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Cataracts Surgery Term Paper

Abstract

The eyes form quite an important part of the body. They are very sensitive as compared to the other parts. The main of the eyes is to facilitate a person’s ability to see. Situations may arise whereby the visionary capacity of an individual becomes affected and the normal way of seeing is hindered. A good example relates to Cataracts which form part of these hindrances that lead to eye problems. A cataract is but a cloud that undergoes development in the eye more specifically in the crystalline lens. It can also develop in the lens capsule (Cassin and Solomon 1990). A cataract varies in degree ranging from slight to total cloudiness hence hindering the passage of light into the eye.

Cataracts of are of different types hence depicting deferent signs and symptoms. They include; cortical cataract, sub-capsular cataract and a nuclear cataract. A cortical cataract is that which involves wedge- like opacities characterized by whiteness in the eye. The opacities begin in the periphery of the lens then gradually move to the center of the eye in a manner that resembles spokes. The occurrence of this type of cataract takes place in the cortex lens which forms part of the lens surrounding the eye’s central nucleus. The occurrence of the sub-capsular cataract takes place at the back of the lens (avitt, Wang and West 1996). There are people who have very high chances of getting this type of cataract. These people include; those who take medications that constitute high steroid dosage and those with diabetes or high retinis pigmentosa. A nuclear cataract undergoes formation deep in the nucleus of the lens. Usually the occurrence of this type of cataract is relates to aging (Barbara and Grady 2006).

Cataract clouded lens

Cataracts are characterized by certain signs and symptoms. Early in their development they begin as small with very little impact on vision. One may notice some blurredness in vision which may be like one is looking through a piece o glass that is cloudy. Cataracts are known to make the light from the sun to be like it is so bright or rather glaring. Also for a person who is driving at night the headlights of oncoming vehicles have increased brightness than before which might not be the case. In line with the appearance of colors they may not seem bright as they did before occurrence.

Basically the type of cataract that one has is what determines the symptoms and signs experienced and how soon their occurrence is. For instance the development of a nuclear cataract may result to some improvements being made temporarily in line with near vision known as second sight (Javitt, Wang and West 1996). It is quite unfortunate that second sight vision does not last for long. It disappears as the cataract continues developing to the worse. With a subcapsular cataract signs or symptoms may not appear until it has fully developed.

Researchers have and are still looking for factors that cause cataracts. To begin with the eye constitutes a lens. The lens functions like a camera lens which basically focuses light entering the eye onto the retina. It also adjusts the ability of the eye to focus thus enabling a person to things that are far away and those that are near. The lens is mostly composed of protein and water. The protein is arranged precisely thus enhancing clarity of the lens and allowing passage of light (Cline and Griffin 2007). As one continues aging some protein may clump up clouding the lens at a small region of the lens. This is basically a sign of a cataract which with time it may develop in size thus causing increased cloudiness on the lens. It therefore becomes quite difficult to see.

The eye condition in relation cataracts is cannot be reversed. The only option for the treatment of cataracts is surgery. With cataracts treatment concerning eye contact lenses and prescription eye glasses are deemed to be ineffective. On the other not all types of cataracts necessitate surgical removal. During the early stages of their development they are usually very small and cannot be noticed and are understood not to cause much hindrance to vision in a person’s daily living (Javitt, Wang and West 1996). After they have developed to an extent of causing an impact to the execution of day to day tasks fir instance driving, in this case doctors usually recommend that the cataract be removed through surgery. But at the progression stage of cataracts there is need for patients to get regular monitoring of their eyes by the doctor.

Cataracts removal involves a surgery mostly seen as an outpatient process. Before the surgery is carried pre-operative test are carried out. The entire surgical procedure has little discomfort for the patient being operated. As the surgeon performs the procedure the patient cannot see what is being done other than shadows and colors. For most patients no injections or shots are used instead eye drops that numb the eye are used. In order to reduce anxiousness some patients are given some medication though for most people it is usually not a requirement. As long there is no presence of any other eye disease cataract is of great importance. This test involves the length of the eye being measured through a process known the A-scan (Shearing and Steven 2002).The cornea curve is also measured through a technique known as keratometry. These measurements are quite o great importance. They aid the eye Medical Doctor in the selection process of the proper lens implant for a patient’s eye. In this step the patient is also provided for the various lens options available.
During the preparation of a cataract surgery it is of great importance that the patient provides the ophthalmologist with information concerning the nutritional supplements that they have been taking including medications. This is due to the fact that some medications have been seen to impact to the surgical process. For instance being under the medication of alpha-blocker drugs which are meant to meet prostate problems it is seen that the drugs has the impact of preventing proper dilation of the pupil during the surgical process. At this time complications may occur. By the surgeon having the knowledge that their patients are under the prescription some certain drugs the surgical technique may undergo some adjustments in order to fit the need in as required (Shearing and Steven 2002). From this perspective the success for the procedure of removing a cataract is facilitated. Information concerning the taking of sedative medications should also not be left out. For the purpose of reducing infection risks after the surgery the ophthalmologist may give a prescription of antibiotic eye drops to be used either one or two days before the surgery is carried out.

The commonly used procedure to carry out surgery to remove cataracts is known as phacoemulsification. This procedure involves a small incision being on the side of the cornea. A tiny instrument is inserted on the front part of the eye. The instrument uses high frequency ultra sound for breaking up the central part of the lens with the cloud and carefully suctioning it out. After the removal of the cloudy lens it is replaced with an intraocular lens implant that is made of either acrylic, plastic or silicone. The new lens usually has clarity allowing light into the eye and focusing it more properly on the eye’s retina. The intraocular lens permanently form part of a persons eye. In many cases insertion of the intraocular lens is usually behind the iris and it is known as the posterior chamber lens. Sometimes need arises that the intraocular lens be inserted before the iris. In this case the lens is known as the anterior chamber lens (Shearing and Steven 2002). The incision is usually closed when the intraocular lens has been properly put in place. Stitches may be used or not. After the surgery process is over a protective shield is placed over the patient’s eye. Cataract surgery also constitutes the cost that is involved for the procedure to be performed. This type of surgery has fairly standardized costs across all geographical regions. Cataract patients have many options to choose from in regards to the type of technique to be used during the surgery procedure. Ophthalmologists who are skilled are supposed to help patients in the decision making process of the technique that they best wish to be used.

During the process of deciding about the surgery technique patients should ensure that they put into their overall needs for the surgery. Patients should therefore give proper thought of the initial consultations, the process of scanning and mapping of the eye being part of the process that involves the construction of a model that enables the surgeon to make the right incisions after they are through with follow up consultations (Shearing and Steven 2002). There are other things patients should consider while choosing a surgery technique. They include, the post operation medication, the cost of implants, surgeon’s fees and Optometrist’s fees. This they will be able to choose the best technique that meets their need and which is cost effective.

The cataracts surgery procedure as already explained involves removal of the cataract and a new lens implant that is clear replaces it. The time taken in the performance of the surgery is mostly less than one hour. In the case whereby the patient needs cataract surgery for both eyes the procedure is usually carried on one eye first then the other. A simple cataracts surgical procedure takes about ten minutes. Nevertheless, more time may be spent in the outpatient section up to ninety minutes or even more due to the some extra time that is required during the preparation and recovery processes (Shearing and Steven 2002). The time between the performances of the surgeries may be a few days or weeks in order to give ample time for the recovery of the already operated eye as well as time for evaluating and assessing for the possible problems.

When comparing the time taken by modern and that taken by traditional techniques of carrying out cataract removal (Barry 2003). The traditional techniques are seen to take lesser time. This is due to the fact that the traditional did not require much patient positioning as it with the modern techniques. With modern techniques more time is taken to position the patient under the laser. There is increased safety and quality of surgery due to technology. For example the older cataract surgery technique which involved the use of a large incision being made into the wall of the eye with the next step being removal of the cataract manually has undergone replacement through the technology already mentioned known as “phacoemulsification”. It which involves removal of the cataract through an incision of 2.2mm only that is made on the wall of the eye. Another example is the old techniques that involved the removal of the lens in the eye completely leaving the eye without a lens. Correction was made to the patient’s vision through the use of contact lens or very thick eyeglasses. In the modern world there is what is known as Extra-capsular cataract extraction a procedure under phacoemulsification whereby the entire lens is not removed completely. The lens that is left in the eye enables for the implantation of intraocular lens.

The method of choice of cataract removal usually has an impact on the healing process. Recovery from a cataract surgery can be within few weeks. Nevertheless, the healing process time differs from one patient to another. From this perspective patients are advised not to compare their recovery times with others. This is due to the fact that different techniques may have been used from one patient to another. For instance a patient whose surgery involves a small incision will heal faster than the one whose surgery involved a large incision. The former could begin their daily activities immediately while latter is required to refrain from performing any heavy tasks.

Studies have shown that exposure to the ultraviolet rays of the sun may be associated to the development of cataracts (Barry and Patrick 2008). In this case people should take caution hence recommendations are made that they should wear sunglasses or hats with a wide brim in order to prevent direct exposure to the rays.

In conclusion the technology in relation to the removal of cataracts is still evolving. This is evidenced by surgery equipments that have been recently developed. It is quite important even with the increasing technological advances that patients who want to undergo a cataract that they put into consideration whether they genuinely need the use of the newly developed surgical equipments. If the cataracts are so severe such that they have significantly impaired vision or the patient has complications or the previous surgery was unsuccessful then patients should consider an increased budget in order to be able to access the newest technology in the performance of cataract surgery.

References

Javitt, Wang and West (1996). “Blindness Due to Cataract: Epidemiology and Prevention”. Annual review of public health.
Barry and Patrick L. (2008) “Blinding Flashes”. Science.nasa.gov
Barbara K. and Grady L. (2006). “Statin Use and Incident Nuclear Cataract”. Journal of the American Medical Association.
Shearing and Steven. (2002). “History of the PMMA Intraocular Lens”. Ophthalmic Hyperguide; Vindico Medical Education.
Cline D. and Griffin JR. (2007) Dictionary of Visual Science. Butterworth-Heinemann, Boston.
Cassin, B. and Solomon, S. (1990).Dictionary of Eye Terminology. Gainsville, Florida: Triad Publishing Company.
Barry W. (2003). History of ophthalmology at Baylor University Medical Center. Hi Proc (Bayl Univ Med Cent).

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