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CATARACTS; SYMPTOMS, CAUSES, AND TREATMENT

The ophthalmological diagnosis of “nuclear cataract” is expressed in the opacity of the lens of the eye, concentrated in its core. At first, a small haze seems to divide the core into two halves, later it forms a homogeneous circle filled with thick “fog”. The disease is often age-related. A nuclear cataract of the eyes develops in elderly patients after 50 years, gradually reducing a person’s ability to see far-away objects. Let’s focus in more detail on the features of the disease, its causes, symptoms, and forms of treatment.

Features of the development of nuclear cataract

Throughout life, changes occur in the human eyeball. The lens fibers grow, thanks to the epithelial cells, the capsule of the natural lens is lined from the inside. At first, these fibers have a transparent texture, and after 40 years they become denser, acquiring a yellowish tone.

The changes do not end there, the core becomes even denser, deforms the refractive force. Its color turns yellow. Over time, the cloudy spot affects the surface layers, becoming thick and opaque. From this moment on, the nuclear cataract of the eyes in the elderly ceases to be nuclear, since the nucleus becomes difficult to see even under a microscope.

Stages of the disease

The effectiveness of medical procedures depends on the professionalism of the doctor and the stage at which the disease is diagnosed. In ophthalmological practice, there are 4 stages of the development of disorders;

Initial changes. Vacuoles appear in the core of the lens. These are specific cavities filled with liquid. They create inconveniences for a person, reduce visual acuity, although in some cases it remains unchanged.

Immature senile nuclear cataract ― what it is is best told by a doctor. If we explain it in simple language― this is the proliferation of vacuoles, as a result of which their area increases. They begin to close the pupil, causing the inevitable deterioration of invisibility.

A mature cataract is expressed in the complete closure of the lens, which under the action of areas of opacity acquires a whitish hue. At this stage, the sensitivity of the pupil to light is still preserved.

The overripe form suggests that the liquid of vacuoles thickens with the swelling of nearby tissues. Swelling cataracts and secondary glaucoma develop. Surgical intervention by a doctor will help to stabilize the situation.

Causes of occurrence

The following prerequisites can provoke destructive changes in the structure of the lens:

Age-related changes, due to which the blood supply to tissues worsens, the process of their saturation with useful substances, macro-and microelements slows down.
Peeling of dead cell structures accumulated inside the lens and increasing its density. In everyday life, these processes are called “molting” of the lens.
Protein changes and imbalance of the biochemical composition of the fluid inside the eyeball.
Deformation of the membrane is under the influence of toxins and free radicals.

The cause of the development of nuclear eye cataracts in old age can be systemic pathologies, hormonal imbalance, disorders in the structure of connective tissue, the consequences of complex infectious processes, and radiation exposure. Concomitant eye diseases (glaucoma, retinal detachment), smoking, and alcoholism significantly worsen the situation. A negative role is played by the use of hormonal drugs and unsuccessful ophthalmological surgery.

Symptoms

The most noticeable sign of a nuclear cataract is myopization or a change in refraction towards myopia. Patients who previously saw well in the distance, including due to age-related changes (farsightedness), suddenly begin to see up close everything that they had not perceived before. These changes entail the use of weaker reading glasses, and in some cases, patients refuse glasses altogether.

With myopia, a false increase in myopia is manifested. Such patients change glasses for stronger optics. And after 4-5 months, these optics become uncomfortable and insufficient for them. A nuclear eye cataract is accompanied by the following signs:

the contours of objects at a long distance become indistinct;
the perception of the color background is distorted, the brightness of the tones disappears, all shades become grayish, acquire a “dirty” coating;
the ability to contrast perception of colors and objects disappears;
with unilateral changes (nuclear cataract develops in one eye), discomfort appears when looking at surrounding objects and faces;
there is a bifurcation of the contours, and when the patient closes the eye, this effect disappears;
when looking at the light source (lantern, lamp, TV screen in the dark, car headlight), halos appear, it becomes impossible to see in the dark and twilight.

A nuclear cataract develops slowly. In some cases, it can progress up to 8 years or more. Every year, different symptoms may appear that indicate a worsening of the situation: pain in the eyes, discomfort from overexertion of vision, fear of light, excessive eye sensitivity.

The development of the disease is indicated by a change in the color of the pupil. At the same time, the core with a low density of the structure (stage 1) acquires a gray hue. At stage 2, yellowness appears. At the 3rd stage, an amber shade appears. With the maximum increase in density, the core becomes almost black. The inelastic lens is easily felt when pressing with fingers on the closed eyelid. Drug therapy is powerless in this situation. The only way out is a surgical method of eye restoration.

Nuclear cataract - treatment options

In an ophthalmological clinic, doctors can remove cataracts using suture technology and a seamless method. For the selection of equipment, it is necessary to visit a doctor, undergo an examination, establish the stage of development of the disease. Immature nuclear cataract involves treatment without suturing, as well as the initial form of changes. Surgical intervention of this type is referred to as low-traumatic methods of correction, carried out on an outpatient basis without placing the patient in the clinic. The operation allows you to restore visual acuity. The full recovery period is no more than a month.

In surgical practice, the method of laser extraction (LEK) of nuclear cataracts is used. The treatment is performed using a precisely directed beam of high energy power. The use of this technique is permissible in all forms of cataract maturation, as well as at different levels of core density. However, this method is rarely used in Russian practice.

Phacoemulsification (FEC) technology has been widely used. The method is effective until the disease has passed to the advanced stage. In this case, phacoemulsification cannot be used, because the high-density core is immune to ultrasound energy. Its fragmentation is complicated, and the doctor is forced to use the incision method to extract the natural lens and replace it with an intraocular element (IOL). Having resorted to this technique, at the end of the procedure, the surgeon applies stitches.

With a high density of nuclear cataracts in ophthalmic surgery, intra- or extracapsular extraction techniques are used. The specialist manually removes the clouded lens. The technology is imperfect. It involves a deep impact on the eyeball, retrobulbar anesthesia, and a long period of rehabilitation. The quality of vision after such operations is worse than when using seamless techniques. This is due to postoperative astigmatism or distortion of the upper layer of the cornea caused by suturing.

Remember that the faster the treatment is completed, the better the result and the shorter the rehabilitation period.