaters.

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Does cataracts grow back?

No, once the cataract is removed, it’s gone. But sometimes something called an after-cataract forms. When the surgeon does cataract surgery, the cloudy lens is sitting inside a bag in your eye. The surgeon cuts open the bag, removes the cloudy lens, and inserts the plastic lens into the bag. Sometimes the bag itself can cloud over. This can be fixed with a painless laser procedure that punches holes in the bag and immediately clears up the vision.

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Why does (PCO) occur, even after IOL implantation?

PCO occurs due to the continuous viability of the lens epithelial cells that remain after the removal of cataract.

The proliferation of the epithelial cells causes posterior capsular opacity (PCO) this is the most common late complication in the cataract surgery.

Fortunately it is amenable to treatment by means of simple painless laser procedure (Yag laser capsulotomy)

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Why is the objects with a blue line around after post-cataract surgery with any type of IOL implantation?

Natural lens absorbs the blue light when entering the eye. Modern high definition lens filters blue light and gives original colour with high clarity and contrast.

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Why does redness occur, after a surgery?

Redness occurs after eye surgery due to the inflammation which can be reduced on applying the drops regularly.

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Why there is an irritation in the eye after surgery?

Till the wound heals completely, some patients may experience irritation which can be reduced on proper application of drops.

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Can I have cataract surgery if I have glaucoma?

Yes, it's possible to have cataract surgery if you have glaucoma. In fact, in some cases, cataract surgery can lower high eye pressure, reduce the number of medications you need to manage your glaucoma, or possibly eliminate your need for glaucoma medication altogether.

Also, it may be possible for your cataract surgeon to perform a minimally invasive type of glaucoma surgery at the same time your cataract procedure is performed to address both conditions at once.

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Can I have cataract surgery after LASIK?

YES, cataract surgery can be performed after LASIK.

In fact, cataract surgery can be performed after any type of laser vision correction procedure, including LASIK, PRK, Epi-LASIK and LASEK. LASIK and other types of laser vision correction alter the curvature of the front surface of the eye (cornea). Therefore it's helpful if you can give your cataract surgeon the records of your eye exams that were performed prior to your laser procedure

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Can cataract surgery correct lazy eye?

No. Lazy eye is due to lack of visual perception by the brain.

If cataract occurs in a lazy eye, the defective vision that is attributed to the cataract can be corrected fully.

But the full potential vision cannot be improved.

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What causes cataract in children?

Cataracts are usually seen in older individuals. However, children too can develop cataracts.

Sometimes an infant is born with cataract. This could occur because of some infection that the mother had during her pregnancy like German measles.

In a small percentage of cases it could also be genetic. Most of the times, it is impossible to determine the exact cause of development of cataract.

Cataracts can develop in childhood too often as a result of eye injury or disease states in the other parts of the body. It can also occur because of prolonged ingestion of steroids.

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How is the cataract going to be treated in children ?

Some childhood cataracts may only be partial and thus not interfere with vision.

These small cataracts usually do not require treatment but should be observed regularly to look for progression.

Moderate cataracts may require treatment with glasses or treatment of amblyopia (lazy eye).

Larger cataracts which impair vision are treated with surgery.

The surgery in children is done under general anesthesia and require an incision in the eye. Depending on the age of the child your doctor will take the decision of whether to implant a lens in the eye or not.

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How is the vision going to be corrected after cataract surgery in children?

After cataract surgery your doctor will prescribe your child glasses.

Depending on whether a lens was implanted in the eyes or not your child may have a low or a high power.

The decision whether to implant the lens or not is made by your child’s eye doctor depending on the age of your child. Your doctor may also prescribe contact lenses for your child.

This is usually done if the power of the glasses is high and therefore contact lenses become a better option Very young children too can wear contact lenses so please do not get worried on how your child will wear contact lenses. Your optometrist will educate you as to how to make your child wear the lenses

If your child has amblyopia (laze eye), he or she may also require patching of the better eye to stimulate the weaker eye.

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Can cataracts cause blindness?

YES. Cataract is an important cause of preventable blindness in India.

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Can eye drops prevent or cure cataracts?

No. Everybody who lives long enough develops cataracts, so they are considered a normal part of the aging process, similar to greying hair and aging skin.

There are no known medicines to stop or reverse this change.

Certain factors can speed up cataract formation, such has diabetes, steroid use, trauma, smoking, alcohol, and excessive sunlight or radiation exposure.

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Will cataract surgery improve my night vision?

One of the first symptom of cataract is Loss of Contrast Sensitivity which is more in dim light. It also causes glare and haloes around the light.

Cataract surgery will always improve your night vision for driving, walking and other activities in dim light.

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What happens if cataracts are left untreated?

Worsening of vision occurs, if cataracts are left un-treated.

Cataracts may mature and start leaking inside the anterior chamber of the eye causing pain, redness and increase in intraocular pressure.

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What is a secondary cataract?

Cataracts occurring due to the posterior lens capsule becomes cloudy several months or even years after surgery.

The medical term for this is posterior capsular opacification (PCO) or secondary cataract.

This can be treated by yag capsulotomy.

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When should cataract surgery be avoided?

If the cataract is immature and the eyes have no visual potential it need not be operated.

But mature cataract should definitely be operated even if the eyes do not have visual potential.

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Blurred vision was there before cataract surgery, even now the same problem is there after surgery?

Some postoperative myopia (near sightedness) exists in few patients after cataract surgery

Sometimes it takes a couple of months for the final "refraction" to settle.

Depending on the postoperative myopia, glasses, contact lenses, refractive surgery (e.g., LASIK) or an IOL exchange will be advised

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After cataract surgery, there is swelling at the back of the eye? What is the reason?

This is called cystoid macular edema (CME)

There are a few possible late-onset complications of cataract surgery that can affect the vision four to six months after the surgery.

This condition occurs in susceptible patients even after uncomplicated cataract surgery.

The central portion of the retina responsible for our sharpest vision, the macula, develops some fluid-filled (edema) cysts.

Cystoid macular edema or CME, is a painless disorder which affects the central retina or macula. When this condition is present, multiple cyst-like (cystoid) areas of fluid appear in the macula and cause retinal swelling or edema.

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Can cataract surgery be redone?

Cataract surgery cannot be reversed, since the cloudy natural lens of the eye is removed during a cataract procedure and cannot be put back in.

But if there is a problem with the intraocular lens (IOL) used during your procedure or some other type of cataract surgery complication develops, certain aspects of the surgery can be adjusted or redone. This includes repositioning the IOL or removing it and replacing it with a different lens.

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What should I bring on the day of surgery?

The pre-operative kit that you were given.

All the drops advised

All the medications taken by you

ECG reports

Laboratory reports

Admission card

Post -operative booklet given by the counsellor

If you have, your android mobile to share post-operative procedure

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Can I take aspirin, Plavix, Warfarin before and after my surgery?

Modern cataract surgery rarely causes any bleeding as it is a bloodless surgery

Topical anaesthesia removes the risk of bleeding behind the eye from local anaesthetic injections.

Continue your medications unless you are specifically instructed to stop.

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Can the diabetes medication/insulin be taken on the day of surgery?

No. diabetes medication or insulin should not be taken on the day of surgery. But should be kept in hand.

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What type of food to be taken after cataract surgery?

Any type of food can be taken after cataract surgery.

You can take vegetables, fruits, spinach, tender coconut, butter milk.

Foods rich in vitamin A Carrot, papaya, egg, sea fish, milk, mango ,sprouted grains are good for eyes

Diabetic and hypertensive patients should take food as advised by the physician

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Can head bath be taken after cataract surgery?

NO. it is not advisable to take head bath or wash your face immediately after cataract surgery.

You can bath below neck from the next day of surgery.

Head bath can be taken after your doctor’s advice in your first post -operative follow up.

It is advised to avoid shikakai powder/ besan powder for 1 year after surgery

You can use shampoo or soap

Avoid having bath in ponds/rivers and swimming pools for one year

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Can we travel after cataract surgery?

Yes. You can travel in car, bus, auto, flight on the day of surgery

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How long does the lens remain good inside the eye or should it be changed?

Once the artificial lens is implanted inside the eye, it remains life -long. It need not be changed.

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. Can we watch TV and read newspaper after cataract surgery?

You can watch television and read newspaper after cataract surgery.

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How many days should I take bed rest after cataract surgery?

Bed rest is not necessary after cataract surgery. You can resume your work the next day after surgery.

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How frequently we have to come for check-up?

The first post -operative check-up will be on the 6th day after surgery and the next visit will be after 1 month.

In case of emergencies, you can come to the hospital immediately.