Understanding cataracts: A conversation with Dr Ruchi Prabtani

Last Updated on September 18, 2023 by Shabnam Sengupta

The ability to see clearly and without cataracts is necessary to appreciate the world’s vibrant beauty and intricate details. Since cataracts can significantly impact your eyesight and general health, it is crucial to understand them. Think of cataracts as clouds growing in the eye impairing one’s ability to see properly as they have a key role in affecting a large population worldwide. Therefore, it is crucial to detect cataracts early and receive the necessary treatment to prevent their progression. Moreover, if you want to care for your and your loved ones’ eyes, it is important to understand the conditions that can impact the eyes. In this interview, THIP Media spoke to a distinguished ophthalmologist, Dr Ruchi Prabtani, to understand what cataract is and various aspects of the condition.

Dr Ruchi Prabtani

Dr Ruchi Prabtani is a dedicated young eye specialist who practices at the renowned Sharda Chanakya Hospital, Gondal, Gujarat. She is an enthusiastic ophthalmologist who has previously served as a senior resident at the prestigious Government Medical College in Bhagavad. In addition to her role as a dedicated health educator in eye health, her specialisations are in cataract surgery, glaucoma management, strabismus treatment, and retinal evaluation. Dr Prabtani, in another interview with THIP Media, emphasised the importance of health literacy.

Excerpts:

What is a cataract? How does its formation occur, and what implications does it have for one’s vision?

Dr Ruchi Prabtani: Basically, a cataract is the cloudiness of the lens. The lens proteins with age change in composition and due to free radicals-related injury and get compacted. The resulting clumping of lens proteins leads to the opacification of the lens. Initially, patients complain of difficulty in night vision, change in spectacle prescription, and difficulty in driving or reading.

Dr Ruchi Prabtani: About 80% to 90% of cases are age-related, but it can occur in younger individuals also. Trauma, congenital cataracts, which are hereditary and are metabolic disorders, long use of hormone replacement therapy, and steroid treatments are some of the causes and risk factors that may lead to the early onset of cataracts.

Is diabetes a risk factor for cataracts?

Dr Ruchi Prabtani: Diabetes can lead to the early progression of cataracts. However, metabolic disorders like galactosemia or other metabolic disorders can also cause cataracts. If a father has a cataract, then children may also develop the condition. Parathyroid disorders can also lead to inherited cataracts.

What are the different types of cataracts and how do they differ in characteristics?

Dr Ruchi Prabtani: It’s not much difference at the patient’s end. However, the difference in the characteristics can be seen on the slit lamp during the diagnostic process. Based on that, there are nuclear cataracts, cortical cataracts and subcapsular cataracts.

The posterior capsule is located behind the lens. When it becomes opaque, it is referred to as posterior polar cataract. Operating on posterior polar cataracts can be risky because they tend to adhere to the posterior capsule, increasing the chance of posterior capsule rupture. Other types of cataracts include rosette cataracts and trauma-related cataracts. An ophthalmologist can distinguish these different types on a slit lamp examination.

Although the symptoms that the patients would experience can be common, only the ophthalmologist can differentiate between the various types of cataracts, right?

Dr Ruchi Prabtani: Yes. Also, the way a person’s vision is affected is also different. If the nuclear central posterior capsular or PPC muscle central part is affected, then the patient will have difficulty in day vision. But if the person has cortical cataracts or peripheral cataracts, then they will have problems with night vision and driving.

How do cataracts affect vision, and why are regular eye check-ups important for early detection?

Dr Ruchi Prabtani: In the initial stages, the vision will not get severely affected, but the patient will complain of problems with night vision or the frequency of changing glasses will increase. There will be increased sensitivity to light also. Cataract patients are unable to work in too much light and have difficulty in driving.

Dr Ruchi Prabtani: The definitive treatment will be surgery. The opacified lens will be replaced with the artificial lens. However, in the very early stages, we prescribe spectacles. For delayed progression, we give antioxidant treatments or antiglare glasses to decrease UV light exposure. This slows the progression of cataracts. But it’s not a definitive treatment.

What are the available surgical options for cataract treatment?

Dr Ruchi Prabtani: The field of surgery in ophthalmology is definitely evolving day by day. Previously, we had extra capsule cataract extraction, but now we have manual small incision cataract surgery. We now also have phacoemulsification and in advanced cases, femtosecond laser assisted cataract surgery. In phacoemulsification, the size of the incision is small and we operate with the help of an ultrasound machine, and in femtosecond laser assisted surgery, we make capsular access, the CCC, and make an incision with the laser, which makes it the safest option.

What proactive measures can individuals adopt to potentially lower their risk of developing cataracts?

Dr Ruchi Prabtani: Diet regimes, vitamins and minerals, daily consumption of antioxidants, and wearing UV protective glasses, especially if you are working in a hazardous environment are important to prevent traumatic cataracts. If you have associated diseases like diabetes, then well diabetes will help in delayed progression.

What ongoing research efforts are focusing on enhancing the comprehensive management of cataracts?

Dr Ruchi Prabtani: There is much research going on on delaying the progression of cataracts. Many eye drops are under research that can delay the progression. One such component is acetylcysteine, which we use to delay the progression. In terms of post-operative, they now implant Dexamethasone, which we call Ozdirect. That can lessen the need to put eye drops regularly post-surgery. It is one of the main factors, which affect the patients. A lot of them fail to put the drops properly or maintain hygiene. So, the Ozdirect implant can be a better option for them.

Are there any existing initiatives or ongoing programmes focused on increasing awareness about cataracts?

Dr Ruchi Prabtani: Basically, in India National Programme for Control of Blindness, under which there is Netra Jyoti Abhiyan. This programme was started to increase awareness about cataracts in the community and also increase the number of cataract surgeries and prevent blindness due to cataracts. Also internationally, the USA declared the month of June as Cataract Awareness Month.

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