The most common cataract in our environment is the senile cataract caused by aging and deterioration of the lens proteins due to age, but there are also other causes for this disease: metabolic, traumatic, inflammatory, congenital, etc...

Some diseases:

• Age-related cataracts
• Presbyopia
• Cataract due to trauma

The symptoms of cataracts vary greatly from one person to another, but we can identify a series of common symptoms:

More intense glare with light: The person who suffers from cataracts is more sensitive to light, to the point of bothering them, even when driving at night.

Vision improvement: On some occasions, patients affected by cataracts report that their near vision has improved significantly. This situation is due to the beginning of cataract formation, the eye is becoming myopized, which causes an improvement in the patient's near vision.

Blurry vision: This is one of the most common symptoms of cataracts. The patient perceives a fog that prevents correct vision, which interferes with daily activities such as watching television, driving... At this point, it is essential to go to a specialist, since, if not done so, the evolution of the cataract can lead to more advanced vision loss.

The only definitive treatment that exists, today, to treat cataracts is surgery.

Periodic eye checkups allow early detection of cataracts, which prevents the problem from developing and facilitates its treatment.

Currently, cataract surgery is usually performed by microincision (that is, 2.5 mm hand incisions that do not require sutures) and using equipment known as a phacoemulsifier that vibrates at ultrasonic speed to pulverize and aspirate the cataract.

After removing the cataract, the intraocular lens is inserted into the eye, which is always necessary.

There are many types of intraocular lenses, spherical lenses with which patients with a high possibility can be left with good distance vision, but require wearing glasses after surgery to read. When a condition called astigmatism exists in the cornea, a toric lens is needed to correct it.

Now multifocal intraocular lenses are also available, allowing adequate vision for both distance and near, and therefore offer the patient the independence of glasses for both distances (which is achieved with this type of lens in more than 90% of cases). ). Now, not all patients are good candidates for this type of lens, and therefore a careful evaluation is required before surgery.

On the other hand, given the effectiveness and safety of modern cataract surgery, you do not necessarily have to have a significant cataract to be a candidate for one of these lenses.  People over 50 or 55 years of age and who have significant myopia or hyperopia, even when the opacity of the lens is incipient, could be good candidates for a procedure called phacorefractive surgery, which seeks to remove the lens to place a multifocal intraocular lens (with the same technique of cataract surgery) but made to achieve independence from glasses, in cases where refractive surgery treatment with Excimer laser is not the best option.

In order to accurately evaluate each case and make decisions regarding the aforementioned procedures, it is important to take a complete clinical history, state-of-the-art diagnostic tests, and a comprehensive approach to the patient by the ophthalmologist. Let us remember that each surgery has precise indications and you must have good advice when implanting an intraocular lens.

The main symptom is poor near vision that appears when the patient begins to move away from nearby objects in order to obtain a clear image.

This can lead to visual fatigue or tired eyesight, presenting red eyes, stinging, ocular heaviness, and headache.

Initially patients can read by moving the text away from their eyes, but eventually glasses will be required to read comfortably. Glasses do not influence the worsening of near vision, since this is determined simply by the passage of time.

There is still no medical treatment that can demonstrably prevent or correct presbyopia.

There is also no surgical treatment that can completely correct it, however, there are alternatives thate allow the patient to carry out almost all his activities without glasses, but an appropriate selection of cases is required.

In patients under 50 to 55 years of age, the possibility of surgery with Excimer laser can be evaluated in an alternative known as “monovision,” in which one eye is corrected so that it is focused for distance vision and the other for near vision. A test should always be done before surgery, with a simulation of the correction that will be performed with surgery, using contact lenses. In this way it will be known with certainty if the patient will feel well with this type of surgery. The patient who feels good with the vision achieved in the monovision test will most likely feel just as good after laser surgery.

In patients older than 55 to 60 years, you can consider performing surgery with a special intraocular lens that allows you to focus far and near (such as the Panoptix lens). This surgery is the same as that performed to operate on a cataract, and consists of extracting the eye's natural lens (the crystalline lens) and implanting the intraocular lens.

The results of lens extraction surgery with multifocal intraocular lens implantation are generally very good (around 90% of patients do not require glasses for either distance vision or near vision), however, it must be understood that these lenses do not require glasses. They work exactly the same as the natural lens and therefore there are some details that must be taken into account. A little more light is usually required for reading and texts that are too small can be difficult to read.

Additionally, in some patients, halos may be seen around lights at night. These types of nocturnal visual symptoms generally diminish within a few months, and almost never cause severe discomfort, but in a few cases they do. Therefore, if the patient's activity requires a lot of night driving, especially on the highway, he or she may not be the ideal candidate for this type of surgery.

The most effective is the replacement of the crystalline lens with multifocal intraocular lenses (three distances: far, intermediate and near), allowing us to correct presbyopia and any other associated prescription defect such as myopia, hyperopia or astigmatism.