Cataracts are natural lenses inside the eye that have lost their transparency. When it is transparent it is called crystalline lens. This loss of transparency occurs in almost everyone with age. Cataracts usually progress slowly but can sometimes progress rapidly in a few weeks.
The loss of transparency is a matter of degree, sometimes the doctor indicates “beginning of cataract” means that the loss of transparency is of a mild degree and the patient can live a normal life without surgery. The cataract is shaped like a lentil but larger and yellow in color, in advanced stages it can be brown or white and exceptionally black.
Types and symptoms of cataracts
There are many different types, but the vast majority correspond to what we call age-related cataracts. A less frequent type appears in newborns, they are congenital cataracts. A cataract that deserves special attention is the complicated cataract, which appears together with a second problem such as stress or a previous blow, hard cataract or weakness in other structures of the eye. These are cataracts that require the care of a highly experienced physician.
The presenting symptoms are very varied and often the patient is not aware of them in the early stages. They go unnoticed because the presentation is very slow and usually both eyes evolve at the same time. The main symptoms are a change in the coloration of objects that appear yellowish in color and generalized blurring. However, the range of symptoms is very wide and includes:
- Double or triple vision
- Vision of halos around lights
- Ease of falling
- Difficulty reading
As to what causes cataracts, the main factor is age but the exact mechanism is unknown. In other types of cataracts the cause is clearer, for example we know that the transparent parts of the eye need to have a perfectly ordered and geometric cellular structure, this order is altered with a strong blow and this causes the loss of transparency or cataract. On other occasions, toxic material can be deposited inside the lens and create cell destruction and loss of transparency.
Surgery, the only treatment
The only treatment today is cataract surgery. The operation is a lens replacement, replacing the natural lens with an artificial one by means of microsurgery. Many patients think it is a simple operation, but it is not. With modern techniques we make the process simple for the patient and this gives a false impression of simplicity, however complications in cataract surgery can be very serious.
The surgeon’s experience is crucial in the occurrence and resolution of complications. In very experienced hands the complications can be reduced up to 20 times compared to a normal surgeon. Most surgeons operate 300 patients per year and surgeons with very high experience and very low complications operate more than 2,000 patients per year. Less than 10 surgeons have very high experience in Spain. Like any manual activity repetition and attention to detail is the key to success.