World Sight Day is observed on October 13 every year to raise awareness about healthy eyesight and eye diseases. Today we are highlighting how cataract cases are increasing in India. Did you know cataract is the number cause of global blindness? A lot of people in India also suffer from the problem. According to the Center for Global Development, more than 80 percent of blind people in India had bilateral cataracts in the early 1990s, while another 10 million people had cataracts in only one eye. Ever since cases of cataracts have been on a rise in the country.

To understand why the prevalence of cataract has increased in India, Health Shots asked Dr. Sudipto Pakrasi, Chairman, Ophthalmology, Medanta, Gurugram all about it.

FAQs on the prevalence of cataract in India

1. How common is cataract in India?

Dr Pakrasi: Cataract is a highly preventable visual impairment in India. Indians get cataracts about ten years earlier than people in Western countries, and the average age for getting cataracts in India is between 50 and 60 years. Genetic factors are responsible for 10-30 percent of paediatric cataract cases. High UV exposure in our sunny tropical climate is also a factor in early cataract formation and progression.

One of the primary causes of the crisis is a lack of manpower in terms of the number of ophthalmologists. Furthermore, the rising prevalence of diabetes in India adds to the burden because high blood sugar (blood glucose) levels over time can cause structural changes in the lens of the eye, hastening the development of cataracts. Cataract is one of the leading causes of visual impairment in diabetic patients, and India is known as the world’s diabetic capital.

2. Why do we see cataracts at an early age?

Dr Pakrasi: The factors that are responsible for cataract formation in young people is due to exposure to ultraviolet (UV) rays, eye injury, genetic disorders, steroid use, radiation therapy, smoking, and diabetes. Children can also develop cataracts (acquired cataract) and babies might be born with congenital cataracts.

3. What happens if you leave cataract untreated for a long time?

Dr Pakrasi: If a cataract is left untreated for an extended period, it matures, swells, and there is a risk of developing secondary glaucoma at the hyper mature stage. When treatment is delayed for an extended period, the cataract turns brown or white and becomes difficult to operate due to the complications that are associated with it. Patients with hyper-mature white cataracts face issues such as lens drop to the back and inflammation, which can lead to secondary glaucoma.

4. How can cataract be prevented?

Dr Pakrasi: According to research, we cannot prevent or slow the progression of cataracts because the lenses become more rigid and hard as we age. However, in some families with a genetic predisposition to cataract, even young people in their 30s and 40s can develop the condition and should be screened once a year and can prevent the same if detected early. There are also some diseases that cause redness and inflammation in the eye, which can lead to a cataract change.

5. What are some causes of the disease?

Dr Pakrasi: Diabetes, trauma, inflammation inside the eye, and sudden diseases inside the eye are some other common causes in India aside from genetic predisposition. Smoking, obesity, high blood pressure, previous eye injury, and previous eye surgery are all risk factors for cataract.

6. How is cataract removed?

Dr Pakrasi: Cataract removal surgery has advanced significantly in the last decade. We used to perform cataract surgeries with thick stitches that took about 10 days to recover from. Following this, extracapsular surgery was introduced in 1985, with the capsule being left behind and a plastic lens implanted. In 1993, phacoemulsification surgery was performed, in which doctors made a small hole and then went inside to crush the cataract emulsified and take the entire lens material out of the small hole. Currently, Femto Laser Assisted Cataract Surgery is used, which is an extremely precise, effective, and safe technology that uses lasers.

Apart from that, extremely high-quality lenses are now available, providing significantly improved vision. As a result, many people may not need to wear glasses after surgery.

7. Even after such advancements, why there is still a rise in cases of preventable blindness?

Dr Pakrasi: People are becoming more prone to diseases such as macular degeneration and diabetic retinopathy as they age. Furthermore, diabetes is on the rise in India, which causes problems with the eyes and retinas, as well as cataract formation. Furthermore, awareness is extremely low in small towns and rural setups. The importance of eye health education and the need for timely screening and treatment cannot be overstated.

We must look for opportunities to use current social media and technology to disseminate information because that is the only way to ensure that people come forward for checkups. Policy decisions by the government, schools and institutions are required to raise awareness, as well as training for doctors to manage, treat, and diagnose the condition.

8. What precautions are needed after cataract surgery?

Dr Pakrasi: Some precautions suggested by the doctor include using only the eye drops recommended by the operating surgeon, avoiding long-term use of steroid eye drops unless advised, not splashing the eyes with water after the surgery, avoiding heavy weightlifting, swimming for a while, avoiding activities that can result in injury or eye rubbing, maintaining eye hygiene, staying away from sunlight, avoiding the use of eye make-up, and going to dusty areas.