- Ultraviolet radiation from sunlight and other sources
- Diabetes
- Hypertension
- Obesity
- Prolonged use of corticosteroid medications
- Statin medicines used to reduce cholesterol
- Previous eye injury or inflammation
- Previous eye surgery
- Hormone replacement therapy
- Significant alcohol consumption
- High myopia
- Family history
- What is the nature of your profession? Do you have an office job or an outdoor job? Do you have to do very fine work like
- graphics, painting or carving, etc.?
- What is your lifestyle and hobby? Are you an ‘indoor’ person, or do you have interest in outdoor activities, sports, swimming, mountaineering etc.?
- Do you need excellent unaided vision as per the need of your profession, like pilots, drivers, etc?
- How important is night vision or vision in dim light for you for your job or activities?
- What is the nature of your refractive error: near-sightedness, or farsightedness? Do you have astigmatism or a cylindrical glass power?
- Would you mind using glasses routinely after the surgery or would you rather not?
- And last but not the least, if you are paying for the cost of your surgery from your pocket, what is your budget? The cost
- of certain IOLs can be exorbitantly high. Types of IOLs It is important for you to know about various types of IOLs and their features. Let us see what different types of IOLs are available. IOLs come in different materials, designs and optical properties.
- Material: Various materials that IOLs are made of include:
- Poly methyl meth acrylate (PMMA)
- Silicone
- Acrylic hydrophilic
- Acrylic hydrophobic
- Monofocal IOLs: These are the simplest type of IOLs available. These IOLs give you good distance vision, but you have to use reading glasses for near work or reading. These IOLs are relatively low cost. If you don’t want to spend too much and don’t mind wearing glasses after the surgery, you can opt for this IOL. Commonly available IOLs of this type include ACRYSOF, AKREOS SOFTPORT, ACRYFOLD, SPHERIS, CLARIFLEX, etc.
- Multifocal IOLs: These IOLs not only give you good vision for distance, but give you good near vision as well; so one can manage most of the needs for distance and near vision with this lens without using glasses. However, one may still require glasses for reading very fine print like a telephone directory. Also, vision at middle distance may not be very good, e.g. looking at the computer monitor. Another drawback is that some patients complain of glare while driving at night, and so it is not suitable for people who routinely drive at night. Cost of these IOLs is high. So, if you don’t like to wear glasses, don’t drive much at night, and if you can afford its price, you can go for multifocal IOLs.
- Accommodative IOLs: These lenses are designed in such a manner that they, likethe natural crystalline lens of the eye, can change and hence give good vision without glasses for all distances. These lenses, although in use currently, are extremely costly and their design has not been perfected yet. Sometimes, they fail to give the desired result and also their capacity for providing near vision can decrease with time. If you have a fad for the latest things and don’t mind the cost, you may go for it, keeping the possible shortcomings in mind.
- Toric IOLs: These IOLs, unlike other IOLS, can also correct astigmatism or cylindrical power. So people who have cylindrical number in their glasses and want to get rid of their glasses can benefit with these IOLs. Sometimes these IOLs may need to be readjusted after the initial surgery and are quite costly. Also, you can get a multifocal IOL combined with a toric design, but again the cost is very high.
- Aspheric IOLs: The lenses have a design, such as used in cameras and telescopes, which increases the quality of vision by removing or reducing the optical aberrations. These IOLs give a better quality or contrast sensitivity, particularly at night time. These IOLs cost more than the routine IOLs, but only marginally, so people who require better quality of vision like artists, drivers, pilots, graphic designers, etc, can opt for this IOL.
- Blue light filtering IOLs: These lenses have a yellowish pigment impregnated, which cuts off blue light. Blue light is harmful for the sensitive part of the retina called the macula, and normally is cut off by the cataractous lens. However, the normal IOL doesn’t block it and hence the macula is at risk to be damaged by the blue light. So, people who have macular degeneration can opt for this IOL. Cost is similar to normal or aspheric IOLs
CATARACT-
A PLEASANT EXPERIENCE
I have done cataract surgery process in both my eyes.
About cataract:
What is
a cataract?
A cataract is a
clouding of the lens in the eye that affects vision. Most cataracts are
related to aging. Cataracts are very common in older people. By age 80, more
than half of all Americans either have a cataract or have had
cataract surgery.
Cataracts
are the most common cause of vision loss in people over age 40 and is the
principal cause of blindness in the world. In fact, there are more cases of
cataracts worldwide than there are of glaucoma,macular degeneration and diabetic retinopathy combined, according to Prevent
Blindness America (PBA)
Causes
Cataract
Symptoms and Signs
A cataract starts
out small and at first has little effect on your vision. You may notice that
your vision is blurred a little, like looking through a cloudy piece of glass
or viewing an impressionist painting.
Hazy, blurred
vision may mean you have a cataract.
A cataract may
make light from the sun or a lamp seem too bright or glaring. Or you may
notice when you drive at night that the oncoming headlights cause more glare
than before. Colors may not appear as bright as they once did.
The type of
cataract you have will affect exactly which symptoms you experience and how
soon they will occur. When a nuclear cataract first develops, it can bring
about a temporary improvement in your near vision, called "second
sight."
Unfortunately,
the improved vision is short-lived and will disappear as the cataract worsens.
On the other hand, a subcapsular cataract may not produce any symptoms until
it's well-developed.
What
Causes Cataracts?
The
lens inside the eye works much like a camera lens, focusing light onto the retina for clear vision. It also adjusts the eye's focus, letting
us see things clearly both up close and far away.
The lens is
mostly made of water and protein. The protein is arranged in a precise way
that keeps the lens clear and lets light pass through it.
But as we age,
some of the protein may clump together and start to cloud a small area of the
lens. This is a cataract, and over time, it may grow larger and cloud more of
the lens, making it harder to see.
No one knows for
sure why the eye's lens changes as we age, forming cataracts. But researchers
worldwide have identified factors that may cause cataracts or are associated
with cataract development. Besides advancing age, cataract risk factors
include:
One
theory of cataract formation that's gaining favor is that many cataracts are
caused by oxidative changes in the human lens. This is supported by nutrition
studies that show fruits and vegetables high inantioxidants may help prevent certain types
of cataracts (see below).
WHAT IS DONE IN CATARACT SURGERY?
The front portion of the original eye lens is disintegrated using a
slit hole and sucked out. A new lens with the required power is inserted
through the slit which then expands and sits in position.
The procedure per se takes not more than 5 minutes. However the
preparation , pre operation checks do take time.
Post operative care is more important and it extends to one month.
However one can start regular routine work after 3 days.
Immediately after the surgery one can go about normal life
including watching TV, using computer etc of course taking care to see that
dust and water do not enter the eye.
Full
details given here.
How to choose a IOL lens
pollo Hospitals on Aug 21, 2015 in blog, Cure & Remedies,Proactive Healthcare | 0 comments | 118 views
Intraocular
Lenses How To Choose
Most of us must have seen our grandparents or
great grandparents using thick unsightly glasses after
having undergone cataract surgery. These glasses looked like big
magnifying glasses. People needed to use these glasses to compensate
for the loss of refractive power of the eye, which occurred because
of removal of the natural lens during cataract surgery. It was an
English ophthalmologist called Harold Ridley, who first suggested that a
lens could be implanted inside the eye instead of using thick glasses
post operatively.
It was as early as in 1949 that Ridley implanted the first
intraocular lens (IOL), made of glass, in the eye. However, it
took another four decades for the lens design and materials to be
refined and perfected for intraocular use, and the IOLs
became popular only in late eighties. Nevertheless, this idea did
change the course of ophthalmology and the life of
cataract patients forever. Now, implanting an IOL is commonplace and
in fact an integral part of cataract surgery. As a result,
patients no longer have to wear those thick ugly glasses after the
surgery, and can see well with ordinary very low power glasses
or without any glasses at all.
Currently there are many types of IOLs available. When you
approach a surgeon ophthalmology and the life of cataract patients
forever. Now, implanting an IOL is commonplace and in fact an integral
part of cataract surgery. As a result, patients no longer have to
wear those thick ugly glasses after the surgery, and can see
well with ordinary very low power glasses or without any glasses at
all. Currently there are many types of IOLs available. When you
approach a surgeon for your cataract surgery, you will have to make
an informed decision with the help of your surgeon, as to which type of
IOL you will prefer. Although, sometimes if there is a specific need
for a particular design or material for your eye, your surgeon may
decide as to which IOL is to be used, but mostly the surgeon will give
you the alternatives and will like to know about your preference
about the type of IOL. Factors that you will have to consider in
making a right choice of IOL for you:
PMMA lenses are rigid lenses and can’t be folded, and
therefore require a large incision (about five mm) to be inserted
in the eye. These IOLs are very low cost. IOLs made of the other
three materials are soft and are foldable, and hence can be inserted
through a very small incision (up to one mm) by folding them into a
small size. Once inside the eye, they open into their full size.
Acrylic lenses are generally preferred over silicone as the latter can be
problematic in certain situations. Out of the acrylic ones, hydrophobic
material is thought to be friendlier to the eye as compared to the
hydrophilic one; however, that issue is debatable. In any case,
the decision regarding which material IOL to be used, will be
usually taken by the surgeon.
Design/optical properties
There are a large variety of lens designs available,
and the surgeon will usually like to know your preference as well as
affordability for the IOL to be used.
Comparison Chart of Presbyopia-correcting Lens
Implants
|
INTRAOCULAR LENS (IOL) TYPE
|
BASIC MONOFOCAL LENS
|
 |
 |
 |
 |
|
PRESBYOPIA
CORRECTION
|
No
|
No
|
Yes
|
Yes
|
Yes
|
|
ZONES
OF BEST VISION WITHOUT GLASSES PROVIDED BY EACH LENS IMPLANT. THERE ARE 3
ZONES OF VISION: 1.) Far (TV, Driving), 2.) Mid-Range (computer, desk-work),
3) Near (reading documents up-close, sewing).
|
Far
OR Near (not both). Vision may still be out of focus without glasses near
and far because or residual uncorrected astigmatism.
|
Far
OR Near (noth both) Generally clearer long-disctance vision without glasses
than a basic lens.
|
Far
and Mid-range
|
Far
and Near
|
Far
and Near
|
|
ASTIGMATISM
CORRECTION WITH LENS
|
No
|
Yes
|
No
|
No
|
No
|
|
SUCCESS
RATE ACHIEVING SPECTACLE INDEPENDENCE WITH LENSES IN BOTH EYES
|
5-10%
|
5-10%
|
Approx
50%
|
80%
of patients “Never” need to wear glasses
|
Nearly 90% of patients do notrequire
glasses
|
|
STRENGTHS
AND BENEFITS OF THE LENS IMPLANT
|
Excellent
vision through bifocal glasses. Many individuals see relatively well far
away without glasses. Lens cost covered by medical insurance.
|
Excellent
vision far away without glasses
|
Excellent
night vision, far and computer vision. Very little night glare or haloes.
Astigmatism corrected with the Lensx laser.
|
Excellent
far and reading vision. Good computer vision (mid-range). Astigmatism
corrected with the Lensx laser.
|
Excellent
far and near vision. Ability to read small print in all lighting
environments. Astigmatism corrected with the Lensx laser.
|
|
WEAKNESSES
OR SIDE-EFFECTS OF THE LENS IMPLANT
|
Most
patients (90% or more) will use glasses after surgery for most activities
(Eg. Bifocals).Does not correct astigmatism.
|
No
ability to refocus mid-range (computer) or near (reading printed documents).
Patients will definitely use glasses to see computer and reading distances.
|
Most
patients will need +1.50 over-the-counter reading glasses to read printed
documents up-close. Most patients will need a “Yag capsulotomy procedure”
within one year after implantation.
|
May
need over-the-counter (+1.25) glasses to see the computer or mid-range. Some
patients see a halo effect around lights at night. Reading in low light may
require glasses. Lens reflection may be seen cosmetically at times.
|
May
need over-the-counter (+1.25) glasses to see the computer or mid-range. Some
patients see a halo effect around lights at night.
|
|
NIGHTTIMEGLARE
AND HALO
|
Minimal
|
Minimal
|
Minimal
|
Moderate
|
Moderate
|
|
COST
OF IOL COVERED BY MEDICAL INSURANCE AND/OR MEDICARE
|
Yes
|
No
|
No
|
No
|
No
|
|
METHOD
OF CATARACT SURGERY REMOVAL
|
Manual surgery – bladed incisions
|
Laser cataract surgery
|
Laser cataract surgery
|
Laser cataract surgery
|
Laser cataract surgery
|
The
whole process was a pleasant experience.
I could come home in half an hour and be normal watching TV and
computer.
The
hospital I was operated is a small one and managed by the Docter herself with
her husband who is a ENT surgeon. The Doctor is well experienced and
proficient. The support staff and nursing staff are pleasing and helpful. I
was feeling quite at home during the whole process. There was Personalized care with each
patient which is found wanting in any big hospital.
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