All about cataracts

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Cataract Surgery

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What is Cataract?

A cataract is a clouding of the lens in the eye that affects vision. A cataract can occur in either or both eyes. It does not spread from one eye to the other.

Most cataracts are age related. Cataracts are very common in older people. Most elderly Malaysians either have a cataract or have had cataract surgery.

 

Understanding your eye lens?

To understand how cataract affects a person, you need to understand how the lenses of your eyes work.

The lens is a clear part of the eye that helps to focus light or an image onto the retina. The retina is the light-sensitive tissue at the back of the eye.

In a normal eye, light passes through the transparent lens to the retina. Once it reaches the retina, light is changed into nerve signals and sent to your brain.

eye lens structure

In order to receive a sharp image, lenses must be clear for the retina to receive the image accurately. If the lens is cloudy from a cataract, the image you see will be blurred.

Vision of a person without cataract by Dr Vanessa Neoh
Normal vision
The same scene as viewed by a person with cataract by Dr Vanessa Neoh
The same scene as viewed by a person with cataract

 

What causes cataracts?

The lens is made of mostly 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 cloud is what we know as cataract. Cataracts can grow in size over time, making it harder to see.

How do cataracts affect vision?

Age-related cataracts can affect your vision in two ways:

  1. Clumps of protein reduce the sharpness of the image reaching the retina.

    As mentioned above, when the protein clumps up, it clouds the lens and reduces the light that reaches the retina. The clouding may become severe enough to cause blurred vision. Most age-related cataracts develop from protein clumping.

  2. Your lens color change to a yellowish/brownish color, adding a brownish tint to vision.

    As the clear lens slowly colours with age, your vision gradually may acquire a brownish shade. At first, the amount of tinting may be small and may not cause a vision problem.

    Over time, increased tinting may make it more difficult to read and perform other routine activities. This is slightly different from the protein clumps as it does not affect the sharpness of the image transmitted to the retina.

    If you have advanced lens discoloration, you may not be able to identify blues and purples.

 

What are the symptoms of a cataract?

The most common symptoms of a cataract are:

  • Clouded or blurry vision

  • Faded colors in your vision

  • Difficulty seeing at night

  • Double vision or multiple images in one eye

  • Glare. For example, headlights, lamps, or sunlight may appear too bright. A halo may appear around lights

  • Constant changes in your glasses or contact lens prescription

 


Cataract Treatment

Cataracts can be removed at any age. You do not have to wait until the cataract “ripens” or until you lose your sight before surgery can be performed.

In fact, treatment is best done earlier. Especially once the cataract interferes with your daily activities or causes a decrease in vision.

In removing cataracts, the clouded lens (cataract) must be removed surgically. Cataracts cannot be removed via laser.

 

Learn more about cataract surgery and how it is done

There are two common types of surgical procedures used today.

  1. One procedure is called extracapsular cataract extraction.

  2. Another common type of extracapsular cataract extraction is called phacoemulsification (often just called “phaco”).

    Here in Dr Vanessa’s clinic, we focus on the use of Phacoemulsification (Phaco) cataract extraction.

    The key benefit of the phaco approach includes an early restoration of vision, making recovery faster allowing you to return to your normal activities quicker.

    Phacoemulsification (often just called “phaco”) cataract extraction. This is where the surgeon removes the cataract through an even smaller incision than the one used in conventional surgery. In this procedure, the surgeon uses a computerised instrument consisting of a needle about the size of a ballpoint pen tip which vibrates at about 40,000 times a second.

    This ultrasonic vibration dissolves the cataract into fine particles, which are then vacuumed through an opening in the instrument.

 

How cataract surgery is performed 

Before having cataract surgery, Dr Vanessa will assess your eyes and general health, and check for any other eye conditions that may be affecting your vision.

Measurements will be taken of your eyes to assess the strength of the artificial lens that will replace your natural lens.

 


The procedure

Cataract surgery is a common and relatively straightforward procedure that usually takes up to 15-30 minutes. It’s usually carried out as day surgery under local anaesthetic, which means you’re conscious during the procedure and can go home on the same day.

  1. When undergoing phacoemulsification, before the operation, eye drops will be given to widen (dilate) your pupil.

  2. A local anesthetic, which can be applied as eye drops into the tissue around your eye will be given to you after dilating your pupil.

  3. Your surgeon will make a tiny cut in your cornea, the transparent layer of tissue at the front of your eye.

  4. A small probe that emits ultrasound waves is inserted through your cornea into the eye to break the affected lens into pieces.

  5. The pieces are then liquified and sucked out. A second probe sucks out the remaining soft pieces of outer lens.

  6. Once the affected lens has been removed, your doctor will insert a small acrylic lens in its place. The replacement lens is usually curled up in an injector and injected through the cut in the cornea. When the lens in place, it unfolds itself and adopts the natural position of the old lens.

    Cataract Surgery with IOL lenses. Once the affected lens has been removed, Dr Vanessa Neoh will insert a small acrylic lens in its place. The replacement lens is usually curled up in an injector and injected through the cut in the cornea. When the lens in place, it unfolds itself and adopts the natural position of the old lens.

 


Replacement lenses

Your old cloudy lens is replaced with an artificial clear acrylic lens. The replacement lens is called an intraocular implant, or intraocular lens (IOL).

 

Your lens options after cataract surgery

We offer the most advanced lens implants after cataract removal. These premium intraocular lenses (IOLs) give you the best possible vision. With premium IOLs, many people never need glasses after cataract surgery, or only wear them occasionally.

Your options include:

  • Standard (Monofocus) IOLs

    Have one point of focus and can usually give you clear distances vision. While distance vision is improved, most patient still need to wear glasses for certain tasks, such as reading or working on a computer

  • Multifocal (Trifocal) IOLs, for your best vision without glasses

    This is designed to replace cataract and correct presbyopia (reading difficulty) at the same time. Their goal is to give you a full range of clear vision, near to far and everywhere in between.

  • Astigmatism-correcting lenses (Toric intraocular lenses)

    These are for patients with existing corneal astigmatism. Similar to monofocal lenses, these lenses usually give patients quality distance vision with less dependence on glasses. Most patients will still need to wear glasses for tasks such as reading or working on a computer.

  • Multifocal with astigmatism correction lenses ( Toric multifocal)

    These correct astigmatism along with presbyopia (difficulty in reading) at the same time so as to give good vision at all distances in patients who have astigmatism and do not want to wear reading glasses

 

What is Premium Intracular Lenses (IOLs) ?

An IOL serves as an artificial replacement for the eye’s natural lens, allowing patients to see clearly after treatment at all distances and hence allowing patients to be somewhat spectacle independent. Prior to having IOL lenses, patients that underwent cataract surgery had to wear thick glasses or contact lenses.

Premium intraocular lens implants (IOLs) are a safe and an effective means of restoring sight to patients undergoing cataract surgery or clear lens exchange surgery. They are made from a bio compatible material. Many patients who have received intraocular lens implants credit premium IOLs with improving their quality of life.

Premium IOL Candidates

Ideal candidates for premium intraocular lens implants at our practice typically:

• are between the ages of 21 and 80 
• have a clinically significant cataract, but are in otherwise excellent ocular health 
• communicate a strong desire for a range of vision with reduced dependence on corrective lenses

To determine whether you are a good candidate for premium IOLs, Dr. Vanessa will conduct a thorough examination.

 


After surgery

After a few hours, most people can go home after surgery, but you’ll need to arrange for someone to take you home. You’ll usually have a plastic eye shield over your eye when you go home.

You will experience some discomfort in and around your eye after the procedure, but this should improve within a few days.

Complications in the days and weeks after surgery are rare, but you should contact the hospital as soon as possible if you experience increasing pain or vision loss at any point.

 


Common FAQs

 

Q: Is cataract surgery effective?

A: Cataract removal is one of the most common operations performed in Malaysia. It also is one of the safest and most effective types of surgery. Most patients who have cataract surgery have better vision afterwards.

 

Q: What are the risks of cataract surgery?

A: As with any surgery, cataract surgery poses risks, such as infection and bleeding.  

After surgery, you must keep your eye clean. You should wash your hands before touching your eye, and use the prescribed medications to help minimise the risk of infection.

Cataract surgery slightly increases your risk of retinal detachment. Other eye disorders, such as high myopia (shortsightedness), can further increase your risk of retinal detachment after cataract surgery.

One sign of a retinal detachment is a sudden increase in flashes or floaters. Floaters are little “cobwebs” or specks that seem to float about in your field of vision.

 

Q: What if I have other eye conditions and need cataract surgery?

A: Many people who need cataract surgery also have other eye conditions, such as glaucoma. If you have other eye conditions in addition to cataract, talk with your doctor. Learn about the risks, benefits, alternatives, and expected results of cataract surgery.

 

Q: When will my vision be normal again?

A: Recovery is quick but your vision may be blurry for a few days. The healing eye needs time to adjust so that it can focus properly with the other eye.

If you received an IOL, you may notice that colours tend to be brighter. The IOL is clear, unlike your natural lens that may have had a yellowish/brownish tint. Within a few months after receiving an IOL, you will become used to improved colour vision.


If you notice any of the symptoms mentioned above, make an appointment earliest possible to visit Dr. Vanessa. At this visit, Dr.Vanessa will be able to give you a clearer idea of what results you might expect, based on your unique condition and specific needs.

You can also fill out the form or book an appointment on the Contact Us page, and we will contact you as quickly as possible.

 

CONTACT US TODAY

Telephone (Direct):
+604 2383 491
+604 2383 499

Telephone (General):
Toll-free: 1300-880-788 (Malaysia)

Address:
Island Hospital
308 Macalister Road 10450 Penang Malaysia

Email: 
vanessaneoh@islandhospital.com

CONTACT US TODAY

Telephone (Direct):
+604 2383 491
+604 2383 499

Telephone (General):
Toll-free: 1300-880-788 (Malaysia)

Address:
Island Hospital
308 Macalister Road 10450 Penang Malaysia

Email: 
vanessaneoh@islandhospital.com

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