Primary cataract: how it manifests itself and is treated. Treatment of the initial stage of cataract: what to do and how to stop the development Principles of conservative therapy

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A cataract is a pathological process that affects the lens or its capsule and causes their irreversible clouding, as a result of which vision weakens. If cataracts are not treated on time, visual impairment will progress, and a person may become completely blind. Knowing what a cataract is, the cause, symptoms, treatment and methods of its prevention, you can avoid serious complications and severe consequences of the disease.

Mechanism of Education

The human eye sees thanks to the lens, which resembles a convex lens with a thickening in the middle and thin edges. It is located behind the iris behind the pupil. Small ligaments hold the lens in place.

The lens consists of 3 layers. The first layer, or capsule, is a transparent membrane. Then comes the second, softer layer - the bark. The third layer is called the core. This is the hard inner layer of the lens.

Light enters the lens by passing through the iris and pupil. The function of the lens is to focus light. It passes light through itself, refracting it, and transmits the correct display of an external object to the retina. Receiving focused light, the retina produces a clear image.

A healthy eye has a transparent and elastic lens that instantly changes shape and quickly focuses on the desired place. Thanks to this, the eye sees objects located close and far equally clearly.

As a result pathological process that occurs with a cataract, the lens becomes cloudy, the light begins to scatter, and the image on the retina is fuzzy and blurry. When the lens becomes cloudy, little light enters the eye, and vision gradually deteriorates.

Reasons for the development of pathology

The causes of cataract development have not been established with absolute certainty. Cataracts usually show up in old age. However, cases of the disease in young people are periodically recorded.

Doctors know the main causes of cataracts. They are usually divided into 2 groups depending on the root cause: congenital or acquired. Therefore, a distinction is made between congenital and acquired cataracts. In most children, congenital cataracts are diagnosed in the first months of life, in others the disease develops over several years.

Congenital cataract causes:

  • intrauterine infection of the fetus as a result of a disease of infectious etiology transferred by the mother: measles, mumps, chickenpox, rubella, influenza, syphilis, toxoplasmosis;
  • conflict of the Rh factor in the child and mother;
  • inflammatory processes inside the eye;
  • genetic disorders;
  • hereditary diseases;
  • metabolic changes: diabetes, beriberi, hypocalcemia, hypoglycemia, galactosemia;
  • poisoning with toxic substances;
  • exposure;
  • the use of certain medications;
  • intrauterine development disorders.

Important: a cataract, which is congenital, does not always impair vision, however, in the event of visual impairment, it is removed.

The main reason for the appearance of acquired cataracts is a violation of the blood circulation of the eye as a result of aging and wear and tear of the body. With age, the lens receives less and less complete and necessary nutrition due to metabolic disorders that occur in people after 50 years. It begins to lose elasticity and transparency, and eventually becomes cloudy.

However, the changes that occur in the lens due to age are not the only reason that provokes the development of pathology. Doctors name other common causes of cataracts

  • the presence of bad habits: smoking and alcohol abuse;
  • improper and unbalanced diet;
  • heredity: close relatives are diagnosed with cataracts;
  • some medications for a long time (corticosteroids);
  • previous surgical interventions in the eye area or traumatic eye lesions (mechanical or chemical nature, contusion, penetrating injury);
  • existing eye diseases: glaucoma, myopia of the 3rd degree, retinal detachment;
  • endocrine pathologies: metabolic disorders, anemia, diabetes mellitus, beriberi, disruption of work thyroid gland(titanium, muscular dystrophy);
  • Down's disease;
  • related chronic diseases Key words: diabetes mellitus, ulcer pathologies, cholecystitis, hepatitis, arterial hypertension;
  • prolonged exposure to ultraviolet light, ionizing radiation, insolation;
  • toxic poisoning with naphthalene, mercury, ergot.

Important: many people think that cataracts can form due to reading books or watching TV often, but these reasons do not cause this disease.

Types and degrees of development of the disease

Cataracts can affect one eye or both. The most common case of the formation of an ailment is symmetrical on both sides. Less commonly, or as a result of damage (trauma) to the eye, a cataract forms in one of the eyes. A cataract can affect the lens completely, or any part of it (layer).

Localization of pathological opacification makes it possible to distinguish the following types of cataracts:

  • Nuclear, arising in the central part of the lens - in the nucleus.
  • Cortical, formed in the outer layer of the lens in the form of wedge-shaped inclusions or whitish stripes.
  • Capsular, the formation of which occurs under the lens capsule.
  • Polar, affecting the peripheral layers of the posterior and anterior poles of the lens.
  • Zonular (layered), expressed in the alternation of the affected tissue and healthy.
  • Filmy, formed due to the fusion of the posterior and anterior lens capsules.
  • Complete, as a result of which the entire tissue of the lens is affected.

This ophthalmic disease develops slowly, progressing with age. However, some types of cataracts develop rapidly and can lead to vision loss in a very short period of time.

Depending on the stage of development of the disease (maturation), cataracts are distinguished:

  • Initial, characterized by clouding of the lens around the periphery. The lesion does not reach the optical zone.
  • Immature, during which turbidity occurs in the center of the optical zone of the lens. At this stage, there is a significant decrease in visual acuity.
  • Mature, in which the entire area of ​​the lens is clouded. Visual impairment progresses, object vision may be lost. At the stage of mature cataract, the patient is able to recognize only shadow and light.
  • Overripe - the final stage, accompanied by the complete destruction of the fibers of the lens. Characteristic features the last stage is the milky-white color of the lens and its uniform consistency. An overripe cataract is extremely dangerous for the development of serious complications in the form of a rupture of the capsule and the ingress of its contents into the eye cavity.

Important: cataracts are treated most effectively in the initial stages of the disease. Therefore, it is necessary to know the first signs of the disease in order to prevent its transition into a chronic form.

Symptoms of the disease

Symptoms of cataracts appear depending on the root cause of the development of the disease, the location of the lesion, the form of the course and the stage. However, each patient suffering from cataract notices a gradual deterioration of vision with varying degrees of progression. Many of them observe fog or a veil before their eyes, complain about visible black dots.

The most common symptoms of the disease are:

  • doubling of objects;
  • observation of halos around objects when looking at a light source;
  • the appearance of myopia;
  • color vision deteriorates;
  • fear of light;
  • dizziness;
  • visual discomfort;
  • increased visual impairment at night, when driving a car, reading books, writing or working with small objects.

As the cataract develops, the clinical picture continues to increase:

  • vision deteriorates;
  • the ability to read is lost;
  • not recognizing familiar objects and people;
  • the ability to distinguish between light and shadow is lost.

If the symptoms of the disease are very pronounced, professional and social maladaptation of the patient may occur, and if left untreated, complete blindness and a decrease in the quality of life.

Delay in the treatment of the disease can lead to severe complications:

  • Amaurosis - complete blindness.
  • Dislocation of the lens.
  • Phacolic iridocyclitis.
  • Phacogenic glaucoma.
  • Obscurative amblyopia.

How to prevent terrible complications of cataract? Timely diagnosis of the disease and adequate treatment under the strict supervision of the attending doctor are necessary. Should apply for medical care at the first sign of cataract.

Preventive measures to prevent cataracts

Prevention of cataracts can significantly reduce the risk of developing the disease, especially in people over 65 years of age. To prevent the occurrence of the disease, the following rules must be observed:

  • Regular examination by an ophthalmologist (at least 2 times a year).
  • Mandatory eye protection with sunglasses that block the negative effects of ultraviolet light on the lens.
  • Inclusion in the diet of foods containing antioxidants, vegetables, fruits.
  • Periodic monitoring of blood sugar;
  • In the case of diabetes - timely treatment of pathology;
  • Use of safety equipment in work with toxic substances;
  • Maintain hand hygiene to prevent eye infections.
  • Quit smoking and alcohol.
  • Maintain moderate physical activity.
  • Application vitamin complexes and drops prescribed by the attending doctor.

In the treatment of cataracts located on early stage, the prognosis of doctors is often positive. Half the success in curing this serious pathology is early diagnosis. Therefore, it is extremely important to know what a cataract is, the causes and symptoms, and methods of treating the disease. People over the age of 65 should be especially careful about their health.

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- pathology of the light-refracting structure of the eye - the lens, characterized by its clouding and loss of natural transparency. Cataract is manifested by "blurred" vision, deterioration of night vision, weakening of color perception, sensitivity to bright light, diplopia. Ophthalmological examination for cataracts includes visometry, perimetry, ophthalmoscopy, biomicroscopy, tonometry, refractometry, ophthalmometry, ultrasound scanning of the eye, electrophysiological studies. To slow the progression of cataracts, conservative therapy is performed; cataract removal is performed by microsurgical intervention with the replacement of the lens with an intraocular lens.

General information

Cataract (from the Greek. katarrhaktes - waterfall) - clouding or discoloration of part or all of the lens, leading to a decrease in its light transmission and a decrease in visual acuity. According to WHO, half of the cases of blindness worldwide are due to cataracts. In the age group of 50-60 years, cataracts are detected in 15% of the population, 70-80 years - in 26% -46%, over 80 years - in almost everyone. Among congenital eye diseases, cataract also occupies a leading position. The high prevalence and social consequences of the disease make cataract one of the most urgent problems of modern ophthalmology.

The lens is part of the dioptric (light-transmitting and light-refracting) apparatus of the eye, located posterior to the iris, opposite the pupil. Structurally, the lens is formed by a capsule (bag), capsular epithelium and lens substance. The surfaces of the lens (anterior and posterior) are spherical with different radii of curvature. The lens diameter is 9-10 mm. The lens is an avascular epithelial formation; Nutrients enter it by diffusion from the surrounding intraocular fluid.

According to its optical properties, the lens is a biological biconvex transparent lens, the function of which is to refract the rays entering it and focus them on the retina. The refractive power of the lens is not uniform in thickness and depends on the state of accommodation (at rest - 19.11 diopters; in a state of tension - 33.06 diopters).

Any change in the shape, size, position of the lens leads to significant violations of its functions. Among the anomalies and pathology of the lens, there is aphakia (absence of the lens), microphakia (reduction in size), coloboma (absence of part of the lens and its deformation), lenticonus (protrusion of the surface in the form of a cone), cataract. Cataract formation can occur in any of the layers of the lens.

Causes of cataract

The etiology and mechanisms of cataractogenesis - the development of cataracts are explained from the standpoint of several theories, but none of them gives an exhaustive answer to the question of the causes of the disease.

In ophthalmology, the theory of free radical oxidation is most widely used, which explains the mechanism of cataract formation in terms of the formation of free radicals in the body - unstable organic molecules with an unpaired electron that easily enter into chemical reactions and cause severe oxidative stress. It is believed that lipid peroxidation is the interaction of free radicals with lipids, especially unsaturated ones. fatty acids, leads to the destruction of cell membranes, which causes the development of senile and diabetic cataracts, glaucoma, microcirculation disorders in brain tissues, and hepatitis. The formation of free radicals in the body, in the first place, is promoted by smoking and ultraviolet radiation.

An important role in the mechanism of cataract development is played by age-related decrease in antioxidant protection and deficiency of natural antioxidants (vitamins A, E, glutathione, etc.). In addition, with age, the physicochemical properties of the protein fibers of the lens change, which make up more than 50% in its structure. Disruption of the lens metabolism and the development of opacities may be associated with a change in the composition of the intraocular fluid during recurrent inflammatory diseases eyes (iridocyclitis, chorioretinitis), as well as dysfunction of the ciliary body and iris (Fuchs syndrome), terminal glaucoma, pigmentary degeneration and retinal detachment.

In addition to age-related involution, deep general exhaustion after severe infectious diseases(typhoid, malaria, smallpox, etc.), starvation, anemia, excessive insolation, exposure to radiation, toxic poisoning (mercury, thallium, naphthalene, ergot). Risk factors for the development of cataracts are endocrinopathies (diabetes mellitus, tetany, muscular dystrophy, adiposogenital syndrome), Down's disease, skin diseases (scleroderma, eczema, neurodermatitis, Jacobi's poikiloderma). Complicated cataracts can occur with mechanical and contusion eye injuries, eye burns, eye surgeries, unfavorable heredity for cataracts in the family, high myopia, uveitis.

Congenital cataracts in most cases are caused by toxic effects on the embryo during the period of lens formation. Among the causes of congenital cataracts, there are transferred pregnant infections (flu, rubella, herpes, measles, toxoplasmosis), hypoparathyroidism, taking corticosteroids, etc. Congenital cataracts can occur with hereditary syndromes and be combined with malformations of other organs.

Cataract classification

In ophthalmology, cataracts are divided into two large groups: congenital and acquired. Congenital cataracts are usually limited in area and stationary (do not progress); with acquired cataracts, changes in the lens progress.

Among the acquired cataracts, depending on the etiology, there are senile (senile, age-related - about 70%), complicated (with eye diseases - about 20%), traumatic (with eye injuries), radiation (with damage to the lens by X-ray, radiation, infrared radiation ), toxic (with chemical and medicinal intoxications), cataracts associated with general diseases.

According to the localization of opacification in the lens, there are:

  • anterior polar cataract - located under the capsule in the region of the anterior pole of the lens; turbidity has the appearance of a round spot of whitish and grayish color;
  • posterior polar cataract - located under the capsule of the posterior pole of the lens; similar in color and shape to the anterior polar cataract;
  • spindle-shaped cataract - located along the anteroposterior axis of the lens; has the shape of a spindle, looks like a thin gray ribbon;
  • nuclear cataract - located in the center of the lens;
  • layered (zonular) cataract - located around the nucleus of the lens, while cloudy and transparent layers alternate;
  • cortical (cortical) cataract - located on the outer edge of the lens shell; looks like whitish wedge-shaped inclusions;
  • posterior subcapsular - located under the capsule behind the lens;
  • complete (total) cataract - always bilateral, characterized by clouding of the entire substance and the lens capsule.

Overmature cataract can be complicated by phacogenous (phacolytic) glaucoma associated with clogging of the natural outflow pathways of intraocular fluid by macrophages and protein molecules. In some cases, a rupture of the lens capsule and the release of protein detritus into the eye cavity may occur, which entails the development of phacolytic iridocyclitis.

Cataract maturation can be rapidly progressive, slowly progressive, or moderately progressive. In the first variant, 4-6 years pass from the initial stage to extensive clouding of the lens. Rapidly progressive cataract develops in approximately 12% of cases. Slow maturation of cataract occurs within 10-15 years and occurs in 15% of patients. Moderate progression of cataract in 70% of cases occurs over a period of 6-10 years.

Symptoms of a cataract

The severity of clinical manifestations depends on the stage of cataract. Visual acuity with an initial cataract may not suffer. Early signs of the disease may be double vision of objects (diplopia), flickering of "flies" before the eyes, blurred vision ("as in a fog"), staining of visible objects in a yellowish tint. Patients with cataracts report difficulty in writing, reading, and working with small details.

For the cataract clinic, an increased sensitivity of the eyes to light, worsening of night vision, weakening of color perception, the need to use bright lighting when reading, the appearance of a "halo" when looking at any light sources are typical. Vision with cataracts changes towards myopia, so patients with severe farsightedness sometimes suddenly find that they see perfectly well up close without glasses. The visible image blurs before the eyes, but correct it with glasses or contact lenses does not succeed, despite the change in the level of diopters.

In the stage of immature and especially mature cataracts, visual acuity decreases sharply, object vision is lost, only light perception is preserved. As the cataract matures, the color of the pupil becomes milky white instead of black.

Cataract diagnostics

The detection of cataracts is carried out by an ophthalmologist on the basis of a number of standard and additional examinations.

Routine ophthalmological examination for suspected cataracts includes visometry (checking visual acuity), perimetry (determination of visual fields), color testing, tonometry (measurement of intraocular pressure), biomicroscopy (examination eyeball using a slit lamp), ophthalmoscopy (examination of the fundus). Taken together, a standard ophthalmological examination reveals such signs of cataract as reduced visual acuity, impaired color perception; to investigate the structure of the lens, to assess the localization and magnitude of opacification, to detect the dislocation of the lens, etc. If it is impossible to examine the fundus, with severe opacification of the lens, they resort to the study of entopic phenomena (mechanophosphene and the phenomenon of autoophthalmoscopy), which make it possible to judge the state of the neuroreceptor apparatus of the retina.

Special examination methods for cataracts include refractometry, ophthalmometry, ultrasound scanning of the eye in A- and B-mode, ultrasound biomicroscopy, etc. Additional methods allow the ophthalmologist to calculate the strength of the intraocular lens (artificial lens), determine the optimal operating technique.

To assess the functional state of the retina, optic nerve and the central parts of the visual analyzer in cataracts, electrophysiological studies are carried out: electrooculography (EOG), electroretinography (ERG), registration of visual evoked potentials (VEP).

Cataract treatment

In the initial stages of senile cataract, conservative therapy is used, including instillations of eye drops (azapentacene, pyrenoxine, combined preparations with cytochrome C, taurine, etc.). Such measures do not lead to the resorption of lens opacities, but only slow down the progression of cataracts.

The meaning of the so-called substitution therapy is the introduction of substances, the lack of which leads to the development of cataracts. Therefore, the composition of eye drops includes amino acids, vitamins (riboflavin, a nicotinic acid, ascorbic acid), antioxidants, potassium iodide, ATP and other substances. The drug azapentacene has a different mechanism of action - due to the activation of proteolytic enzymes, it to some extent contributes to the resorption of opaque protein structures of the lens.

Conservative treatment of cataracts is ineffective, so the only way to eliminate the pathology and restore vision is a microsurgical operation - removal of the altered lens and its replacement with an intraocular lens. The possibilities of modern eye microsurgery eliminate the need to wait for the full maturation of the cataract for its removal.

Medical indications for surgical treatment include: swelling cataract, overmature cataract, subluxation or dislocation of the lens, detection of secondary glaucoma, concomitant pathology of the fundus requiring treatment (diabetic retinopathy, retinal detachment, etc.). Additional indications for surgical treatment of cataracts are determined by professional and domestic needs to improve the quality of vision. With bilateral cataracts, the eye with lower visual acuity is operated on first.

In modern cataract surgery, several methods are used to remove the clouded lens: extracapsular and intracapsular cataract extraction, ultrasound and laser phacoemulsification.

The most serious prognosis for visual function is associated with congenital cataract, since in this case, as a rule, there are changes in the neuroreceptor apparatus of the eye. Surgery acquired cataract, in most cases leads to the achievement of acceptable visual acuity, and often - and the restoration of the patient's ability to work.

Prevention of congenital cataracts requires prevention viral diseases during pregnancy, exclusion of radiation exposure. To prevent the development of acquired cataracts, especially at a young age, antioxidant protection of the body, earlier treatment of concomitant general and ophthalmic pathology, prevention of eye injuries, and annual medical examinations by an ophthalmologist are necessary.

The physiology of the visual apparatus provides for the presence in it of a special structure - the lens. This is a kind of optical lens through which light rays pass and are focused on the retina.

Most ophthalmic diseases occur in people over forty years of age. The most common pathology is cataract. The development of this disease is based on complete or partial clouding of the lens. The accumulation of a large amount of lens fibers leads to its dehydration and compaction. This directly affects the visual acuity and quality.

Opacification of the lens can occur on one or both visual organs. A person begins to see a fuzzy picture in front of him. Cataract is chronic illness which will certainly progress.

Pathology can lead to the development of serious complications, up to a complete loss of visual function. To avoid this, attention must be paid to characteristic symptoms. Some signs may indicate that a person is developing an initial OU cataract. At this stage, the disease has not yet had time to spread widely, so it is much easier to treat.

What it is?

The initial stage of a cataract is characterized by hydration, or flooding of the lens. Fluid inside the eye accumulates between the fibers in the cortical layers. This leads to the formation of water gaps. Over time, these vacuoles are supplemented by larger areas of turbidity, which are located in deeper areas.

The optical lens increases in volume. Its refractive abilities change. In patients with presbyopia (senile farsightedness), the illusion of improved vision may be created.

The next stage of the pathological process is the peripheral changes in the lens, as well as the formation of opacities. The refractive properties of the optical lens gradually deteriorate. In the absence of proper treatment, the initial stage of cataract will progress steadily.

IMPORTANT! Primary cataract most often develops in people over 60 years of age.

First, opacities form on the periphery of the lens - outside the optical zone. For a long time, the central part retains its transparency. Most often, cataracts occur in both eyes.

The disease is congenital and acquired. The first variant of the pathology is fixed immediately after the birth of a child or at the age of up to a year. The rate of progression of acquired cataracts largely depends on lifestyle, external factors, as well as individual characteristics of the body.

One of the subtypes of pathology is senile cataract. First, it manifests itself in the form of a slight improvement in vision, after which a sharp deterioration in the quality of vision occurs. The initial stage of lens opacity is amenable to drug therapy, but over time, the patient is still offered surgery.

There are four main degrees of clouding of the lens:

  • Initial . The cataract is just beginning. Vision deteriorates only if the cloudiness extends to the pupil. At this stage, treatment includes the use of eye drops that inhibit the development of the disease.
  • Immature or swelling. The lens increases in size, blocking the pupil. Patients lose the ability to see even those objects that are very close.
  • Mature . Object vision is practically lost. Requires immediate treatment.
  • Overripe. In addition to surgery, it is impossible to stop the development of the disease.

At the initial stage, the turbidity zones capture the periphery and the equatorial region, which goes beyond the optical zone. There is no noticeable decrease in vision at the stage of initial cataract. From time to time, patients tend to attribute the symptoms that arise to fatigue or other existing ophthalmic disorders. It is not easy to detect the disease at this stage. This will require the use of special equipment.

In immature cataracts, they move to the capsule of the optical lens. If at the previous stage, patients do not experience visual discomfort, then the immature form is characterized by a decrease in visual acuity.

With a mature cataract, the entire area around the lens is filled with opacities. The lens becomes cloudy and takes on a gray tint. The quality of vision drops to the level of sensation of light.

An overripe cataract is a stage of complete degeneration and disintegration of the lens fibers. The lens acquires a characteristic milky white tint.

Among all types of cataracts, the senile form is considered the most common. Due to the natural aging of the body, the initial clouding of the lens occurs after forty years. With age, the amount of natural antioxidants decreases, which are simply necessary to fight free radicals - organic molecules, the number of which, due to natural aging, is increasing.

Metabolic processes in the lens are also disturbed. Changes in the composition of the intraocular fluid. The number of amino acids, enzymes decreases, and the number of insoluble proteins also increases.

The senile cataract of both eyes can progress not synchronously. In old age, the symptoms of the disease may not appear for a long time due to the slow development of the pathology.

Incipient cataracts are very easy to miss, so you need to be attentive to all changes in vision.

The reasons

Despite the fact that older people are more susceptible to the disease, initial cataracts can also occur among younger patients. This can be facilitated by working conditions, injuries, poor environmental situation, bad habits, visual fatigue, chronic pathologies, diseases of the spine.

ATTENTION! At risk for the occurrence of the disease are patients with endocrine disorders, as well as those with a hereditary predisposition.

Other reasons can serve as a catalyst for the development of an ophthalmic disorder:

  • the influence of radiation;
  • infectious pathologies: syphilis, tuberculosis, toxoplasmosis (complicated cataract);
  • long-term use of corticosteroids;
  • eye diseases: glaucoma, myopia;
  • avitaminosis;
  • Rh-conflict of mother and child;
  • intrauterine anomalies;
  • intoxication;
  • angiopathy;
  • alcoholism, smoking;
  • skin pathologies;
  • anemia;
  • Down's disease;
  • eye burns.

Symptoms

Each person should be familiar with the initial manifestations of cataracts:

  • the appearance of spots, circles or specks before the eyes;
  • diplopia - doubling of the image;
  • the appearance of a halo around the light source;
  • temporary return of the ability to read without glasses (in elderly patients);
  • deterioration of twilight vision, the appearance of glare and flashes in the dark;
  • photophobia;
  • loss of vision;
  • lack of lighting when reading;
  • fog in the eyes, lack of clear outlines of objects;
  • patients often have to change diopters when ordering glasses or contact lenses.
  • colors become dull.

Clinical symptoms largely depend not only on the stage, but also on the localization of the pathological process. Age-related cataract in most cases begins with the cortical part of the lens and gradually develops towards the center. The closer the lesion advances to the central part, the stronger the symptoms will appear.

Age-related cataracts are characterized by the appearance of such signs:

  • general decrease in visual acuity;
  • increased sensitivity to light;
  • double vision;
  • farsightedness is replaced by myopia;
  • clouding of the picture;
  • deterioration in brightness and clarity of the image;
  • the appearance of halos when looking at the light source;
  • deterioration in the quality of vision poor lighting;
  • the appearance of spots and flies before the eyes;
  • difficulty in working with small parts;
  • pupil color change.

REFERENCE! The first signs of cataract are rarely pronounced, so patients rarely turn to an ophthalmologist at this stage of the disease.

Externally early symptoms pathology cannot be determined. However, upon the appearance pain, burning or irritation should be seen by an ophthalmologist.

With a congenital form, the child has strabismus. He has no reaction to objects. The pupil becomes white.

It is quite difficult to identify the disease on your own, since transparency remains in most of the lens and nothing indicates the development of pathological changes. In general, in each case, the symptoms may manifest themselves in different ways. Some may be disturbed by the appearance of dots before their eyes, while others do not complain about anything.

Diagnostics

Problems with the detection of cataracts usually do not arise. Difficulties are associated with determining the stage, localization, cause of clouding, as well as the choice of treatment tactics.


The diagnosis is made by an ophthalmologist based on the results of the studies (the photo shows a visual acuity test)

Ophthalmic diagnostics includes the following examinations:

  • visometry;
  • perimetry;
  • tonometry;
  • biomicroscopy;
  • refractometry.

It will also require laboratory research. Ophthalmologist prescribes to patients general analysis blood and urine, biochemistry, glucometry.

If a cataract has been identified by a doctor, treatment should begin as soon as possible. Due to the fact that the lens increases in size, the outflow of intraocular fluid is disturbed. This leads to glaucoma. Cataract can cause atrophic changes in the optic nerve.

What to do?

Cataracts can be treated with medications and folk remedies. However, a complete cure can only be hoped for with the help of an operation.

Medical therapy

Conservative therapy of initial cataract includes the use of eye drops saturated with vitamins, as well as drugs, the active ingredient of which is lanosterol. This substance contributes to the dissolution of protein accumulations of the lens.


Leading ophthalmologists agree that it is not necessary to wait for the maturation of cataracts, but to start treatment as soon as possible

The use of medicines is more of a preventive or preparatory measure. Only in extreme cases does it help prevent clouding. Consider a list of the most famous and effective means with initial cataract:

  • Taufon. Drops restore the metabolic processes of the lens and improve regeneration processes. The drug stops the processes of turbidity and additionally protects against the effects of infectious agents;
  • Catarax. The drug affects the reaction of proteins, stopping the degeneration of the lens. Catarax is approved for use during pregnancy and lactation;
  • Quinax. Drops protect the lens from oxidation, improve metabolic processes, and increase its transparency.

ATTENTION! Cataracts cannot be cured with eye drops. Such drugs can only temporarily slow down pathological changes in the lens.

Surgery

by the most best method cataract treatment is phacoemulsification. The clouded substance of the lens is removed, while its capsule is preserved. The procedure is performed under local anesthesia. The patient is instilled eye drops with an anesthetic, after which the surgeon makes microscopic incisions and inserts a probe into the lens.

With the help of ultrasound, the modified lens softens. Turbidities are removed. The washing procedure is carried out using irrigation solutions. An intraocular lens is placed in place of the removed lens. It is an optical system that is equipped with fixing elements. The incision is self-sealing, so no sutures are required.

Phacoemulsification is carried out using the latest equipment. The procedure is carried out within twenty minutes. There is no need for hospitalization. The ability to see returns just a few hours after the operation.

ethnoscience

Often, honey is mentioned among non-traditional recipes for cataracts. The bee product can be used in the form of eye drops. For their preparation, you can use filtered water or caustic buttercup juice. Also, honey can be taken orally in combination with freshly squeezed onion juice.

IMPORTANT! Populists claim that regular consumption of blueberries improves visual acuity.

For cooking medicinal decoction dried sage is required. One teaspoon of raw materials should be poured with two glasses of water. The solution should be boiled for several minutes. Infused and filtered broth is taken in half a glass before meals. The course of admission should be at least a month.

With cataracts, populists recommend preparing a compress. A teaspoon of honey is poured into a glass of water and put on a large fire. After the solution boils, it still needs to be boiled for five minutes. The cooled mixture is spread on gauze and applied to closed eyelids for five minutes. This procedure is best done before bedtime.

Summarizing

An initial cataract is the first phase of clouding of the lens. At this stage, the disease is easiest to treat. Patients often do not pay attention to the symptoms of the initial cataract, attributing them to fatigue. The only treatment is surgery. Drugs are not able to cure the disease, they can only stop the progression of turbidity for a while.

Cataract is the most common ophthalmic disease. This is a pathology of the eye lens, during the development of which, its clouding is observed. To understand its mechanism, it is necessary to know that the lens of the eye is a biconvex lens that is located inside the eye directly behind the pupil.

It provides adjustment of vision to different distances, which is called focusing or accommodation in accordance with medical terminology. It is thanks to the lens that a person can see equally well, both near and far.

Cataract classification - operation

With age, or under the influence of any adverse external or internal factors, opacities in the lens may be observed. It is worth noting that cataract in most cases is an age-related disease and cataract surgery is often required.

As a rule, it develops in older people from 55 years of age. Moreover, it is diagnosed equally often in both men and women. But due to the fact that the life expectancy of women is longer, they often turn to specialists about this disease.

Currently, two types of cataracts are classified - age-related or primary and complicated, which develops in the presence of other internal diseases, such as diabetes mellitus, rheumatic pathologies, or traumatic eye injuries.

Therefore, this disease develops individually, and it is currently not possible to identify any risk factors for the occurrence of primary pathology. In the case of complicated cataracts, the main risk factor is diabetes, which can be a trigger for the development of lens opacity.

No genetic predisposition to this disease has been identified. It is worth noting that there is a congenital cataract, which occurs due to intrauterine infections of the fetus on different terms pregnancies affecting the organs of vision. In the case of traumatic cataracts, eye bruises or penetrating wounds can be its causes. The lens remains transparent only if its capsule is intact. When it is damaged, it becomes cloudy.

Cataracts can also be caused by some medications, such as antimetabolites used in the treatment of cancer. It can also occur during radiotherapy, which can cause radiation cataracts that occur when ionizing radiation affects the structure of the lens of the eye, resulting in its structural changes.


Cataract treatment

It is worth noting that at present ophthalmologists are moving away from the classical cataract gradation, which implies four stages of this disease - initial, immature, mature and overripe. This classification was relevant in the past, when it was required to determine the possibility of surgical intervention.

Previously, the operation to remove the lens involved an extensive corneoscleral incision of the eyeball and removal of the lens nucleus. If it was not formed and was not dense enough, it was very difficult to remove the soft lens masses, so one had to wait until the cataract matured and became dense.

In this case, it became possible to remove the lens in one block. With the development of technology and the use of phatoemulsification methods, it does not currently matter at what stage of development the cataract is.

It is even easier to operate and treat immature cataracts because the soft lens masses are easier to aspirate and less ultrasound is used to fragment them. It should be noted that a cataract implies only surgical treatment, since all other conservative methods will not lead to the desired result. Prices for cataract treatment can be found in

Cataract It is the most common illness eyes occurring at any age from birth. But most often the disease develops in people after 50 years - this is an age-related (senile) cataract.

A cataract is the clouding of the lens of the eye and the loss of its natural transparency. Pathology is accompanied by various visual disorders - the appearance of sensitivity to bright daylight, deterioration of twilight vision, diplopia, up to a complete loss of the ability to see.

Symptoms of the disease

In a normally seeing person, the lens is a transparent natural lens that can quickly change its shape in order to always focus the light entering the eye on the retina. Then a person sees equally well both far and near. Through the change chemical composition With a cataract, the lens becomes cloudy, thickens and loses its transparency, letting less and less light into the eye. A person sees everything fuzzy and blurry, as if through a veil of water or misted glass. This phenomenon can be considered the main symptom of cataract. In addition to blurred vision, patients' complaints include:

  • deterioration of night vision;
  • distortion of the contours of objects;
  • poor color perception;
  • flashing before the eyes of spots, stripes and strokes;
  • halos around objects that occur in bright light;
  • photophobia;
  • doubling of the objects in question;
  • difficulty reading, sewing;
  • inability to pick up glasses.

For an external observer, the development of a cataract in a patient is accompanied by a change in the color of his pupil from black to gray, grayish white and milky white. Accordingly, his visual acuity also decreases.

The reasons

Medicine calls the following causes of cataract development:

  • the natural aging process of the body;
  • endocrine disorders: beriberi, diabetes mellitus, metabolic disorders;
  • eye injuries (mechanical, chemical, radiation);
  • unfavorable environment;
  • hereditary predisposition;
  • some medicines;
  • poisoning (naphthalene, mercury, dinitrophenol, ergot, thallium);

stages

Untreated age-related cataract goes away 4 stages of development:

  • initial cataract- characterized by peripheral opacity of the lens, which does not significantly affect vision;
  • immature cataract- clouding of the lens captures the central optical zone, visual acuity is markedly reduced;
  • mature cataract- the lens is completely clouded, vision is reduced to the level of light perception;
  • overripe cataract- due to the decay and liquefaction of the fibers, the lens absolutely does not transmit light, complete blindness.

Cataract treatment

Observation in oneself or in relatives of the above symptoms should force a person to consult a doctor to clarify the diagnosis and determine the stage of development of the disease. The diagnosis is made on the basis of the patient's complaints and the observed clinical picture. Modern equipment makes it possible to detect even slight clouding of the lens and start treatment on time.

To date, medicine does not have drugs that can radically cure eye diseases such as farsightedness, myopia, retinal detachment or cataracts. medicines the development of the disease can only be slowed down or, at best, stopped at a level acceptable for normal life. This is possible if the initial stage of the disease is not missed. Modern ophthalmology mainly uses eye drops and ointments containing hormones, vitamins and various animal and animal extracts. plant origin. Their large number indicates that it is not always possible to normalize metabolic processes in the lens with medicines.

Operation

Conservative treatment of cataract does not give the desired effect and can only slow down the progression of the disease. The only way to completely get rid of a cataract is to perform a microsurgical operation.

Currently the most effective method is replacement of a clouded lens with an artificial intraocular lens.

The stage of mature cataract is considered optimal for the operation. At this time, all the fibers of the lens are clouded, and they can be easily separated from the capsule. But the current state of eye microsurgery makes it possible to successfully operate on immature cataracts, if circumstances so require. Vision after surgery is not only restored, but often even better than it was before the cataract disease.

The essence of the operation

In modern ophthalmology, cataract surgery is called ultrasonic phacoemulsification. It is a fragmentation of the lens using ultrasound with its subsequent removal.

There are 2 ways to perform phacoemulsification - longitudinal and torsion. The second method is the most effective and safe, which ensured its wide distribution.

To gain access to the lens, 2, and if necessary, 3 incisions are made on the edge of the cornea. The main one has a length of 1.8 to 2.2 mm, the additional one is 1.2 mm. Through the main incision, the tip of the phacoemulsifier is inserted into the eye cavity and separates the lens into separate fragments, turning them into an emulsion and thus allowing its anterior capsule to be removed. The design of the device allows simultaneously with defragmentation to aspirate the destroyed tissues of the lens, as well as to stabilize the intraocular pressure with an isotonic solution.

Through additional incisions, less dense lens tissues are removed without prior destruction. Then in the capsular bag is installed intraocular lens (artificial lens). Implantation is performed using a special device through the main incision. No suture is required, as the incision is self-sealing once the lens is placed. The operation is performed under local anesthesia and takes 25 to 50 minutes. If necessary, to provide more serious pain relief, anesthetic injections and blockade of the facial nerve are prescribed.

Training

With phacoemulsification, complications rarely occur, so no special measures are required before the operation. Recommended:

  • limit physical and visual stress;
  • categorically exclude alcohol;
  • not later than 5 days before the operation, stop taking anticoagulants.

In preparation for the operation, the ophthalmic surgeon evaluates the density of the lens nucleus to determine the safety of this method.

Contraindications

The low invasiveness of phacoemulsification makes this method suitable for most patients. And even advanced age is not a contraindication. However, the earlier treatment is started, the lower the risk of complications. Absolute contraindications are:

  • dystrophic conditions of the cornea. These phenomena often accompany senile cataract. The operation improves vision very slightly;
  • oncological diseases of the organs of vision. The lack of knowledge of the disease makes the results of the operation unpredictable;
  • decompensated glaucoma - accompanied by hardening of the eyeball, which excludes the use of a laser;
  • subluxation of the lens. The condition prevents the operation due to the inability to determine the degree of displacement of the lens.

Holding phacoemulsification not recommended if the patient has:

  • violations of color perception;
  • narrow pupil with a diameter of less than 6 mm;
  • brown cataract (in patients older than 60 years).

Doctors do not undertake to carry out surgical intervention when a person is diagnosed with a viral or bacterial infection up to a complete cure.

Recovery after surgery

In the absence of complications, the patient can leave the clinic a few hours after the operation. It will take several days for the final restoration of vision.

To prevent the development of complications in the postoperative period, the patient is prescribed antibacterial eye drops and taking non-steroidal anti-inflammatory drugs.

Within a month after the operation, you should limit any physical exercise, avoid exposure to the sun, and also do not use makeup and avoid getting soap, shampoo or other substances into the operated eye. You should be especially careful about your own safety and avoid injury to the head and especially the eye. Within a few days after phacoemulsification, the working capacity of the organ of vision is fully restored, a person can read, watch TV, and no later than a week later, start working.

Prevention

To prevent congenital cataracts in children future mom should monitor their health, carry out the prevention of viral diseases and eliminate the influence of negative environmental factors on their body. Avoid acquired cataracts timely treatment of diseases that contribute to their occurrence will help. It is necessary to strictly observe safety regulations in production, in chemical plants and when working with poisons. Prevention of complicated cataracts consists in the timely treatment of inflammation and eye injuries. Senile cataracts are preventable in a healthy way life, slowing down the aging of the body.

  • It is necessary to exclude bad habits that contribute to the development of cataracts - smoking, drinking alcohol;
  • when in the sun, use protective goggles;
  • always monitor the side effects of medications taken;
  • adequately respond to adverse environmental conditions.

Find out the opinion of experts on cataracts from the video.

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