Cataract is derived from the Greek word cataraetos, which describes especially running water. Rapidly running water turns white, as do nature of cataracts. The lens is a crystalline transparent structure, situated within the eyeball composed of protein and water. As long as the lens is transparent we are able to see the world. Any factor that leads to a loss of transparency of the lens can cause cataract. 

Certain harmful products called free radicals are produced in the lens. These cause an alteration in the protein structure which causes scattering of light rays and subsequently decrease lens transparency and hence the cataract. 

Following drugs can lead to the formation of cataract.
Cortiosteroids - (e.g. Wysolone etc.,)
Drugs which, are used to treat conditions such as Bronchial Asthma, Rheumatoid arthritis etc.,
 
1. Phenothiazines:
Used in the treatment of psychiatric disorders.

2. Amiodorone:
 Drug used in the treatment of certain heart ailments (arrhythmias). These are rarely visually significant.

3. Following trauma
Blind injuries, penetrating injuries and radiation exposure can cause cataract. Ionizing radiation in the X-Ray range can rarely cause cataracts. UV radiation is an important factor in the tropical countries.
 
4. Metabolic causes
Diabetes Mellitus

It has clearly been established that antibiotics especially if administered by the fourth day reduces the complications of the disease. Severe cases are treated with antibiotics like Penicillin or Ampicillin for 10 days. Less severe cases with antibiotics like Doxycycline 100 mg orally twice a day for 7 days along with supportive therapy for multiorgan damage.

In addition to being the most common cause of preventable Blindness (80%) in our country and the profound bio-economic impact it can produce, a patient who harbors a mature cataract for a long time can develop certain compilation such as "phacolytic glaucoma" - Increase in the pressure within the eye due to leakage of lens proteins. Such people develop pain, redness, watering of the eye, and may not regain vision even after surgery.

What are the symptoms of cataract ?

Patients generally complain of:

Cloudy, fuzzy, foggy, or filmy vision.

Changes in the way you see colors.

Problems driving at night because headlights seem too bright.

Problems with glare from lamps or the sun.

Frequent changes in your eyeglass prescription.

Double vision.

Better near vision for a while only in farsighted people. These symptoms also can be signs of other eye problems.

Surgery in ancient India practiced couching as early as 800 BC. In this crude technique the surgeon would sit in front of the patient. Using the illumination from the sun and with a blunt needle he would enter the eye from the sides and knock the white opacity backward. The complications are very high and couch technique soon fell disrepute.

This was followed by a technique known as "Extra capsular cataract extraction" with the placement of an intraocular lens.

It was in 1967 that Charles Kelman introduced the Phacoemulsification technique which is the modern cataract surgery with all its inherent advantages. This procedure differ from the standard ECCE in that

No suturing required .

There are no constraints on the patient after surgery an he can resume his day to day activities very quickly which has preformed economic repercussions.

The complications due to surgery are less.

There is no necessity for anesthesia in the form of injections around the eye. The surgery can be performed using 'topical' anesthetic, in the form of eye drops.

The quality of vision after surgery is much better. There is relatively less pain, redness after surgery because their is less tissue injury.

In most cataract surgeries, the removed lens is replaced by an intraocular lens (IOL). An IOL is a clear, artificial lens that requires no care and becomes a permanent part of your eye. With an IOL, you'll have improved vision because light will be able to pass through the retina. Also, you won't feel or see the new lens.

Some people cannot have an IOL. They may have problems during surgery, or maybe they have another eye disease. For these people, a soft contact lens may be suggested. For others, glasses that provide powerful magnification may be better.

1. Spectacles .

2. Contact lens. Extended wear contact lenses (contact lenses can be worn for longer duration) usually recommended.

3. A second surgery with IOL implanted. To be devised by the consultant Ophthalmologist only! after looking into the pro's and con's of the same.

The patient is required to instill eye drops as advised. The eye drops include, an antibiotic solution to combat infection and steroids and or nonsteroidal antinflammatory eye drops to control valves and watering.

When at home, the patient is advised not to bend or lift heavy objects. Bending increases pressure in the eye. He can walk, climb stairs, and do light household chores.

He is reviewed after 1 week, 1 month and 3 month intervals. Glasses are normally prescribed at the end of 6 weeks

Cataract surgery tends to worsen their retinopathy status. Diabetes tends to develop damage to the blood vessels in the retina (the screen where the light rays fall) due to high blood glucose levels. This damage worsens following cataract surgery.

At present lasers to unmove the cataract is only in its early institutional status and under trial.