Symptoms of Cataracts:

• Blurred or cloudy vision
• Difficulty seeing at night or in low light
• Sensitivity to light and glare (e.g., headlights from cars at night may appear too bright)
• Seeing "halos" around lights
• Fading or yellowing of colors
• Double vision in one eye

Causes and Risk Factors:

• Aging: The most common cause of cataracts. As you get older, the proteins in the lens can break down and form clumps, causing the lens to cloud over time.
• Genetics: Family history of cataracts may increase your risk.
• Eye injury or surgery: An eye injury or previous eye surgery can lead to cataracts.
• Certain medical conditions: Conditions like diabetes can make cataracts more likely.
• Medications: Long-term use of corticosteroid medications can increase the risk.
• Lifestyle factors: Smoking, heavy alcohol use, and excessive exposure to UV rays from the sun can raise the risk.

• Early stages: In the early stages, cataracts can sometimes be managed with stronger prescription glasses or better lighting.
• Surgical removal: If cataracts progress to the point where they significantly affect vision, surgery is the most effective treatment. Cataract surgery involves removing the cloudy lens and replacing it with an artificial intraocular lens (IOL) to restore clear vision. This is a very common and safe procedure.

Cataracts develop slowly and may not cause significant symptoms initially. Regular eye exams are important for detecting cataracts early and monitoring their progress. If they start interfering with daily activities, surgery may be recommended.

Cataract surgery is primarily performed to remove the clouded lens of the eye and replace it with an artificial lens (intraocular lens or IOL). There are several surgical techniques and modalities used to perform cataract surgery, depending on the patient's condition and the surgeon's approach. The main modalities include:

1. Phacoemulsification (Phaco Surgery)

• Most common and advanced method: A small incision is made in the cornea, and an ultrasound device is used to break up (emulsify) the cloudy lens. The pieces are then suctioned out.
• Benefits: Less invasive, quicker recovery, smaller incision, No stitches.

2. Manual Small Incision Cataract Surgery (MSICS)

• Manual technique: A small incision is made, and the cataract is removed manually with specialized instruments, similar to phacoemulsification but without the use of ultrasound.
• Benefits: Suitable for low-resource settings, faster recovery compared to larger incisions.

3. Extracapsular Cataract Extraction (ECCE)

• Traditional method: Involves making a larger incision to remove the cataract in one piece, with the lens capsule left intact.
• Benefits: Used in cases where phacoemulsification isn't feasible, such as very dense cataracts.

4. Combined Cataract and Glaucoma Surgery

• When both conditions exist: For patients who also have glaucoma, cataract surgery may be combined with a glaucoma procedure (like trabeculectomy or a drainage device).
• Benefits: Treats both issues in one procedure.

5. Clear Lens Extraction (CLE)

• For refractive errors: In some cases, cataract surgery is performed before a cataract forms to correct refractive errors (like myopia or hyperopia). It involves removing the clear natural lens and replacing it with an IOL.
• Benefits: Reduces the need for glasses or contacts for patients with high refractive errors.

Types of IOLs (Intraocular Lenses)

• Monofocal IOL: Corrects vision at one distance (near, intermediate, or far).
• Multifocal IOL: Offers multiple focal points, reducing the need for glasses at various distances.
• Toric IOL: Used for astigmatism correction.

The choice of technique and IOL depends on factors like the cataract's severity, the patient’s eye health, and personal preferences regarding vision after surgery.