Cataract

Classification of Cataract

Cataracts may be

• Partial or complete
• Stationary or progressive
• Hard or soft

The main types of age-related cataracts are nuclear sclerosis, cortical, and posterior subcapsular.

1. Nuclear sclerosis:

• It is the most common type of cataract, and involves the central or ‘nuclear’ part of the lens.
• This eventually becomes hard, or ‘sclerotic’, due to condensation on the lens nucleus and the deposition of brown pigment within the lens.
• In its advanced stages it is called a brunescent cataract. In early stages, an increase in sclerosis may cause an increase in refractive index of the lens.
• This causes a myopic shift (lenticular shift) that decreases hyperopia and enables presbyopia patients to see at near without reading glasses.
• This is only temporary and is called second sight.[2]

2. Cortical cataract:

• It is due to the lens cortex (outer layer) becoming opaque. They occur when changes in the fluid contained in the periphery of the lens causes fissuring.
• When these cataracts are viewed through an ophthalmoscope, or other magnification system, the appearance is similar to white spokes of a wheel.
• Symptoms often include problems with glare and light scatter at night.

3. Posterior subcapsular cataracts:

• It is cloudy at the back of the lens adjacent to the capsule (or bag) in which the lens sits. Because light becomes more focused toward the back of the lens, they can cause disproportionate symptoms for their size.

4. An immature cataract:

• It has some transparent protein, but with a mature cataract, all the lens protein is opaque.
• In a hypermature or Morgagnian cataract, the lens proteins have become liquid.

5. Congenital cataract:

• Which may be detected in adulthood, has a different classification and includes lamellar, polar, and sutural cataracts.

Cataracts can be classified by using the lens opacities classification system LOCS III. In this system, cataracts are classified based on type as

• Nuclear
• Cortical
• Posterior[2]

Sign & Symptoms of cataract

• People with nuclear sclerotic or brunescent cataracts often notice a reduction of vision.
• Nuclear cataracts typically cause greater impairment of distance vision than of near vision.
• Those with posterior subcapsular cataracts usually complain of glare as their major symptom.
• Other symptoms include frequent changes of glasses and colored halos due to hydration of lens.
• Congenital cataracts can result in amblyopia if not treated in a timely manner.

Diagnosis of Cataract

To determine whether you have a cataract, your doctor will review your medical history and symptoms, and perform an eye examination. Your doctor may conduct several tests, including:

• Visual acuity test

  A visual acuity test uses an eye chart to measure how well you can read a series of letters. Your eyes are tested one at a time, while the other eye is covered. Using a chart or a viewing device with progressively smaller letters, your eye doctor determines if you have 20/20 vision or if your vision shows signs of impairment.

• Slit-lamp examination

  A slit lamp allows your eye doctor to see the structures at the front of your eye under magnification. The microscope is called a slit lamp because it uses an intense line of light, a slit, to illuminate your cornea, iris, lens, and the space between your iris and cornea. The slit allows your doctor to view these structures in small sections, which makes it easier to detect any tiny abnormalities.

• Retinal exam

  To prepare for a retinal exam, your eye doctor puts drops in your eyes to open your pupils wide (dilate). This makes it easier to examine the back of your eyes (especially retina). Using a slit lamp or a special device called an ophthalmoscope, your eye doctor can examine your lens for signs of a cataract.

• Applanation tonometry

  This test measures fluid pressure in your eye. There are multiple different devices available to do this.[5]

Prevention of Cataract 

Risk factors such as UVB exposure and smoking can addressed.

Although no means of preventing cataracts has been scientifically proven, wearing sunglasses that counteract ultraviolet light may slow their development.

While adequate intake of antioxidants (such as vitamins A, C, and E) has thought to protect against the risk of cataracts, clinical trials have shown no benefit from supplements; though evidence mixed, but weakly positive, for a potential protective effect of the nutrient’s lutein and zeaxanthin.[2]

Homeopathic Treatment of Cataract

Homeopathy treats the person as a whole. It means that homeopathic treatment focuses on the patient as a person, as well as his pathological condition. The homeopathic medicines selected after a full individualizing examination and case-analysis.

which includes

• The medical history of the patient,
• Physical and mental constitution,
• Family history,
• Presenting symptoms,
• Underlying pathology,
• Possible causative factors etc.

A miasmatic tendency (predisposition/susceptibility) also often taken into account for the treatment of chronic conditions.

What Homoeopathic doctors do?

A homeopathy doctor tries to treat more than just the presenting symptoms. The focus is usually on what caused the disease condition? Why ‘this patient’ is sick ‘this way’?.

The disease diagnosis is important but in homeopathy, the cause of disease not just probed to the level of bacteria and viruses. Other factors like mental, emotional and physical stress that could predispose a person to illness also looked for. No a days, even modern medicine also considers a large number of diseases as psychosomatic. The correct homeopathy remedy tries to correct this disease predisposition.

The focus is not on curing the disease but to cure the person who is sick, to restore the health. If a disease pathology not very advanced, homeopathy remedies do give a hope for cure but even in incurable cases, the quality of life can greatly improved with homeopathic medicines.

Medicine:

CALCAREA CARB :

• Very useful medicine for cataract when a person has the feeling of looking through a mist.
• Given when person feel chilliness, having swollen glands, weight problems and get easy tired from exertion

CALCAREA FLOUR :

• Well indicated medicine for cataract when tissues harden or thicken abnormally.
• There is tendency toward hard swollen lymph nodes, joint pains, fibrous growths, or bone-spurs.
• Given when person generally feels worse during weather changes and improved by warmth.

CAUSTICUM : 

• Helpful in developing cataracts when person had problems moving the eyes, as if the muscles around the eyeballs were either stiff or weak.
• Given when symptoms get worse especially after getting cold in the either wind or open air.
• generally, There is feeling of sand in the eyes.
• Given to those persons who may tend to have muscular stiffness in many body areas.
• Recommended when symptoms get generally worse from cold and improved by warmth, also often feel best in damp or rainy weather.

SILICEA : 

• Helpful for cataract on those who developed cataracts after extended periods of eyestrain, or after perspiration of the feet had suppressed.
• There is  tendency toward chill (although they often sweat at night) and often have low resistance to infection.
• Especially suited to those person who has fine hair, weak nails, easy tired, and swollen lymph nodes.

NATRUM MUR : 

• Mostly indicated when cataracts begin to develop.
• Given when muscles around the eyes can feel bruised and weak, especially when the person looks down.
• There is feeling of gauze across the eyes, and parts of the field of vision may be hard to focus on.
• There is craving of salt. Patient feels worse from being in the sun, and has deep emotions yet appears to reserve.

PHOSPHORUS : 

• Useful for cataract with feeling that dust or mist in the eyes is obscuring vision.
• There soreness that feels like eyestrain after very little use .Given when there appearance of little bright dots of colored light when the eyes closed.
• Suited to those people who are sympathetic and fond of company, but can tire easily.
• There is an active imagination (including many fears) and a strong desire for cold drinks and refreshing things.

Diet & Regimen of  Cataract

• Adequate light, especially while reading and writing
• Proper eye glasses or contact lenses should be worn as prescribed by the physician
• Avoid night driving as much as possible
• Take proper rest and practice eye movement exercises [3]