Cataracts: Cloudy Eye Lenses Come with Aging

Last updated on September 9, 2021.

What are Cataracts | Causes | Risk Factors | Signs & Symptoms | Diagnosis | Non-invasive Treatment | Cataract Sugery | Lifestyle & Home Remedies | Costs of Cataract Surgery | Insurance Coverage

A cataract is the most common type of age-related degeneration of the lens of the eye. As you age, a cataract is when the lenses in your eyes become cloudy and your vision gradually gets blurry. Are cataracts an unavoidable consequence of aging or can modern medicine cure cataracts? Our guide has everything you need to know about cataracts.

What are Cataracts?

A cataract is an eye disease commonly associated with aging. It is a clouding of the clear crystalline lens of the eye that causes blurred vision. Initially one may not notice any symptoms from cataracts. However, over time cataracts can lead to blurry, hazy and less colorful vision over time. As a result, cataracts may block you from reading and carrying out daily tasks.

Causes of Cataracts

Our eyes are a sophisticated camera that allows us to perceive the world around us. The lens in a human eye is nearly transparent to allow light beams to pass through readily. As light beams enter the eye and pass through the lens, the lens refracts and focuses the light onto the retina. Such light focused on the retina then stimulates photoreceptor cells in the retina to transmit nerve signals to the visual cortex of the brain through the optic nerve and visual pathway, allowing the formation of visual images in the brain.

The most common cause of cataracts is the degeneration of the aging process. Our optical lenses consist mainly of water-soluble proteins. As proteins break down over time, amino acids accumulate within the lens and cause it to become cloudy. Besides, proteins may also bind to each other and become stiffer as we age. As a result, light cannot pass through the lens as easily as before, making the individual more difficult to see clearly. 

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Risk factors of Cataracts

Since aging is the primary cause of cataracts, cataracts most commonly occur in the elderly. However, other risk factors may also increase the risk of cataracts in younger people, such as:

  • Inborn or congenital diseases: The eyes may not develop properly during the fetal stage in the mother’s uterus during pregnancy.
  • Serious myopia (shortsightedness).
  • Excessive eyes exposure to ultraviolet light: For example exposing bare eyes under the sun without sunglasses.
  • Eyes injuries or eyes surgery: such as glaucoma surgery.
  • Long-term use of certain medicines: Including corticosteroids, phenothiazines and miotics.
  • Diabetes 

Signs and Symptoms of Cataracts

Cataracts may not cause any symptoms in the early stage. Signs of slight lens opacity inside the eyes can be observed as cataracts develop. Depending on the severity of lens degeneration, you may experience the following symptoms:

  • Blurry vision
  • Changes in eyeglass prescription
  • Poor night vision or even night blindness
  • Dulled color or yellowish vision
  • Faded or dimmed vision
  • Glare or double vision (particularly in bright sunlight or when driving at night)
  • Gradual impairment of vision
  • Photophobia (sensitivity to light)

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Diagnosis of Cataracts

If you notice any cataract symptoms or signs, visit an ophthalmologist for a complete eye examination with the following tests.

  • Visual acuity test: You will read eye charts from a distance with a single eye or both eyes to examine your vision.
  • Slit-lamp examination: The doctor examines the anatomical structure of your eyes using a microscope under bright light.
  • Tonometry test: A small probe gently flatten part of your cornea to measure eye pressure.
  • You may also be given medication to dilate your pupil so that physicians can observe the inside of your eyes. When the pupil is enlarged, the doctor can examine the eye to see if cataracts and other vision problems occur.

Eyeglasses: Non-invasive Treatments of Cataracts

Treatment approaches of cataracts depend greatly on their severity. In the early stage of mild cataracts, you can improve your vision by wearing eyeglasses with the correct prescription. However, as the cataract progresses and causes vision loss, eyeglasses might not help anymore.

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Cataract Surgery: Invasive Treatments of Cataracts

Cataract surgery would be recommended and operated by ophthalmologists when daily living is affected by the visual impairment of cataracts. In general, cataract surgery involves the steps of cataract removal and intraocular lens implantation. During cataract surgery, you will be given local anesthetics as eye drops or injections to numb the eye area before incisions. The surgeon would then remove the clouded lens and replace it with a clear artificial lens, called an intraocular lens (IOL). 

Types of cataract removal surgeries

  1. Phacoemulsification (phaco): A small incision is made on the side of the cornea, and a tiny probe that emits ultrasound waves is inserted into the eye. The ultrasound waves soften and break down the lens into fragments, which can be removed by suction.
  2. Femtosecond laser cataract treatment: A small incision is made on the side of the cornea, the laser is used to break down the lens into smaller fragments that can be removed by suction.
  3. Extracapsular surgery: The surgeon would make a longer incision on the side of the cornea and remove the cloudy core of the lens in one piece. The rest of the lens is removed by suction. It is less commonly operated nowadays as suturing and a longer recovery period is needed.

Although cataract surgery is relatively safe with a high success rate, keep in mind that intraocular lens implantation is not suitable for patients with severe myopia (shortsightedness) and it may result in complications such as glaucoma or infection. If cataract surgery is necessary for both eyes, your ophthalmologist will schedule the surgery to treat another eye after you have healed from the first surgery. 

After the surgery, you should allow adequate rest of the eyes. You should follow the treatment prescribed and attend regular follow-ups. Your eyes generally heal within 8 weeks. Wear eye protection, such as sunglasses, during the recovery period. Avoid driving or activities that require eye precision before vision recovered.

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How much does cataract surgery cost in Hong Kong?

Costs of cataract surgery in Hong Kong’s Public Sector:

Cataract surgeries are private services in clinics and hospitals of the Hong Kong Hospital Authority, cataract surgeries in the HK public sector are classified into Major I, Major II and Ultra-Major II levels, costing from $37,800 to $110,600.

Beware of the waiting times which can be long in the public sector. For more details, please contact the Hospital Authority at 2300 6555.

Costs of cataract surgery in Hong Kong’s Private Sector:

The cost of cataract surgery varies widely among private practices depending on the types of cataract removal and types of intraocular lenses. Cataract surgery may cost $12,500 to $45,000 for day surgery, or $26,100 – $85,000 with overnight stay.

HK Government subsidy – Cataract Surgeries Programme
In 2008, the Hong Kong Government established the “Cataract Surgeries Programme”, which funds eligible patients for cataract surgery in private settings. It offers an $8,000 subsidy for each cataract surgery if a patient receives treatment from a private ophthalmologist, subject to a co-payment of not more than $8,000. 

The Hospital Authority (HA) would invite patients fulfilling the following criteria to participate in the programme:
– He/She has been on the HA cataract surgery waiting list for at least 18 months or longer (those with long waiting time will be given higher priority).
– He/She has been triaged to the routine waiting list.
– Local anesthesia is suitable for the patient.
For details, refer to the Hospital Authority’s website.

*All amounts are in HKD and were last updated in September 2021. Healthy Matters takes no responsibility for any inaccuracies, errors, or omissions. It is always best to call ahead to make sure the information is up-to-date.

Lifestyle and home remedies for Cataracts

To protect your eyes and relieve cataract symptoms, try the following:

  • Conduct regular eye examinations with an ophthalmologist.
  • Make sure your eyeglasses or contact lenses are of an accurate prescription.
  • Use a magnifying glass to read if you have difficulty reading.
  • Improve the lighting during work, especially when reading. 
  • Wear eye protection like sunglasses and a hat with a brim to block sunlight.
  • Quit smoking and alcohol.

Does insurance cover consultations and treatments for cataracts in Hong Kong?

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FAQs

What is an intraocular lens (IOL)?

The cataractous lens can be removed from the eye and replaced by a clear artificial lens called an intraocular lens (IOL) through cataract surgery. If you have short-sightedness, farsightedness, astigmatism, multifocal or accommodative intraocular lenses can provide correction for near and distance vision.

Are cataracts only found in older people?

Most cataracts develop slowly over time with ageing and mostly affect people over age 50. In rare cases, infants can be born with congenital cataracts as a result of poor eye development during pregnancy, or they can be inherited.

How is cataract surgery performed?

During cataract surgery, your surgeon makes an incision in your cornea and removes the cataract lens in your eye. Your surgeon usually applies ultrasound (phacoemulsification/phaco) or laser (femtosecond laser) to break the lens and then suction away the lens fragments. After your lens is removed, an artificial intraocular lens (IOL) is implanted in its place to replace the previous cataractous lens.

What are the possible side effects of cataract surgery?

As with any surgery, possible side effects may include inflammation, pain, infection, swelling and bleeding, glaucoma is also possible, but serious complications after cataract surgery are relatively uncommon. To reduce your chance for complications after cataract surgery, make sure to follow your surgeon’s instructions and report any unusual signs and symptoms right away.

 

Dr. Marcus M. Marcet is a Specialist in Ophthalmology in Hong Kong and a Diplomate of the American Board of Ophthalmology. Dr. Marcet holds Honorary Clinical Assistant Professor appointments at HKU and CUHK. Dr. Marcet's subspecialty interest is in oculoplastic surgery. He is currently practicing at the Beacon Medical Centre in Central.

This article was independently written by Healthy Matters and is not sponsored. It is informative only and not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be relied upon for specific medical advice.