Cataract Surgery - Diagnosis, Procedure and Recovery

How Is Cataract Diagnosed?

To determine whether you have a cataract, your eye specialist will check your medical history and symptoms and conduct an eye examination. Your doctor may conduct several tests, including:

• Visual Acuity Test: In this test, you will be asked to read the letters on a chart to assess the sharpness and clarity of your vision. Your eyes will be tested one at a time to recognize signs of impairment.
• Slit-Lamp Examination: A slit-lamp examination, also known as biomicroscopy, involves the use of a specialized microscope called a slit lamp. Your doctor will examine your eyes with this instrument, which delivers a magnified view of the front structures of the eye, including the cornea, iris, lens, and the space between them. This examination allows them to know the presence and severity of cataracts.
• Retinal Examination: For the retinal exam, your doctor will use eye drops to dilate (open wide) your pupils. This allows the doctor to view the retina for signs of cataracts better.
• Refraction Test: A refraction test may be performed to determine the extent of any refractive error (e.g., nearsightedness, farsightedness, astigmatism) that may coexist with cataracts. 
• Visual Field Testing: This test determines how much side (or peripheral) vision you have and how much surrounding area you can see. The most common type of visual field test in a regular eye exam is called a confrontation field test, in which the doctor briefly flashes several fingers in each of the four quadrants of your visual field while seated opposite you. It is commonly performed to detect and monitor conditions such as cataracts, glaucoma, and neurological disorders that may affect vision.
• Optical Coherence Tomography (OCT): OCT is a  non-invasive imaging technique that provides cross-sectional images of the eye’s structures, including the cornea, iris, and lens. It utilizes light waves to generate high-resolution, precise images of the lens and other parts of the eye. OCT can help determine the thickness and integrity of the lens, assess any associated macular changes or swelling, and evaluate the impact of cataracts on the overall eye health.
• Contrast Sensitivity Test: Contrast sensitivity testing evaluates your ability to differentiate objects with low contrast, such as shades of gray or slight differences in light and dark. This test estimates your ability to discern details under various lighting conditions, which can be affected by cataracts.

Who Is The Right Candidate For Cataract Surgery?

The decision of cataract surgery is typically made by an ophthalmologist based on the person’s symptoms, visual impairment, and the impact of cataracts on their daily activities and quality of life. While each case is unique, certain criteria help decide if someone is a suitable candidate for cataract surgery. These criteria include:

• Visual Symptoms: Cataract surgery is considered appropriate when the clouding of the lens significantly impacts a person’s vision, leading to problems with daily activities such as reading and driving. Surgery may be suggested if cataracts cause significant visual impairment that cannot be corrected with glasses or contact lenses.
• Impact on Daily Life: Cataracts can interfere with an individual’s ability to perform activities essential for daily life, such as driving, reading, or working. If cataracts affect the person’s quality of life and independence, cataract surgery may be considered.
• Overall Eye Health: Apart from cataracts, the eye’s overall health is also considered to ensure that cataract surgery is the right intervention. Other eye conditions, such as glaucoma or macular degeneration, may coexist with cataracts and must be considered while considering surgical intervention.
• Cataract Progression: The rate of cataract progression differs among people. If cataracts progress rapidly and significantly impair vision, surgery may be advised at an earlier stage. However, if cataracts develop slowly and have less impact on vision, the surgery may be delayed until they cause more prominent vision impairment.

What Are The Benefits Of Cataract Surgery?

Cataract surgery is a highly effective procedure that offers numerous benefits to people with cataracts. Some of the key benefits of cataract surgery include:

• Improved Vision: The cataract surgery lens helps to restore clear vision by concentrating light properly onto the retina. After the surgery, many people experience a significant improvement in their visual clarity.
• Reduced Visual Symptoms: Cataracts can lead to various visual symptoms such as blurred vision, difficulty reading, glare or sensitivity to light, reduced night vision, color distortion, etc. Cataract surgery can help alleviate these symptoms.
• Increased Quality of Life: Cataract surgery can enhance a person’s independence and overall quality of life. It helps them recover functional vision and perform tasks like driving, reading, and participating in hobbies or social activities.
• Clearer Colors: Cataracts can cause colors to appear dull, faded, or yellowed. By removing the clouded lens and planting an artificial IOL, cataract eye surgery can restore the ability to perceive colors accurately.
• Potential Decrease in Eyeglass Dependence: Depending on the type of cataract surgery and artificial lenses placed, you may be able to see better than you have in a while. With advanced intraocular lens implants, your vision may be corrected entirely so that you can see properly without glasses or contacts.
• Long-term Benefits: Cataract surgery provides long-term benefits. Once the cataract is removed and an IOL is placed, it does not regrow or return. The advantages of improved vision typically persist for the long term, allowing people to enjoy clear vision for years to come.
• Prevents injuries from falls: Falls are a leading cause of death and injury among older adults. Cataract removal can reduce the risk of falls.

How To Prepare For Cataract Surgery?

Here are some ways to prepare for cataract surgery:

• Medications: Follow your doctor’s instructions regarding the use of eye drops or medications before the surgery. You may be prescribed antibiotics or anti-inflammatory eye drops to use in the days leading up to the procedure to prevent infection and ease swelling.
• Remove all makeup before surgery: Do not apply makeup to the eyes or any other part of the face on the day of your surgery. This includes facial lotions, creams, and aftershave. Before surgery, wash your face with soap and water. Bacteria that enter the eye come from the eyelids or eyelashes, so it is essential to keep them (and the surrounding area) as clean as possible. 
• Stop wearing contact lenses: Your doctor will probably advise you to stop wearing contact lenses for 1 to 4 weeks before cataract surgery. It is essential to follow your doctor’s instructions. Contact lenses change the shape of the cornea’s surface, which is important to measure for proper IOL selection. If you use hard lenses, you may be asked to stop wearing them longer than someone who uses soft lenses. This is because it takes longer for the corneal surface to return to its natural shape after wearing hard lenses. 
• Fasting Instructions: Depending on the type of anesthesia used, you may be instructed to fast for a certain period before the surgery. This ensures an empty stomach during the procedure and reduces the risk of anesthesia-related complications.
• Arrange Transportation: Since cataract surgery involves using anesthesia, you cannot drive yourself home after the procedure. Therefore, arrange for a family member or friend to accompany you to the hospital and drive you home afterward.
• Inform Your Surgeon: Inform your surgeon about any changes in your health or if you develop a sickness, such as a cold or fever, before the surgery. These factors can potentially affect the timing of the procedure.
• Treat blepharitis before surgery: Blepharitis is an inflammation of the eyelids. It happens when small oil glands near the base of the eyelid become clogged, but allergies and other conditions can also cause it. It is important to treat blepharitis before cataract surgery. If you have been diagnosed with blepharitis, your doctor may prescribe medications to control inflammation and fight infection. 
• Manage dry eye: Dry eye is a common eye condition that happens when your eyes do not make enough quality tears and don’t provide sufficient lubrication. If your doctor determines that you have dry eye, he/she will probably suggest treating it before surgery. You may be prescribed artificial tears or other topical medications. Using eye drops and other medications as directed is essential to improve the ocular surface before cataract surgery.

What Are The Recovery Tips To Follow After Cataract Surgery?

In most cases, full recovery from cataract surgery takes 3 to 4 weeks. But people often notice an improvement in their vision within a few days. However, they can experience little pain or discomfort during the recovery period. It is essential to follow certain postoperative tips to minimize pain and discomfort, promote healing, minimize complications, and optimize your visual outcome. Here are some essential cataract surgery aftercare tips to follow:

• Use Prescribed Eye Drops: Follow your ophthalmologist’s instructions regarding the use of prescribed eye drops. Use them as advised to prevent infection, relieve inflammation, and facilitate healing. 
• Protect Your Eyes: Wear the protective eye shield provided by your ophthalmologist, particularly while sleeping, to prevent pressure on the operated eye. Also, consider wearing sunglasses when outdoors to protect your eyes from bright light and dust during the initial recovery period.
• Avoid Rubbing Your Eyes: It is vital to avoid rubbing or putting pressure on your eyes during the recovery period. Rubbing your eyes can increase the risk of infection, dislocate the IOL, or hamper the healing process. 
• Avoid showering and head wash: In the first few weeks after the cataract surgery, it is better to avoid getting soap water in your eye. It is recommended not to swim or visit a sauna or spa. This is because there is a small cut in the eye after a cataract operation, and it should not get contaminated.
• Rest and Limit Activities: Give yourself time to rest and avoid strenuous activities, heavy lifting, or activities that may strain your eyes. It is important to give your eyes sufficient time to heal and adapt to the new IOL.
• Practice Good Hygiene: Maintain good hygiene by washing your hands thoroughly before touching your eyes or applying eye drops. 
• Take time off work: Most people recover and see well enough within a few days after cataract surgery. Vision is clear enough to go to work. However, returning to work for some people may mean hectic schedules and not enough time to care for the operated eyes. If you are one of those, then it is better to avoid going to work for a few days. 
• Inform Your Doctor of Any Concerns: If you experience severe pain, sudden vision changes, increased redness, persistent discharge, or any other concerning symptoms, contact your ophthalmologist promptly. Timely communication with your doctor is crucial in identifying and addressing potential complications.

It is essential to take these precautions after cataract surgery to ensure a successful and complication-free recovery. If you have any questions or concerns during your recovery, don’t hesitate to contact your eye care professional for guidance and support. Following these precautions will help promote a smooth and successful recovery after cataract surgery.

What Is The Cost Of Cataract Surgery In India?

Cataract surgery cost in India may range from Rs. 25,000 to Rs. 1,40,000. However, various factors can impact the cost of cataract surgery. Some factors that affect the cost of surgery in India include the following:

• Hospital or Clinic: The choice of hospital or clinic can affect the cost of cataract surgery. Different healthcare facilities may have distinct pricing structures, which can result in deviations in the overall cost.
• Location of The Clinic: Depending on the city, the cost might change. Metropolitan cities often have expensive hospital setups in comparison to smaller towns. Also, the cost of setting up a hospital is much higher in big cities.
• Technology: An eye care hospital with the latest technology, a reputed eye surgeon, and state-of-the-art equipment may charge a bit more than other hospitals.
• Surgeon’s Expertise and Reputation: The surgeon’s experience, skill level, and reputation can affect the cost. Highly experienced and well-known surgeons may charge higher fees for their services.
• Type of IOL: The intraocular lens chosen for implantation can influence the cost. Premium lenses, which provide added benefits such as reduced dependence on glasses, may have a higher cost than standard lenses.
• Type of Technique: Depending on the type of cataract ( age-related cataracts, congenital cataracts, traumatic cataracts, etc.), the eye doctor will determine the best-suited technique for removing the affected lens. The cost range of one surgical procedure may differ from another technique for cataract removal and will impact the overall cost of the cataract treatment.
• Diagnostic Tests and Preoperative Evaluation: The cost of diagnostic tests and preoperative evaluations may be included in the total cost of cataract surgery. The extent and complexity of these evaluations can affect the surgery cost.
• Anesthesia: The type of anesthesia used during the surgery can impact the overall cost. Cataract surgery can be performed under local anesthesia with or without sedation or sometimes under general anesthesia. 
• Additional Services and Facilities: Additional services or facilities provided by the hospital or clinic, such as postoperative care, follow-up appointments, or specialized equipment, may contribute to the overall cost.

Case Study

Deepak Mehta, a man in his late 60s was diagnosed with a cataract in both his eyes. He was facing issues seeing things at a long distance and mild discomfort in his left eye. Mr. Mehta contacted Pristyn Care, Bangalore for his cataract surgery. Our experienced ophthalmologist performed the surgery without any complications. Our doctors and staff took excellent care of Mr. Mehta before as well as after the surgery. He is recovering well without any complications.