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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.
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.
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.
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:
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:
If you notice any cataract symptoms or signs, visit an ophthalmologist for a complete eye examination with the following tests.
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.
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
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.
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.
To people with eligible HKID, cataract surgery in public sectors of the Hong Kong Hospital Authority is an elective surgery nearly free of charge. Choices and timing of cataract surgery would be decided by mutual agreement between patients and doctors based on the evaluation of clinical conditions and severity. In order to receive cataract surgery in the public sector, the patient has to make a booking and be put on the waitlist.
Beware of the waiting times in the public sector can be long. For more details, please contact the Hospital Authority at 2300 6555.
Besides public cataract surgery, clinics and hospitals of the HK Hospital Authority also offer cataract surgeries as private services. These private surgeries are classified into Major I, Major II and Ultra-Major II levels, costing from $37,800 to $110,600. For more details, please refer to the list of private services of the Hospital Authority.
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.
To protect your eyes and relieve cataract symptoms, try the following:
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.
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.
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.
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 Marcet is a Specialist in Ophthalmology in Hong Kong and a Diplomate of the American Board of Ophthalmology. Dr. Marcet's particular area of interest is in conditions of the eyelid and oculoplastic surgery.
This article was independently written by Healthy Matters. 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.
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