Eye surgery - cataract: removal of senile overripe. Methods of treatment of age-related cataract Overmature cataract

Cataract - clouding of the lens, covering it partially or completely. It is congenital and acquired.

Acquired cataracts are age-related, complicated (associated with eye diseases), caused by general diseases, toxic (the action of certain drugs) and traumatic, arising from the action of physical, chemical or thermal and radiation factors.

With age (more often after 50 years), the fibers of the lens become denser and its clouding is possible. Eye diseases such as recurrent iridocyclitis, chorioretinitis, glaucoma, retinal degeneration, and high myopia also lead to the development of cataracts. In all these conditions, degenerative changes occur in the lens.

Quite a lot of common diseases lead to the development of cataracts. For example, diabetes mellitus, exhaustion due to starvation, infectious diseases (malaria, typhoid). Hormonal drugs have a toxic effect on the lens.

Traumatic cataracts can occur with blunt and penetrating wounds of the eye. Very often, the so-called Fossius ring appears (an imprint of the pigment ring of the iris, which resolves with adequate treatment). With the development of a true cataract, vision steadily decreases.

Because the lens is able to absorb invisible infrared rays, it is possible to develop radiation cataracts in workers in hot shops and when the eye is irradiated without the use of protective equipment (glasses, masks).

Congenital cataracts are associated with impaired lens differentiation during embryogenesis and are not amenable to conservative treatment.

congenital cataract

Symptoms of a cataract

Depending on the location, cataracts are distinguished:

- polar (anterior and posterior) - located at the anterior or posterior pole

- spindle-shaped - located along the anterior-posterior axis in the center of the lens

- layered - around the nucleus

- cortical (under an oval-shaped capsule)

- nuclear - occupy the entire core

- complete - clouding of the entire lens

According to the degree of development, cataract stages are distinguished: initial, immature, mature and overripe.

With initial changes, they begin in the periphery, there is no or slight decrease in vision. Amenable to conservative treatment.

Initial cataract

With an immature degree of opacities increases and vision falls. Swelling cataracts may develop, leading to complications (phacogenous glaucoma).

Immature cataract

Mature is characterized by compaction of clouded lens masses and a persistent decrease in visual acuity. Requires surgical treatment.

mature cataract

Overripe cataract (milk cataract, morgan's cataract) is rare. At the same time, the cortical substance disintegrates, the dense core separates from the capsule and “settles” at its bottom. It can be complicated by glaucoma (because inflammation occurs) and iridocyclitis when the capsule ruptures and the lens masses enter the anterior and posterior chambers of the eye. Treatment is only surgical.

overripe cataract

Symptoms in which you can suspect the development of cataracts and consult a doctor:

- Decreased visual acuity up to light perception. If the opacity occupies the central part, then the patient sees better at dusk, when the pupil expands and the unaffected area of ​​the lens increases;

- the lens may acquire a gray color.

If the above symptoms appear, you should consult a doctor to clarify the diagnosis.

Cataract diagnostics

Examination methods:

- determination of visual acuity (from normal to light perception and blindness). With a normal retina, light perception with the correct projection. Otherwise, surgical treatment will not restore vision, but it can save the eye as an organ.

- perimetry to determine the state of the retina and diagnose possible complications;

- determination of intraocular pressure to exclude glaucoma. If necessary, tonography;

— study in transmitted light. With cataracts, against the background of a pink reflex of the fundus, shadows from a cloudy lens are determined;

- biomicroscopy allows you to determine the localization and degree of opacities;

- Examination of the fundus to exclude concomitant pathology.

Based on these studies, the doctor can make a diagnosis, but additional methods and consultations are needed to determine the causes:

- general clinical tests, including blood sugar;

– consultations of a general practitioner, ENT, dentist to exclude concomitant pathology and identify contraindications for surgical treatment (active inflammatory processes, severe decompensated diseases).

Cataract treatment

Treatment should be started in a timely manner, it can be conservative and surgical.

Conservative treatments include prescribing drops that improve the metabolism (metabolism) of the lens to slow the progression of opacities. These include Taufon, Quinax, Oftan-katakhrom. Bury 1-2 drops into the conjunctival sac 3 times a day constantly. Breaks in treatment contribute to the progression of the disease.

The most commonly used surgical methods for the treatment of cataracts. With the development of medicine, it is not even required to go to the hospital. Some operations are performed without incisions, on an outpatient basis, and the patient goes home the same day.

Methods of surgical treatment of cataracts:

— intracapsular cataract extraction — a historical method, is not currently used due to high trauma and complications. In this case, the lens is removed completely with the capsule;

- extracapsular cataract extraction - removal of cloudy masses while preserving the capsule and replacing it with an intraocular lens (IOL), which performs all the functions of the lens. IOLs are either rigid or flexible. Now almost always use the latter.

One of the most common treatments is cataract phacoemulsification with IOL implantation. A micro incision is used, the lens masses are removed by ultrasound and an IOL is implanted. The whole procedure takes about 10 minutes. Local anesthesia reduces the risk of complications. The patient is prescribed drops, and he goes home under the supervision of an ophthalmologist at the place of residence.

Postoperative treatment:

- antibacterial drops (Floxal, Tobrex, Oftakviks) first every hour, then 4 times a day for 10 days,

- anti-inflammatory drops (Indocollir, Diclof) 2 times a day for 2 weeks,

- hormonal drops (Oftan-dexamethasone, Maxidex) every 12 hours for 2 weeks,

- in case of dry eyes, tear substitutes are prescribed (Artificial tear, Systane, Oksial) - drip as needed.

After the operation, it is contraindicated to lift weights, stay in dusty rooms and outdoors in windy weather, hypothermia, and bathing.

There are folk methods of treatment, for example, instillation of diluted honey into the eyes, ingestion of infusion of calendula, sage, etc., but their effectiveness has not been proven, and some substances can harm.

Complications of cataract

With untimely or self-treatment, complications may occur:

Cataract - causes, types, symptoms and signs, diagnosis of clouding of the lens of the eye, complications

Cataract represents eye disease. in which there is a clouding of one of the structural units of the human eye, namely, the lens. Normally, the lens of the eye is absolutely transparent, due to which light rays freely pass through it and are focused on the retina, from where the image of the "picture" of the surrounding world is transmitted to the brain through the optic nerve. Thus, the transparency of the lens is one of the necessary conditions for good vision, because, otherwise, the light rays will not even fall on the retina of the eye, as a result of which a person will not be able to see in principle.

A cataract is a disease in which the lens becomes cloudy and loses its transparency, as a result of which the bangs begin to see poorly. With a long course of cataracts, clouding of the lens can be so significant that a person is completely blind. The main manifestation of cataract is the appearance of a sensation of "fog" before the eyes, through which objects are seen as if through a haze, a layer of water or misted glass. In addition, cataracts worsen vision at night, impaired ability to recognize colors, double vision and increased sensitivity to bright light.

Unfortunately, the only treatment that completely eliminates cataracts is surgery, during which the cloudy lens is removed and a special transparent lens is inserted into the eye instead. But such an operation is not always necessary. So, if a person sees normally, then conservative treatment is recommended to stop the progression of cataracts and maintain vision at the current level, which will be an adequate replacement for surgery.

Brief description of the disease

Cataract has been known since ancient times, since even in ancient Greek medical treatises there is a description of this disease. Greek healers gave the name to the disease from the word katarrhaktes, which means "waterfall". Such a figurative name was due to the fact that a person suffering from this disease sees the world around him as if through the water column.

Currently, according to the World Health Organization, cataract is the most common eye disease in the world. However, the frequency of its occurrence is different in people of different age groups. So, in people under 40 years of age, cataracts develop extremely rarely, and in this age group, cases of a congenital disease that developed in a child in the womb before he was born are recorded mainly. Among people 40-60 years old, cataract occurs in 15%, in the group of 70-80-year-olds, the disease is already fixed in 25-50%, and among those who have crossed the 80-year mark, cataracts are detected to some extent in everyone. Thus, cataract is an urgent and frequently occurring medical problem, as a result of which the disease and methods of its treatment are intensively studied, due to which significant progress has been made in recent years in the success of therapy.

With a cataract, one of the structures of the eye is affected - the lens, which becomes cloudy. To understand the essence of the disease, it is necessary to know the position and functions of the lens in the system of the human visual analyzer.

So, the lens is a biconvex, elliptical, absolutely transparent structure located behind the iris (see Figure 1) with a maximum diameter of 9-10 mm.

Picture 1- The structure of the eye.

Since the lens is completely transparent, even with a careful look into the pupil or at the iris of the eye, it is not visible. By structure, the lens is a gel-like mass enclosed in a dense capsule of connective tissue that holds the necessary shape of the organ. The gel-like content is transparent, so that light rays pass through it freely. The shape of the lens is similar to an ellipse, which is extended from one corner of the eye to the other, and the curved surfaces adjacent to the pupil are optical lenses that can refract light rays. The lens does not contain blood vessels that would violate its complete transparency, as a result of which its cells are nourished by diffusion of oxygen and various necessary substances from the intraocular fluid.

According to the functional purpose, the lens plays a very important role. Firstly, it is through the transparent lens that light rays pass into the eye and are focused on the retina, from where the image for analysis and recognition is transmitted to the structures of the brain along the optic nerve. Secondly, the lens not only transmits light waves into the eye, but also changes the curvature of its surfaces in such a way that the rays are focused exactly on the retina. If the lens did not change its curvature, adjusting to different illumination intensities and distances of the objects under consideration, then the light rays passing through it would not be focused exactly on the retina, as a result of which a person would see blurry rather than clear images. That is, with a constant curvature of the lens, a person's vision would be poor, he would see like those suffering from myopia or hyperopia and not wearing glasses.

Thus, we can say that the main function of the lens is to ensure that the image of the surrounding world is focused directly on the retina. And for such focusing, the lens must constantly change its curvature, adjusting to the conditions of visibility of the environment. If an object is close to the eye, then the lens increases its curvature, thereby increasing the optical power. If the object is far from the eye, then the lens, on the contrary, stretches and becomes almost flat, and not convex on both sides, due to which the optical power decreases.

In fact, the lens of the eye is similar to an ordinary optical lens that refracts light rays with a certain force. However, unlike a lens, the lens is able to change its curvature and refract rays with different strengths required at a given time, so that the image is focused strictly on the retina, and not closer or behind it.

Accordingly, any change in the shape, size, location, degree of transparency and density of the lens leads to visual impairment of greater or lesser severity.

And a cataract is a clouding of the lens, that is, a loss of transparency due to the formation of a different number of dense and opaque structures in its gel-like subcapsular contents. As a result of a cataract, the lens ceases to transmit a sufficient amount of light rays, and a person ceases to see a clear picture of the world around him. Due to the turbidity of the lens, vision becomes, as it were, “foggy”, the outlines of objects become fuzzy and blurry.

The causes of cataracts have not yet been reliably established, but, nevertheless, scientists identify a number of predisposing factors, against the background of which a person develops a cataract. These factors contribute to the development of cataracts, so they are conventionally referred to as the causes of this disease.

At the level of biochemistry, cataracts are caused by the breakdown of proteins that make up the gel-like contents of the lens. Such denatured proteins are deposited in the form of flakes and cloud the lens, which leads to cataracts. But the reasons for the denaturation of lens proteins are very diverse - these can be age-related changes in the body, injuries. chronic inflammatory eye diseases. radiation, metabolic diseases, etc.

The most common predisposing factors for cataracts are the following conditions or diseases:

Depending on the age of cataract onset, the disease can be congenital or acquired. Congenital cataracts occur during fetal development. as a result, the baby is born with a visual defect. Such congenital cataracts do not progress over time and are limited in size.

Acquired cataracts appear during life due to the influence of various causative factors. The most common among the acquired are senile cataracts, due to age-related changes in the body. Other types of acquired cataracts (traumatic, toxic due to poisoning, caused by systemic diseases, etc.) are much less common than senile ones. Unlike congenital, any acquired cataracts progress over time, increase in size, worsening vision more and more, which, ultimately, can lead to complete blindness.

Cataracts are divided into several types. depending on the nature and localization of lens opacities. Determining the type of cataract is important to determine the optimal strategy for its treatment.

Cataract of any kind and localization consistently passes from the moment of appearance 4 stages of maturity- initial, immature, mature and overripe. At the initial stage, the lens becomes hydrated, gaps appear in the gel-like mass that fills it, which violate the transparency of the entire structure. However, since the cracks are located along the periphery, and not in the pupil area, this does not prevent a person from seeing, so he does not notice the development of the disease. Further, at the stage of immature cataract, the number of foci of opacification increases, and they are in the center of the lens opposite the pupil. In this case, the normal passage of light through the lens is already disrupted, as a result of which a person's visual acuity decreases and a feeling of seeing surrounding objects appears as if through fogged glass.

When the opacities fill the entire lens, the cataract becomes mature. At this stage, the person sees very poorly. The pupil with a mature cataract acquires a characteristic white tint. Then comes the stage of overripe cataract, in which the disintegration of the lens substance and the wrinkling of its capsule occurs. At this stage, the person is completely blind.

Cataract progression rate. that is, its passage through all four stages of development may be different. So, in one person, cataracts can progress very slowly, so that vision remains satisfactory for many years. And in other people, on the contrary, cataracts can progress very quickly and lead to complete blindness literally within 2 to 3 years.

Symptoms of a cataract depending on the stage of the disease may be different. In the first stage, a person does not suffer from visual impairment. but notices frequently repeated episodes of double vision, flashing "flies" before the eyes, yellowish coloring of all surrounding objects, as well as some blurring of the visible picture. Blurred vision is often described by people - "you see, as if in a fog." In connection with the symptoms that have appeared, it becomes difficult to read, write and perform any work with small details.

At the stage of immature and mature cataracts, visual acuity sharply decreases towards myopia, objects begin to blur before the eyes, there is no discrimination of colors, a person sees only blurry contours and outlines. A person no longer sees any small details (people's faces, letters, etc.). By the end of the stage of mature cataract, a person ceases to see anything at all, and only light perception remains.

In addition, at any stage of development, cataracts are characterized by increased photosensitivity, poor vision in the dark, and the appearance of a halo around lighting fixtures when looking at them.

For diagnosing cataracts an ophthalmologist checks visual acuity (visometry), determines the field of view (perimetry), the ability to distinguish colors, measures intraocular pressure. examines the fundus of the eye (ophthalmoscopy), and also makes a detailed study of the lens using a slit lamp (biomicroscopy). In addition, sometimes additional refractometry and ultrasound scanning of the eye can be performed, which are necessary to calculate the optical power of the lens and determine the method of the operation to replace the lens. Based on the results of examinations, the diagnosis of cataract is confirmed or refuted. In cataracts, visual acuity is usually impaired, color discrimination is impaired, and, most importantly, clouding of the lens is visible when examined with a slit lamp.

Cataract treatment may be operative or conservative. If the disease is detected in the initial stages, when vision practically does not suffer, then conservative therapy is carried out aimed at slowing down the progression of cataracts. In addition, conservative therapy is recommended in all cases where a cataract does not prevent a person from engaging in any normal activity. Currently, various eye drops are used as a means of conservative therapy for the disease. containing vitamins. antioxidants. amino acids and nutrients (for example, Oftan-Katachrom, Quinax, Vitafacol, Vitaiodurol, Taufon. Taurine, etc.). However, it must be remembered that eye drops are not able to lead to the disappearance of existing opacities in the lens, but can only prevent the appearance of new foci of opacity. Accordingly, eye drops are used to maintain vision at the current level and prevent the progression of cataracts. In many cases, such conservative therapy is very effective and allows a person to live for a long period of time without resorting to surgery.

Surgical treatment of cataracts consists in removing opacities and then installing a special lens in the eye, which, in essence, is like a lens prosthesis. This artificial lens performs the functions of a lens, allows a person to completely and permanently get rid of cataracts and restore vision. Accordingly, the only complete and radical treatment of cataract is surgery.

Currently, ophthalmologists, knowing that surgery is the treatment with the most visible positive result, recommend the removal of opacities and the installation of a lens in almost all cases of cataract. This position of actively promoting the surgical treatment of cataracts is due to the convenience for the doctor, who simply needs to perform a relatively simple operation, after which the patient can be considered cured. But conservative therapy requires effort from both the doctor and the patient, since it is necessary to constantly apply eye drops in courses, undergo examinations and control vision. And yet, despite the advantages of surgery, in many cases, cataracts are preferable to conservative therapy, which stops the progression of the disease.

Causes of cataract

The causes of congenital and acquired cataracts are different, since the formation of the former occurs when the fetus is exposed to various adverse factors during pregnancy, and the latter are formed during a person's life due to various pathological processes in the body.

The causes of congenital cataracts are divided into two large groups - these are genetic anomalies and the impact of adverse factors during pregnancy that can disrupt the formation of the lens of the fetal eye.

Genetic anomalies, among the manifestations of which there is a congenital cataract, include the following diseases or conditions:

The factors, the impact of which on a woman during pregnancy can provoke a violation of the formation of the lens and congenital cataract in a child, include the following:

• Rubella, toxoplasmosis or cytomegalovirus infection. transferred in the first 12 - 14 weeks of pregnancy;
• The effect of ionizing (radioactive) radiation on the body of a pregnant woman in any period of gestation;
• Rhesus incompatibility of the fetus and mother;
• Fetal hypoxia;
• Lack of vitamins A, E, folic (B 9) and pantothenic (B 5) acids, as well as protein;
• Chronic intoxication of the body of a pregnant woman with various substances (for example, smoking, drinking alcohol, drugs, taking contraceptives or abortion pills).

As for acquired cataract, the spectrum of its causal factors is reduced to conditions or diseases in which metabolism is disturbed to some extent, antioxidant deficiency occurs, and the processes of damage to cellular structures prevail over their repair (recovery). Unfortunately, at present, the exact causes of acquired cataracts have not been established, however, scientists were able to identify a number of factors that they conditionally called predisposing, since if they are present, the likelihood of clouding of the lens is very high. Traditionally, it is the predisposing factors at the everyday level that are considered the causes, although this is not entirely correct from the point of view of science. However, we will also indicate predisposing factors as causes, since it is under these conditions that cataracts develop.

So, the following diseases or conditions can be the causes of acquired cataract:

• Hereditary predisposition (if parents, grandparents had a cataract, then the risk of its occurrence in a person in old age is very high);
• Female gender (women develop cataracts several times more often than men);
• Age-related changes in the body (slowdown of metabolism, accumulating pathological changes in cells, deterioration of immunity and chronic diseases in combination lead to the formation of opacities in the lens);
• Alcohol, drug use and smoking;
• Endocrine diseases (diabetes mellitus, hypothyroidism, hyperthyroidism, muscular dystrophy, obesity, etc.);
• Chronic autoimmune or inflammatory diseases that worsen the condition of the vessels (for example, rheumatoid arthritis, etc.);
• Exhaustion due to starvation, malnutrition or severe past diseases (for example, typhoid, malaria, etc.);
• Hypertonic disease;
• Anemia;
• Excessive exposure of the eyes to ultraviolet radiation (stay in the sun without protective glasses);
• Exposure to the eyes of strong thermal radiation (for example, work in a hot shop, frequent visits to hot baths, saunas);
• Exposure to radiation, ionizing radiation or electromagnetic waves on the eyes or the body as a whole;
• Poisoning with poisons (mercury, thallium, ergot, naphthalene, dinitrophenol);
• Down's disease;
• Skin diseases (scleroderma, eczema, neurodermatitis, poikiloderma Jacobi, etc.);
• Injuries, burns, eye surgery;
• Myopia of a high degree (3 degrees);
• Severe eye diseases (uveitis, iridocyclitis, chorioretinitis, Fuchs syndrome, pigmentary degeneration, retinal detachment, glaucoma, etc.);
• Infections transferred during pregnancy (flu, rubella, herpes, measles, toxoplasmosis, etc.) - in this case, the newborn may have a congenital cataract;
• Reception for a long time or in high dosages of glucocorticosteroid drugs (Prednisolone, Dexamethasone, etc.), tetracycline. amiodarone, tricyclic antidepressants;
• Living or working in adverse environmental conditions.

Varieties of cataract

Consider the various types of cataracts and their characterological features.

First of all, cataracts are divided into congenital and acquired. Accordingly, congenital cataracts are formed in the fetus during fetal development, as a result of which the baby is born already with an eye pathology. Acquired cataracts develop during a person's life under the influence of predisposing factors. Congenital cataracts do not progress, that is, the number of opacities and their intensity do not increase over time. And any acquired cataracts progress - over time, the number of opacities and the degree of their intensity in the lens increase.

Acquired cataracts are divided into the following types depending on the nature of the causative factor that caused them:

Both acquired and congenital cataracts are classified into the following different types, depending on the location and form of clouding in the lens:

1. Layered peripheral cataract(picture 1 in figure 2). Opacities are located under the lens shell, while transparent and opaque areas alternate.

2. Zonular cataract(picture 2 in figure 2). Opacities are located around the center of the lens, while transparent and opaque areas alternate.

3. Anterior and posterior polar cataracts(picture 3 in figure 2). Opacification in the form of a round white or grayish spot is located directly under the capsule in the region of the posterior or anterior pole of the lens in the center of the pupil. Polar cataracts are almost always bilateral.

4. Fusiform cataract(picture 4 in figure 2). Opacity in the form of a thin gray ribbon has the shape of a spindle, and occupies the entire width of the lens in its anteroposterior dimension.

5. Posterior subcapsular cataract(picture 5 in figure 2). The opacities are whitish wedge-shaped lesions located along the outer edge of the posterior part of the lens sheath.

6. Nuclear cataract(picture 6 in figure 2). Opacification in the form of a spot about 2 mm in diameter, located in the center of the lens.

7. Cortical (cortical) cataract(picture 7 in figure 2). Opacities are whitish wedge-shaped lesions located along the outer edge of the lens sheath.

8. Complete cataract(picture 8 in figure 2). The entire substance of the lens and capsule is turbid. As a rule, such a cataract is bilateral, that is, both eyes are affected.

Figure 2- Types of cataracts depending on the location and form of opacities.

Congenital cataracts can be represented by any of the above types, and acquired ones are only nuclear, cortical and complete. According to the form of opacities, cataracts can be very diverse - stellate, disc-shaped, bowl-shaped, rosette, etc.

Age-related cataracts, in turn, go through the following stages of development, which are also their types:

Diagnosis of cataracts is made on the basis of an examination by an ophthalmologist and data from instrumental examinations. The examination consists in examining the iris and pupil of the eye, during which the doctor sees foci of white-gray opacities located in various parts of the lens. At the same time, if the light is directed into the patient's eyes, then opacities are visible in the form of flakes of gray or gray-white colors. If the eye is viewed in transmitted light, then opacities are visible in the form of black stripes or spots on a red background. It is the presence of such opacities that makes the ophthalmologist suspect a cataract.

If the clouding of the lens is very strong, as a result of which it is impossible to examine the fundus, then a study of mechanophosphene and the phenomenon of autoophthalmoscopy is carried out, which allow determining the state of the retina.

In addition, in some cases, in addition to assessing the state of the retina, optic nerve and visual cortex of the cerebral hemispheres, functional diagnostics are carried out using electrooculography (EOG), electroretinography (ERG) and registration of visual evoked potentials (VEP).

Clinical picture of a cataract

Symptoms of cataracts can be different, depending on what stage the pathological process goes through - initial, immature, mature or overripe. Moreover, acquired cataracts are characterized by a gradual passage through all stages of development with the alternate appearance of symptoms inherent in a certain stage. And for congenital cataracts, the absence of progression is characteristic, as a result of which the symptomatology remains constant for a long period of time, and the clinical manifestations generally correspond to the stages of initial, immature or overripe acquired cataracts. For example, if a congenital cataract was initially small, opacities were located on the peripheral zone of the lens, then this corresponds to the initial stage of an acquired cataract. Naturally, the symptoms of this type of pathology will also correspond to the initial stage of the acquired cataract. If a congenital cataract is located in the visual region of the lens, then this corresponds to an immature cataract with the corresponding symptoms. A congenital cataract, completely covering the lens of a child, corresponds to the stage of a mature acquired cataract with the corresponding clinical manifestations.

We will consider the clinical manifestations of each stage of acquired cataracts and the distinctive features of the symptoms of congenital cataracts separately in order to avoid confusion.

Symptoms of acquired cataracts. At the initial stage of cataract, a person has the following clinical symptoms:

Figure 3- Vision of surrounding objects with cataracts. On the left is the picture that a person suffering from cataracts sees, and on the right are objects as they are seen by a normal eye.

With the transition of a cataract from the initial stage to the immature stage, myopia sharply increases in a person. In addition, he sees very poorly any objects located far away (at a distance of 3 meters and further from the eye). Nebula and blurring of the visible picture of the surrounding world, photosensitivity, difficulty in distinguishing small details and inability to distinguish colors increase, but double vision, flickering of “flies”, spots, flashes, and a halo around the light source disappear. The light sensitivity becomes so strong that a person sees better in cloudy weather or at dusk than in daylight or in good artificial light. At the same time, large foci of milky-white cataract spots are clearly visible in the depth of the pupil (see Figure 4). During the entire stage of immature cataract, vision deteriorates, a person sees worse and worse, the ability to distinguish more and more details is lost, and only the vision of blurred outlines of surrounding objects remains.

Figure 4- Pupil in immature cataract.

When a cataract passes into the mature stage, a person loses objective vision, and only light perception remains. That is, a person does not even see the outlines of surrounding objects, his eye is able to distinguish only light or dark at the present moment in the room or on the street. The pupil in the center becomes whitish-gray, and black-violet areas are visible along its edges.

When a cataract passes into the overripe stage, a person becomes completely blind and even loses light perception. At this stage, treatment is absolutely useless, since vision will not be restored. Surgery for overripe cataracts is performed only to save the eye, because. the disintegrating lens masses are toxic to all other eye tissues, which can lead to glaucoma or other serious complications. An overmature cataract is also called a morgania cataract or a milk cataract because the pupil is completely milky white. Sometimes with an overripe cataract, the pupil turns black due to excessive sclerosis of the lens nucleus.

Symptoms of congenital cataracts. With congenital cataracts, the child is still too young to say that he does not see well, so their symptoms are indirect, detected by a doctor or parents. So, the symptoms of congenital cataract in children are as follows:

As a rule, parents can independently notice signs of congenital cataract only if it is present in both eyes. If the cataract affects only one eye, then it is very difficult to notice, since the child will look with one eye, which, up to a certain age, will be able to compensate for the absence of the second. Therefore, babies should regularly undergo preventive examinations by an ophthalmologist, who can notice signs of cataracts by simply carefully examining the baby's pupils.

lens for cataract

With a cataract, the lens is gradually destroyed, manifested by the formation of opacities in it and proceeding in several stages. At the first, initial stage the lens becomes hydrated, that is, an excess amount of liquid appears in it. This liquid separates the fibers of the lens, forming gaps between them filled with water. These gaps are the primary foci of opacities.

Further, in the second, immature stage due to the stratification of the fibers, a sufficient amount of nutrients does not penetrate into them, as a result of which the proteins of the structural components of the lens break down. The decayed proteins cannot be removed anywhere, since the lens is covered with a capsule, as a result of which they are deposited in the previously formed gaps between the fibers. Such deposits of decomposed proteins are clouding of the lens. At this stage, the lens increases in size and can provoke an attack of glaucoma due to a violation of the outflow of intraocular fluid.

In the third stage of mature cataract all the proteins of the lens gradually disintegrate, and it turns out to be all occupied by turbid masses.

Stage 4 overripe cataract the cortical substance of the lens disintegrates, as a result of which its dense nucleus is separated from the capsule and falls to the back wall. The entire lens is wrinkled. The process of disintegration of the cortical substance is accompanied by inflammation, as a result of which a rupture of the lens membrane and the release of necrotic masses into the chambers of the eye are possible. And since the masses of the decaying cortical substance are toxic, the development of complications in the form of iridocyclitis, glaucoma, etc. is possible. The lens at the fourth stage of cataract is recommended to be urgently removed in order to avoid possible complications and at least save the eye, albeit completely blind.

Vision with cataracts

Vision with cataracts is very specific and characteristic. Firstly, a person sees the surrounding objects as if in a fog, it seems to him that before his eyes there is a haze, a misted glass or a layer of water, which makes it difficult to see all the details well. All outlines of objects are blurred, with fuzzy contours and without small details. Due to such blurring, a person does not distinguish fine details of objects (letters, faces, etc.), as a result of which it is difficult for him to read, write, sew and perform other activities related to the need to see small objects.

Objects located far away (3 meters and further from the eye), a person sees poorly, and those objects that are close cannot be seen due to the blurring of the picture. Blurred vision is not corrected with glasses or lenses.

In addition, when looking at light sources, a person sees a halo around them, so it is difficult for him to drive a car in the dark or walk along a street lit by lanterns, as the glare from llamas leads him astray. In addition to the specific vision of light sources, photophobia appears with cataracts, when any normal lighting (solar or artificial) seems too bright and irritating to the eyes. Because of photophobia, paradoxically, a person sees better on cloudy days or at dusk, and not in sunny clear weather.

With a cataract, it is very difficult for a person to distinguish colors because they become pale, especially blue, indigo and purple. In addition, all colors acquire a certain yellowish tint. The colored world becomes, as it were, pale, fuzzy.

Also, with a cataract, a person is worried about double vision, constantly flashing flashes and flashes of light before the eyes in the dark.

If a person was farsighted before the onset of cataracts, he may find that he is suddenly able to see well up close and even read without glasses. This short-term improvement in vision is due to the fact that a cataract changes visual acuity towards myopia. But as the disease progresses, myopia will increase, and the acquired ability to read without glasses will disappear.

Cataract - what is it? Symptoms and signs. The operation to install an artificial lens - video

Complications

A cataract left untreated can lead to the following complications.

Signs and symptoms of cataract

Cataract is an insidious disease: it develops gradually, gradually, and in the early stages does not give the patient any cause for concern. However, in the absence of timely treatment, cataract progresses, leading to a significant deterioration in the quality of life. Signs of cataracts increase as the pathological process develops.

Stages of a cataract

A cataract goes through four stages in its development:

1. initial cataract;
2. immature cataract;
3. mature cataract;
4. overripe cataract.

Initial cataract

There are small areas of clouding of the lens. If they are not located opposite the pupil, but in the peripheral parts, then no visual impairment occurs in a person. Only a qualified ophthalmologist with the help of special equipment can recognize the disease.

To prevent further progression of the disease, people over 50 should visit an ophthalmologist annually.

Immature cataract

Opacity captures more and more large areas of the lens, cataract symptoms appear:

• there is a feeling of flashing dots, strokes or spots before the eyes;
• halos appear around objects in the light, the contours of objects are blurred;
• it becomes difficult to disassemble small print, thread a needle and perform other actions related to examining small details;
• when reading or working, I want to turn on additional light, ordinary illumination becomes insufficient;
• there may be violations of color perception, twilight vision worsens;
• there is a feeling of fog or a veil before the eyes.

The symptoms of cataracts at this stage are perceived by many as the inevitable deterioration of vision associated with age. Therefore, even noticeable visual discomfort for some patients does not become a signal to visit a doctor. Ophthalmologists warn: if urgent measures are not taken at this stage, the disease will lead to blindness.

mature cataract

The lens finally becomes cloudy, the color of the pupil changes to white. The patient, at best, can see his own hands if he brings them directly to his face. Then, out of all the richness of colors, only the recognition of light remains, which eventually also disappears. The patient's world is plunged into darkness.

Fortunately, blindness at this stage is reversible. Carrying out qualified surgical treatment allows patients to restore their vision.

overripe cataract

With the loss of vision, the troubles for a patient with untreated cataracts do not end, as the pathological process continues. In most cases, the lens not only becomes cloudy, but also expands, which creates obstacles for the outflow of intraocular fluid. As a result, intraocular pressure increases, that is, secondary glaucoma develops, which in turn leads to atrophy of the optic nerve. Other formidable complications may occur, for example, rupture of the lens capsule with subsequent inflammation and possible complete loss of the eye.

If such complications occur, blindness becomes irreversible, and no operation will help restore vision.

It is not difficult to recognize a cataract using modern methods of ophthalmic diagnostics. Another issue is that not all patients turn to ophthalmologists in the early stages of the process. Given the absence of symptoms at the onset of the disease and the rather slow development of visual discomfort, a person's attention to his health comes to the fore in the timely diagnosis of cataracts.

Even in the absence of cataract symptoms, people over 50 years of age should have an annual eye examination. If you have these symptoms, contact your ophthalmologist as soon as possible. Remember: the sooner treatment is started, the better the result will be!

Cataract is called the most common eye disease in people of mature and old age. In connection with a serious decrease in visual acuity, which causes this disease, professional activities may be complicated and restrictions may arise in the self-service of citizens, and in advanced cases, blindness occurs altogether. However, a cataract is not a death sentence. And with a timely appeal to an ophthalmologist, a high-quality treatment of the disease is possible, which will allow a person to restore vision as much as possible and quickly return to a traditional lifestyle.

Cataract - what is this disease?

In medicine, a cataract is called clouding of the natural lens of the eye - a natural lens that transmits and refracts streams of light rays. While a person is young, the lens is transparent and elastic. It has the ability to instantly change its shape to focus on an object. Due to this property of the lens, a person has the ability to see equally well both near and far.

In cataracts, the transparency of the lens is broken. Due to its partial or complete clouding, only part of the light rays enter the eye, leading to blurred, blurred vision, and a decrease in its sharpness. With the progression of the disease over time, the area of ​​opacification increases, worsening vision more and more. Left untreated, cataracts can lead to blindness.

The causes of the disease can be many factors: pathologies of intrauterine development, trauma, radiation, general diseases of the body. However, the so-called. age (senile) cataract, which is caused by the aging process of the whole organism. It develops, as a rule, after 50 years and at the moment, in the world, at least 17 million people are affected by this disease.

According to WHO statistics, by the age of 70-80, 26% of men and approximately 46% of women suffer from cataracts. While after 80 years, the disease is detected in almost every person. Particularly disturbing is the fact that about 20 million people in the world have already completely lost their sight due to cataracts.

Causes of the disease

Normally, the human lens is completely transparent. It contains water, proteins and some minerals. The lens is nourished by intraocular moisture, which is produced in the eye. With age, metabolic products with a toxic effect accumulate in the intraocular fluid. Thus, malnutrition occurs, and the lens gradually loses its former transparency. The typical variety of cataracts is very extensive, due to differences in the resulting lens opacities.

The formation of opacities, in addition to age, is affected by a number of eye diseases and pathologies of other organs. Cataracts arising in this case are called complicated, they can develop against the background of glaucoma, myopia, diseases of the choroid, retinal detachments and pigmentary dystrophies.

Common diseases are often the cause of clouding of the lens: diabetes mellitus, diseases of the blood and joints, bronchial asthma, skin diseases (such as eczema or psoriasis).

Some external factors also influence the development of cataracts: poor nutrition, vitamin deficiency (calcium, vitamin C), occupational hazards, ultraviolet radiation and radiation, polluted ecology, smoking.

Symptoms of a cataract

This disease has been known since ancient times. Its name comes from the Greek kataraktes - "waterfall". Indeed, a person with a cataract sees as if in a fog - as if through misted glass or falling water. The development of the disease makes this "fog" even thicker and the person feels the veil before his eyes sharper and sharper. There is intolerance to bright light, sometimes the images are doubled, there are serious difficulties when working with small elements, reading, writing. At a late stage of the disease, the pupil becomes white.

As a rule, a cataract begins in one eye (usually the left), then gradually develops in the second. Age-related cataract is a progressively developing disease that undergoes several stages in its development:

• The stage of the initial cataract, when the clouding of the lens occurs outside the optical zone - on its periphery. The patient at this moment does not feel anything, and the disease is determined by an ophthalmologist by chance, during the next examination.
• The stage of immature cataract, when opacification gradually moves towards the central optical zone. By this time, visual acuity is already markedly reduced. The patient complains of the presence of a thick fog before the eyes. He begins to have difficulties in the professional and domestic spheres. There is a need for surgical treatment.
• The stage of a mature cataract, when opacities cover the entire area of ​​​​the lens. Visual acuity is reduced to the level of light perception. The patient manages to see only the contours of objects that are at arm's length from him.
• The stage of overripe cataract, characterized by liquefaction of the lens substance, after which it acquires a milky white hue. The visual acuity of the patient at this moment is such that he can only distinguish a bright spot of the window in the room and feel the light of a flashlight directed directly into the eye. At this stage of the disease, numerous complications can occur, the most dangerous of which is secondary glaucoma. It develops as a result of compression of the surrounding tissues of the eye by an enlarged clouded lens. In the dystrophic process, the ligaments that hold the lens are also involved. At the same time, they often tear, leading to dislocation (dislocation) of the lens into the vitreous body. The protein composition of the overripe lens is perceived by the tissues of the eye as foreign and this often causes iridocyclitis.

The manifestations of cataracts are varied and most often they are associated with visual impairment. Like any other disease, it is better to diagnose it in the initial stages and immediately begin treatment.

Cataract treatment

Among the methods of cataract treatment, it is customary to single out conservative (drug) and operational (surgical).

At the initial stage of the disease, if the patient does not want to have an operation, doctors recommend the use of eye drops: Quinax, Taufon, Vita-Yodurol, Oftan-Katahrom. These drugs inhibit the progression of opacities, but they are not capable of resolving existing ones. To prescribe them and determine the correct dosage, you need to consult a doctor.

However, a radical method of getting rid of cataracts is surgery. This operation is called cataract extraction, and its most commonly used technique is phacoemulsification, with implantation of a posterior chamber intraocular lens. It is phacoemulsification that is performed in 99% of cases of uncomplicated cataract. Moreover, the most favorable outcome of the operation can be expected in patients with an early stage of immature cataract.

Russian doctors have been using the phacoemulsification method for at least 20 years. The operation is performed under local anesthesia, on an outpatient basis.

The course of the operation is as follows: through the corneal micro-incision, the cloudy lens is destroyed by ultrasound and brought out. A folded flexible intraocular lens is introduced into the left lens capsule, which unfolds inside and fixes itself. The operation takes about 20 minutes. Vision, up to the preoperative level, is restored immediately. The maximum possible visual acuity is within 4 weeks.

During the month of the recovery period, the patient needs to instill anti-inflammatory and disinfectant drops into the eye. At the end of the recovery period, you can return to the traditional way of life.

When a mature or overmature cataract is detected, which is complicated by weakness of the ligaments supporting the lens, an extra- or intracapsular cataract extraction is prescribed. The essence of the surgical intervention is the removal of the entire lens along with the capsule. Instead, a rigid intraocular lens is implanted, which is sutured to the iris. The operation requires a large incision and postoperative sutures, which are removed after 4-6 months.

For several months after the operation, the patient has low vision due to postoperative reverse astigmatism. But after the removal of the sutures, the patient's level of vision returns to what it was before the cataract. Of particular danger in the rehabilitation period is the divergence of the postoperative wound.

Complications of cataract surgery

When an unusable lens is removed, the human eye loses a very important detail - an optical lens. The refractive properties of the cornea, the vitreous body and the moisture of the anterior chamber are not enough for good vision. The operated eye needs additional spectacle correction or implantation of an artificial lens.

Implantation of an artificial lens is the best way to treat cataracts. However, its application is not always possible. The condition of the tissues or vessels of the patient's eye in old age, as well as the presence of some systemic diseases, do not allow the implantation of an artificial lens, due to the minimization of the results of the operation. In the stage of mature and overmature cataract, the swollen lens occupies almost the entire volume of the anterior chamber of the eye, due to which the outflow of intraocular fluid is disturbed. As a result, a dangerous complication of the disease often occurs - secondary glaucoma. At the same time, delay in the operation, threatens the patient with irreversible loss of vision.

Prevention

The main measure for the prevention of cataracts can be considered a timely visit to a specialist. So, people who have crossed the threshold of the age of forty, it is necessary to see an ophthalmologist once a year to identify lens opacities. It is worth remembering that only a specialist can determine the need for medical or surgical treatment. Self-treatment of cataracts is useless and will only result in wasted time and complete loss of vision.

Today, eye drops are widely used to help slow down the process of cataract maturation. Such vitamin products contain amino acids, enzymes, and trace elements necessary for the lens. With their systematic use, the processes of metabolism and nutrition of the lens improve, which inhibits the development of cataracts. True, such drops cannot stop the clouding process that has already begun. They can only slow down the disease and help "pass" the time before surgery.

conclusions

Age-related (senile) cataracts can be successfully treated even at the most advanced age. The only condition for an excellent result is the absence of complications associated with inflammation, for which you should not start the disease until the late mature and overripe stages. The well-established technique of surgical operations, competent anesthesia and a variety of artificial lenses make surgical treatment of cataracts minimally dangerous. The main thing is to detect the disease in time and hurry up with its treatment as much as possible.

Decreased vision in old age can be caused by a change in the transparency of the lens - its gradual clouding. This leads to cataracts. Age-related cataract is a common disease after sixty years, as it is a consequence of general aging and wear and tear of the body. However, with a slight clouding of the lens, special glasses can help, and blindness is treated surgically. Consider the issues of cataract prevention, nutrition and treatment of lens pathology.

Features of age vision

Decreased elasticity and transparency of the lens occurs naturally. With the initial form of lens pathology, the quality of vision decreases, but few people are worried about this. However, it is this reason that is the reason for a visit to an ophthalmologist, because the timely detection of pathology can help preserve vision. A feature of age-related cataract is that the disease can develop over the years.

With an increase in pathology, a person can only distinguish the outlines of large objects; in a severe stage, the patient distinguishes only the presence or absence of a light source. The patient can accurately point to the light source (lamp, window), but sees nothing else.

Age-related cataract affects both eyes at once, but to varying degrees. That is, the patient sees better with one eye than with the other. Doctors believe that changes in the lens are associated with metabolic disorders and a lack of vitamin C. With age, natural changes occur in the work of the sex glands and the related work of the thyroid gland, which is responsible for the human hormonal background.

Unfortunately, doctors have not established the exact causes of senile pathology of the lens. However, some adverse factors can provoke or accelerate the development of cataracts. These include:

• smoking and alcohol;
• diabetes disease;
• excessive consumption of heavy food;
• the negative impact of ultraviolet radiation;
• various kinds of head or eye injuries;
• previous surgery;
• hormonal disorders.

Sometimes cataracts are inherited. That is, if someone in the family had this disease, it can also appear in relatives. Some doctors believe that the provoking factor is malnutrition and lack of important trace elements in the body.

Age-related cataract: diagnosis and symptoms

When to sound the alarm, how to determine the onset of pathology? The insidiousness of the clouding of the lens is that the patient does not notice any symptoms. Age-related cataract matures for a long time from the inside, not designating itself in any way. Most people begin to notice that objects lose their clarity of form, and vision becomes “blurred”. The patient begins to distinguish between artificial and daylight because the reaction of the eyes becomes different. This is expressed in the fact that in bright sunlight and with insufficient artificial lighting, visual acuity drops sharply.

Another characteristic feature of the manifestation of cataracts is "blinding" by bright artificial light - a person cannot see normally in intense light. The color discrimination of objects is gradually lost - they become faded. The patient can hardly read newspapers, watch television programs and work at a computer. Sometimes objects begin to see double, and when looking at street lights or car headlights, a rainbow sphere appears around them.

Diagnosis of the pathology of the lens is carried out using a visual examination, patient complaints and hardware examination. Depending on the symptoms, senile cataract is divided into several stages.

The stages of senile cataract are as follows:

1. mature;
2. overripe.

Initial stage - pre-cataract

The initial stage is characterized by the appearance of spots or "flies" before the eyes. There is hydration of the lens due to the loss of elasticity of the vessels of the orbit. Decreased vision at this stage is observed if the pathology has reached the pupil. A characteristic feature is myopia, far vision is impaired. The danger lies in the fact that the patient seems to have improved vision, since there is no need for plus glasses. In fact, this is a manifestation of the pathology of the lens.

This stage can last for a long time without visible changes, however, after a complication begins. Treatment consists of prescribing vitamin eye drops. If this pathology is not treated, the disease will continue its development and move to the next stage. Diagnosis consists in the examination of vision using biomicroscopy.

Immature cataract

This form is characterized by an increase in the lens and a further loss of elasticity. A cloudy gray-white color reaches the pupil and completely closes it. At this stage of the development of the pathology, the patient hardly distinguishes objects even near him. The degree of maturity of a cataract is determined by the level of vision loss: the worse the patient sees, the deeper layers the disease has affected. An enlarged lens can provoke a new pathology - phacomorphic glaucoma.

mature cataract

The mature form is already noticeable to others, as the pupil changes color and becomes cloudy due to dehydration of the lens. At this stage, the lens decreases in volume, loses mass. Cataract does not mature immediately, it takes about two years. In the mature form, the patient loses objective vision, that is, he does not see anything in front of him at all.

overripe cataract

This is the last stage of the pathology, in which the lens is completely dehydrated: it shrinks, thickens, becomes overgrown with cholesterol plaques and lime. Sometimes there is a so-called "milk cataract", which is characterized by the presence of a liquid lens mass of milky color. With an overripe form, an operation is necessary to transplant the lens or implant artificial implants.

Cataract symptoms can also be diagnosed in other complex ophthalmic diseases that only a specialist can determine. Elderly people need to undergo a preventive examination by an ophthalmologist every two years in order to identify pathology at the formation stage.

Hardware diagnostics

Ophthalmological examination consists in hardware diagnostics:

• keratotomy;
• ultrasound biometrics;
• gonioscopy;
• optical tomography;
• electrophysiological examination.

The examination is prescribed based on the characteristics of the development of pathological changes in the lens and the choice of anesthesia during surgery. Before the appointment of surgery, the patient is examined. On hand should be positive conclusions of the following specialists:

• a document from the therapist about the absence of contraindications to the operation;
• chest X-ray;
• permission from a dentist, neuropathologist and ENT doctor;
• conjunctival culture tests;
• blood clotting tests and general tests;
• check for toxoplasma;
• urine analysis;
• Wasserman reaction.

Immediately before the operation, the eyelashes and eyebrows are completely trimmed. In the morning the patient does not eat breakfast and does a cleansing enema.

Therapy

Cataract treatment in the elderly is carried out when the patient cannot take care of himself and clearly distinguish people's faces. The ophthalmologist first selects special glasses with reinforced lenses, prescribes drops and medications. However, these measures only slow down the development of lens pathology, but do not eliminate the problem. Often, older people are prescribed an operation to correct the lens - ultrasonic phacoemulsification.

This is a minimally invasive modern method of surgery. The operation consists in removing the clouded lens and replacing it with an implant. This operation is painless under anesthesia, the incision on the eyeball is small. The process of lens replacement lasts no more than 30 minutes. At the same time, the clouded lens is broken with sound waves, the particles are removed and the implant is implanted. After this correction, vision is restored, the rehabilitation period passes without complications. Incisions on the eyeball heal naturally.

Important! After eye surgery, it is forbidden to use cosmetics, wash your eyes with soap, rub your hands and engage in heavy physical labor.

Benefits of ultrasonic phacoemulsification:

• high performance indicators;
• fast recovery period;
• no injury to the tissues of the eyeball;
• the operation takes place without suturing;
• there is no risk of induced astigmatism.

Instead of suturing, sealing is carried out, subsequently the tissues of the eyeball heal on their own. The incision on the eyeball does not exceed 3 mm. To protect the cornea, the iris of the eye, dispersive viscoelastics are used, which are applied before the incision.

artificial lens

An artificial eye lens is made from modern hydrophilic acrylic compositions. Implantation is carried out in a capsular bag, which is a barrier for contact between acrylic and eye tissues. In some difficult situations, the implantation of an artificial lens is performed in other places of the eyeball - behind the iris, in the pupil itself, etc. The choice of localization depends on the characteristics of the development of the patient's pathology.

Sometimes it may appear if the implantation was not successful. In this case, the patient undergoes laser correction. Severe complications after lens surgery include eye bleeding, capsule rupture, corneal deformity, and infection. However, this is not the rule, but the exception. In most cases, everything goes without complications, and the patient regains his lost vision.

Prevention

Is it possible to prevent the pathology of lens opacity, and what needs to be done for this? The lens tissues are devoid of nerves and blood vessels, so inflammatory processes do not appear there. Instead, there are dystrophic changes caused by the failure of metabolic processes in the body. Violation of metabolic processes causes aging of the body as a whole, and it is impossible to stop it. However, the eye can be protected, and for this it is necessary to limit contact with bright sunlight: it is dangerous ultraviolet radiation that has a detrimental effect on our eyes.

Solar radiation provokes a chain of reactions that form free radicals in the body - dangerous toxic compounds. The next risk factor is inadequate dietary nutrition. The lack of useful trace elements has a detrimental effect on metabolic processes in the body and reduces immune defense.

So, the prevention of cataracts in old age is:

• complete nutrition;
• protection of the eyes from sunlight;
• strengthening the immune defense;
• quitting alcohol/tobacco;
• reduction in active physical activity.

In bright sunlight, it is necessary to wear light-protective glasses so that the lens does not suffer from active ultraviolet radiation. You should also periodically unload your eyes if you read a lot or work at a computer. Make sure your eyes don't get tired. Fatty diets are risk factors for cataracts - change your eating habits. Arrange fasting days, cleanse the body of toxins, monitor the tone of blood vessels.

Nutrition for cataracts

Nutrition for cataracts in old age is of fundamental importance, and for prevention too. Give preference to the following products:

• green tea;
• seafood;
• buckwheat flour;
• germinated grains of wheat;
• different combination of vegetable juices.

Mulberry and blueberry berries in any quantities are an excellent means of prevention. You need to eat a glass a day or more.

Honey drops are an excellent means of preventing ophthalmic diseases. Honey is diluted with safe eye drops or boiled water (1:1). Preventive course - 21 days of instillation.

Another means of prevention is the egg method. A homemade egg is boiled, cut in half and the yolk is taken out. Then the halves of the egg are filled with granulated sugar, combined and sent to the oven: until the sugar melts. The syrup is poured into a sterile container and instilled in their eyes (diluted with water). The essence of the method is to wash the eyeball from calcium deposits and mucus. The method is folk, so it is better to consult an ophthalmologist about the application.

Herbal infusions are also preventive measures. A decoction of the marya root is taken orally. To do this, dry raw materials are steamed for 4 hours with boiling water, and then boiled for 5-6 minutes. Drink like tea, but before meals.

Outcome

Prevention of premature aging of the body is the key to the health of the lens of the eye. People after 50 years (sometimes even earlier) need to think about protection from active processes of cell decay, cleansing from toxins, reconsider their diet and lifestyle. If a person was engaged in sedentary work, it is necessary to add physical activity. If a person was engaged in heavy physical work, it is necessary to reduce the load.

An old Russian steam room has an excellent firming and healing effect. Our ancestors enjoyed powerful health thanks to regular bathing and a healthy, organic diet.

Cataract is the most common eye disease among adults and the elderly. Causing a significant decrease in vision, the disease complicates professional activities, limits a person’s self-care, and can even cause irreversible blindness. Timely access to an ophthalmologist and high-quality cataract treatment allow a person to restore vision and return to a normal lifestyle.

What is a cataract?

A cataract is a clouding of the eye lens, which is a natural lens that transmits and refracts light rays.

The lens is located inside the eyeball between the iris and the vitreous body. When a person is young, his lens is transparent, elastic, able to change its shape, instantly focusing on an object. Due to this property, the eye sees equally well at close and far distances.

With a cataract, the transparency of the eye is lost. Due to partial or complete clouding of the lens, only a small part of the light rays enter the eye, as a result of which vision is reduced and the person sees fuzzy and blurry. Over time, the disease progresses: clouding increases and vision decreases even more. If a cataract is left untreated, a person can become completely blind.

Cataracts can start at any age. The disease can be congenital, traumatic, radiation, caused by general diseases of the body. However, the most common is the so-called age-related (senile) cataract, and this disease develops in people after 50 years.

Worldwide, about 17 million people suffer from cataracts; Most of these are people over the age of 60. According to the World Health Organization, by the age of 70-80, about 260 men and 460 women out of 1000 people suffer from this disease, and after 80 years, almost everyone has a cataract. 20 million people in the world have lost their sight due to cataracts.

Reasons for the appearance

Normally, the lens is completely transparent. It consists of water, proteins and minerals. The lens is nourished by intraocular moisture, which, being produced in the eye, constantly bathes it. But with age, metabolic products begin to accumulate in this fluid, which have a toxic effect on the lens. This entails a violation of its nutrition, as a result of which the lens loses its former transparency. The nature of opacities is different, so the typical variety of cataracts is quite extensive.

In addition to age, the formation of lens opacities is also affected by some eye diseases, as well as pathologies of other organs. These types of cataracts are called complicated. They develop with glaucoma, myopia, diseases of the choroid, retinal detachments and pigmentary dystrophies.

Read also about the symptoms of glaucoma in the eye.

The cause of clouding of the lens can be such common diseases as:

• diabetes;
• bronchial asthma;
• diseases of the joints and blood;
• some skin diseases (eczema, psoriasis).

No one is immune from cataracts.

The structure of the eye

Many external factors influence the formation and development of the disease:

• malnutrition;
• lack of vitamins (especially calcium and vitamin C);
• harmful working conditions;
• ultraviolet rays and radiation;
• unfavorable ecological situation;
• smoking.

Usually, cataracts begin in one eye (usually the left), and then develop in both eyes with varying intensity.

Read more about the causes of visual impairment.

Symptoms

The name of the disease was given by the ancient Greeks. The word kataraktes means "waterfall".

With a cataract, a person sees "as if in a fog", as if through a misted glass or through "falling water". As the cataract develops, the “nebula” of vision increases, the person feels the veil before his eyes more and more sharply, the flashing of stripes, spots and strokes. Photophobia appears, images often double, there are difficulties in reading, writing, sewing, working with small details. At the overripe stage of the cataract, the color of the pupil becomes white.

age cataract – a progressive disease that undergoes several stages of development:

1. Initial cataract(clouding of the lens occurs on the periphery, that is, outside the optical zone). The patient usually does not show any complaints, the presence of the disease can be determined by the ophthalmologist during the examination. Doctors often discover it by accident during a medical examination.
2. Immature cataract(turbidity moves into the central optical zone). Visual acuity is markedly reduced. The patient complains of a thick fog before his eyes. The disease leads to difficulties in self-care and performance of professional duties. The patient needs surgical treatment.
3. mature cataract(opacities occupy the entire area of ​​the lens). There is a decrease in vision to the level of light perception. The patient sees only the contours of objects located at arm's length.
4. overripe cataract(the substance of the lens liquefies, and it acquires a uniform milky white shade). The patient can determine the presence of a bright window in the room or the light from a flashlight aimed at the eye. An overripe cataract can cause numerous complications. Especially dangerous is the development of secondary glaucoma due to compression of the surrounding tissues of the eye by an enlarged clouded lens. The ligaments holding the lens are also involved in the dystrophic process (an example is). They can rupture, causing the lens to dislocate into the vitreous. The proteins of the overripe lens are perceived by the tissues of the eye as foreign, and this can cause the development of iridocyclitis.

Read more about eye examination and selection of glasses.

Removal of cataracts in the elderly

The manifestations of cataracts are varied, but most often they relate to visual impairment. Like any other disease, it is better to diagnose a cataract in its early stages in order to immediately begin treatment.

To learn about the treatment of iridocyclitis, go to.

Treatment Methods

medical

Not many are aware of the possibility. At the initial stage of cataract development, doctors recommend using eye drops:

• Quinax;
• Vita-Yodurol;
• Taufon;
• Oftan-Katachrom.

These drugs prevent the progression of opacities, but are not able to resolve existing ones. They can also be used for . It should be remembered: drugs and the method of their use are prescribed only by an ophthalmologist.

Healthy and sick eye

Surgical

The main method of getting rid of cataracts – surgical . This is called phacoemulsification with implantation of an artificial posterior chamber intraocular lens. Those. produce . This operation is carried out in 99% of cases of disease of patients. The most favorable outcome of surgical treatment can be observed in patients with immature cataracts.

Read about the surgical treatment of strabismus in children.

The phacoemulsification method has been used in Russia for about 20 years.

The operation is performed under local anesthesia. The course of the operation is as follows:

1. An ultrasonic tip 2.2 m long is introduced into the eye through a corneal incision, which destroys the cloudy lens.
2. An artificial flexible lens is implanted into the lens capsule.

The operation usually takes no more than 20 minutes. Vision is restored in the first day to the preoperative level. During the recovery period, which is about 4 weeks, the patient needs to inject drops with an anti-inflammatory effect into the eyes. After a month, you can return to your usual way of life.

If a patient has a mature or overripe cataract, complicated by weakness of the ligaments that support the lens, an intra- or extracapsular cataract extraction is performed. The essence of the operation is to remove the entire lens. Instead, a rigid lens is implanted, which is sutured to the iris or attached to the lens capsule. In this case, a continuous suture is required, which can only be removed after 4–6 months. In the first months after surgery, the patient's vision is poor due to postoperative reverse astigmatism. But after the removal of the suture, the level of vision becomes the same as the patient had before the formation of the cataract. The rehabilitation period is dangerous due to the divergence of the postoperative wound.

Possible Complications

After removing the cloudy lens, the human eye loses a very important optical detail - the lens. The refractive properties of the vitreous body, cornea and moisture of the anterior chamber are not enough for good vision. The operated eye needs contact lenses or an artificial lens. You can read about.

How a sick person sees

The most optimal way to treat cataracts is considered. However, it is not always possible to apply it. The condition of the patient's eye tissues or blood vessels, as well as some of his diseases (frequent exacerbations of the joints, recurrent inflammation of the eyes) do not allow the implantation of an artificial lens, since they will minimize the results of the operation.

At the advanced stage of cataract (mature and overripe), the swollen lens occupies most of the anterior chamber of the eye, as a result of which it disrupts the outflow of intraocular fluid. As a result, a dangerous complication of cataracts, secondary glaucoma, can occur. If urgent surgery is not performed, vision may be irretrievably lost.

Do not delay cataract treatment.

Prevention

The main way to prevent cataracts is to timely visit an ophthalmologist. People over the age of 40 need to undergo an examination in the eye office once a year to detect changes in the lens. Remember: only a specialist can determine the need for medical or surgical treatment. Do not try to cope with the problem on your own in unconventional ways, folk remedies. Lost time is the main cause of irreversible blindness.

Drops that can slow down the process of cataract maturation have already been created and are widely used. Such drops, called vitamin, contain amino acids, enzymes and trace elements.

Their systematic use improves nutrition and metabolic processes in the lens, thereby inhibiting the development of cataracts. However, it is impossible to stop the process of clouding that has begun with the help of drops, you can only slow down the disease. Only an ophthalmologist will help you decide on the choice and dosage of drops, who will give the necessary recommendations, taking into account the nature of the opacities and the reasons that caused the onset of cataract formation.

Briefly about cataract: video

conclusions

So, senile cataract, even at a very advanced age, is successfully treated. It is important not to start the disease to a mature and overripe stage, so that it is not complicated by concomitant inflammation. Well-established surgical technique, a variety of models of artificial lenses, competent anesthesia - all this makes this operation minimally dangerous. Today, such operations are carried out at a high level and give successful results, up to getting rid of the consequences. The main thing is to detect a cataract in time and not delay its treatment.

The best way to avoid illness is to prevent it. Therefore, you should not run some factors preceding that, such as.