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Myths and Misconceptions

Most developing countries are now challenged with the problem of blinding cataract. India with its large population has perhaps the largest blind and potentially blind population in the world. About 80% of this blindness is due to cataract which can be easily cured by modern eye surgery.

Due to many myths and misconceptions they continue to remain needlessly blind. The social and financial hardships created by blindness gravely affect individuals and families in particular and the nation at large.

Poor Vision or Blindness can be a devastating experience which can change every aspect of the involved family's life. Many people suffer visual impairment silently and feel isolated leading to depression, social withdrawal giving rise to many myths and misconception.

We do hope that exploring these misconceptions will help you to understand cataract surgery, costs, complications, recovery time and cope up with your problem slightly better.

Commonly asked questions include

What are cataracts or motibindu,

What are the symptoms,

How do cataracts affect Vision,

 How do they remove a cataract,

 What is the cause of Cataract, and

Can cataracts lead to Blindness.

Other questions include queries related to Cataract surgery cost such as whether it is covered under insurance cashless facility, medicare, How much is the cataract operation cost in India or in Bangalore, ( Bengaluru) the price list for cataract surgery, cataract lens types, cataract surgery recovery time,  cataract surgery side effects, cataract surgery complications, cataract surgery steps, and types of cataract surgery. We hope that your questions will be answered and your doubts cleared as you read further about the various myths and misconceptions regarding cataract surgery.

1. Regarding Cataract Surgery:

Myth: Can I avoid surgery since I’m already very old?
      
Fact :Unoperated Cataracts lead to complications such as hypermature cataract and lens-induced glaucoma which may lead to irrecoverable Blindness.

 

 

 

Myth: Is there any eye drop to cure cataract?
      
Fact:  No. Don’t spend money in buying expensive ‘anticataract’ eye drops, which claim to be effective. The only effective treatment world wide is surgery and Phacoemulsification is the most sophisticated form of cataract surgery.

  Myth: Can I wait until next winter for my surgery? I believe wound healing is better in the winter season?
           
Fact: There is no seasonal difference in the success of surgery. Waiting till the next winter will only harden and advance the cataract further, causing more vision loss and handicap as well as more difficulty in its removal by phacoemulsification.

    Soft Cataract- Bloodless, painless, stichless removal possible by phacoemulsifcation with a very small incision**Benefits to the patient in the form of enhanced comfort, safety, and satisfaction.

    HARD Cataract- Bigger incision, more injury, requires manual surgery &/or stitches, painful , longer recovery period(6wks) and more chances of complications.**

FREQUENTLY ASKED QUESTIONS

FAQ: Can I expect clear vision after surgery?
         
Cataract Surgery at Sri Venkateswara Nethralaya has a very high Success rate since we only perform Phacoemulsification as the 1st Procedure of Choice.. In advanced Cataracts or in cases where manual Surgery is required and performed, Prior intimation and discussion with the patient as to the maximum vision that can be achieved in a particular case  is conducted along with the family members so that all your doubts are cleared before you decide on surgery and your expectations are proportionate to the visual prognosis of your condition
. We aim to be the best eye hospital in bengaluru or bangalore for people to undergo cataract surgery in terms of cost, results, experience, expectations and quality of care. Patient reviews and feedback are very important to us and we make a detailed effort to understand each patients needs and concerns so that every patient gets the best outcomes in terms of quality of care.

Sri Venkateshwara Nethralaya is a top, leading eye care hospital in India providing comprehensive eye care services including Lasik laser treatment, Phacoemulsification Cataract surgery, Multifocal IOL implantation, Diabetic Eye Disease treatment, Vitreoretinal Surgery, Squint Treatment, Oculoplasty, Glaucoma Evaluation and Treatment and Corneal Surgery and we aim at making it the best eye hospital chain in Asia by 2030. Our Eye Specialists and Consultants in practice are highly experienced and trained at premier eye institutes such as AIIMS and have over 18 years of surgical experience.

 

2. Regarding IOLs :

FAQ: Why should I go for this newer Intra Ocular Lens (IOL)?

 


           There are different types of intraocular lenses manufactured  today. The foldable lenses that are used for small incision surgery like phacoemulsification tend to be more expensive than the rigid one that are usually made from PMMA. The pricing varies because of

1. the material used to make the lens (hydrophilic/Hydrophobic-Acrylic/silicon/collamer) as well as certain special features that the lens manufacturer puts in such as

a) Square edge design to delay/prevent after cataract,

b) UV light filters to protect against harmful UVrays( implicated in uveal melanomas/ocular cancer),

c) Yellow chromophore(blue light filters) to protect the retina especially the macula and delay the onset of ARMD( Age related Macular Degeneration- The No 1 cause of irreversible blindness in patients over 60years),

d) Wave front technology(Prolate anterior surface) to compensate for spherical abberration,

e) High abbe value to decrease chromatic aberration,

f) Refractive index optimization to decrease negative dysphotopsia and anti glare technology.

Having a good quality lens implanted in your eye does make a difference as this lens will serve you the rest of your life. Your surgeon will be able to advice you on the different type of lenses available.The advantages of Monofocal Foldable IOL implantation include faster recovery and a pain free post operative period. The Comfort levels enjoyed by these patients are much higher as compared to conventional lenses. With Zeiss Aberration corrected IOLs patients enjoy enhanced contrast sensitivity and improved night Vision. With Newer generation Multifocal Intraocular lenses(Carl Zeiss Acritec / Rezoom  / Tecnis from AMO / Restor from Alcon ) you dependence on spectacles for day to day tasks will decrease allowing you to see reasonably well for both near and distance. However Not everyone is a candidate for Multifocal lenses and your eye surgeon will determine which lens is best suited for you depending on the general health of the eye.

Besides Multifocal IOLs, the latest advancements have been Accomodating IOLs (Crystalens from Bausch & Lomb) which further refine the quality of vision achieved post cataract surgery.  We also perform implantation of these lenses and for a detailed information on this, please click here.

                              

FAQ: How long will the IOL last in my eye?
          
Life long.

FAQ: Is it necessary to change the IOL again?
           No.

FAQ: Will the IOL get displaced if I do a lot of physical labour?
          
No, It is implanted inside the eye and Locked into position inside the Capsular bag after which the IOL gets fixed into its    position permanently.

FAQ: Will it cause irritation inside my eye?
          
No.

FAQ: Do I need to wear spectacles after IOL implantation?
          
Most patients do not require glasses after surgery for their distant vision, However,reading spectacles will be required for near    vision if only monofocal lenses are implanted. It also depends on your personal needs and occupation. If Multifocal IOLs are implanted, your dependence on glasses will be vastly reduced for both near and distance visual tasks.

FAQ: How Successful is cataract surgery by Phacoemulsification?

Cataract Surgery by Phacoemulsification is considered to be a miracle. Todays Cataract surgery by Phacoemulsification is blood less, stichless, painless, and is performed in less than 20-25 minutes, and the patient is ready to go home after about 2-3 hrs stay in the hospital.  This surgery is very successful in restoring vision — more than 99.9 percent of people who have a cataract removed have no complications and end up with clear and superior vision. Most people report not only better vision but also a  drastic reduction in the power of their lens prescription enabling spectacle free life leading to highly appreciated improvements in their overall quality of life after the operation.The difference in vision before and after cataract surgery is not only in terms of sharp and clearer Vision, but also brightness, contrast, colour perception, nighttime vision also dramatically improve leading to a rich and rewarding experience for both the patient and the Eye Surgeon.  To the patient, its a once in a lifetime opportunity to start seeing nice and clear once again and to the eye surgeon, its a once in a life time chance to be a part of a miracle in his patients life.. No wonder one can see more and more medical students take up Ophthalmology to specialize in as it offers a good work-Life-Compensation balance with enormous and never ending professional pride and satisfaction.

Approximately 9 million Indians are blind from cataract with another 1.8–3.8 million going blind from cataract every year. Worldwide over 37million people are blind due to cataract and is the No1 cause of reversible blindness.

            More than 7 million cataract operations are performed each year in India alone.  To Know what our patients have to say about these procedures, click here. To know more about the inventor of Phacoemulsification Charles D. Kelman, Please click here

FAQ: When do I have to undergo the procedure?

             As early as possible. The longer you wait, the cataract not only continues to worsen and become more opaque leading to further loss of vision, but it also may thicken further leading to increased intraocular pressure and finally irreversible blindness in the form of glaucoma. It will also harden further to the point where easy automated removal may not be possible and manual surgery requiring a large incision and stitches may have to be performed. The longer you wait,  more difficult it becomes to predict the outcome of surgery since it blocks the view of the retina, which is required to estimate post operative visual recovery. This is the reason why some patients with advanced cataracts who have delayed surgery against medical advice fail to recover completely as advanced cataracts are  more harder  and it becomes more difficult to remove. An older person who needs to be independent in performing his day to day activities progressively isn't very active and is dependent on others for his day to day activities such as

1.Guiding oneself to the bathroom,

2.taking medicines, reading prescriptions and drug information,

3.driving smoothly, accurately visualizing humps and potholes and estimating the distance by braking smoothly and accurately,

4.signing cheques, identifying numbers in the cell phone, or performing tasks like reading notice boards and calendars.

Some elderly patients may be terminally ill &  bedridden & may have less need for sharp vision than a patient in the working age group who needs to drive a car and  be independent in his day to day activities . These group of patients may delay surgery to the point where they are totally blind as their anticipated lifespan is short (days/weeks). However, This misleads many old healthy patients to think that surgery can be delayed till complete blindness ensues, but unfortunately such misadventures may lead to blindness even with successful surgery performed at a late stage with other comorbid complications. Also the success rates of cataract removal with phacoemulsification are different in different surgical hands in different stages and leads to unsatisfactory results in some cases when performed in the last stage. So YOUNG, MIDDLE AGED, or OLD, the treatment has to be AS EARLY AS POSSIBLE.

People with only minor vision loss from a cataract will require surgery because of problems with glare or double vision. Sometimes a cataract should be removed even if it doesn't cause  problems with vision — for example, if it's preventing the treatment of another vision threatening eye problem, such as Age-Related Macular Degeneration  , Diabetic Retinopathy or Retinal detachment.

 

FAQ: What are the risks of not having cataract surgery?

            If you choose not to have cataract surgery, the cataract and its effect on your vision will most likely continue to further worsen. This may affect your ability to do your everyday activities independently and drive safely, especially at night. Vision problems may lead to falls, accidents, and injuries. Your dependence on family members for even minor tasks such as reading the MRP of a product, reading drug information, signing Cheques will continue to increase leading to lifestyle changes and social withdrawal.

                                                           

Cataract has a higher risk of complications if the cataract advances to a stage where it becomes hard and may burst open inside the eye. This causes a very painful condition called Phacomorphic Glaucoma which leads to irreversible loss of vision even with modern eye surgery. In the United States and in other countries whenever cataracts are removed in the early soft stage by phacoemulsification, cataracts rarely cause blindness. Todays Cataract Surgery as practiced  in  Sri Venkateswara Nethralaya is a stichless, bloodless, painless procedure performed in less than 20mins and the patient is sent home immediately after surgery and no hospitalization is required. Benefits of early surgery include restoration of maximum vision without glasses, return to normal activity the next day itself and minimum or no complications whatsoever leading to a happy surgeon and a more happy patient.

FAQ:  Since Cataract surgery is permitted under insurance CASHLESS claim, can i avail cashless facility for this illness ?

            All insurance companies provide two forms of claim facility

                        A) CASHLESS     B) MEDICAL REIMBURSEMENT

We encourage all our patients to pay the hospital charges upfront, take the bills which will be provided by us along with the signed claim form and lodge their claim for Medical reimbursement which is usually settled by most reputed insurers within 15 days. This ensures that the insurer is not able to modify the treatment plan of the doctor/hospital and the best care, treatment, implants and consumables will be made available to the patient as discussed preoperatively with him/her.

However, if the patient avails CASHLESS facility, it gives an opportunity to the insurer to force the hospital to downgrade the treatment plan from the backend as per preagreed tariff with the hospital to the lowest possible package so that the insurer maintains his profitability and does not have to pay the hospital higher package rates demanded by the patient. Please remember that even insurers are a part of this system for earning their profits and they are not ANGELS. Insurers also want hospitals to do this discreetly without raising any alarm bells in the patients mind.

This puts the doctor/hospital managements in a difficult position as they have to look at a long term relationship with the insurer for sending patients and cannot afford to say "NO" to them,

Most patients however do not understand why the best or costlier treatment packages have been denied to them under cashless as they are under the impression that the insurer is obliged to provide the best facility to everyone irrespective of their backgrounds and refuse to accept downgraded packages preoperatively.

However, As we said before, Insurers are not angels and it is their opinion that if the patient wants the best for himself or herself, let them pay for it upfront and claim reimbursement as then, patients will do some due diligence by and for themselves and pay up as per their paying capacity. There is also a strong chance that the patient may not choose higher costlier packages if he/she is asked to pay upfront and claim reimbursement later. All this translates into higher profitability to the insurer which ensures their survival.

But if everyone is provided the best under CASHLESS facility, then insurance cos will have to run their business at a huge loss which is detrimental to their survival as they cannot raise premiums beyond a certain level.

So, many hospitals when squeezed from both sides (patient and insurer) decide internally  to compromise on their own without informing patients by using, reusing & sharing consumables as well as using cheaper implants to cut costs so that the insurers interest are kept foremost and the best surgery is also seemed to have been "done". However, problems occur when the expected results are not accomplished and doctors have to explain post operatively on the specifics when things are questioned, investigated and discovered by the patient later. This creates a lot of negative animosity against the treating team  and the insurer who was responsible for all this is now neatly firewalled & safeguarded as he is not responsible for the results. The patient is the final loser in this system as he realizes that under CASHLESS system, he has the least voice as it was actually a trap to get him/her to undergo a less than ideal procedure meant for the voiceless, poorest of the poor  who usually fall into such lure and traps of "CASHLESS" facility or free healthcare.

Hence, we strongly urge patients to get treated first paying upfront, having a one to one relationship with his/her doctor and hospital and then claim for reimbursement with their insurer on a one to one basis who then has to settle the dues as per the agreed policy terms with the policy holder. This minimizes any scope for the insurer to play in the backend any games that puts the treatment and outcomes at risk. The hospital will provide all relevant documentation, bills, receipts, as well as proof of consumables and implants used in the patient so that the patient does not have any difficulty in claiming reimbursement. Millions of patients who understand the healthcare system in India use this method to avail the best care for themselves and the satisfaction rates achieved by the patient is much higher as compared to the CASHLESS facility.

FAQ: Are all insurers like this  or are there some insurers who are considerate and compassionate?

         Definitely no, There are some insurance companies which are considerate and compassionate and have a sense of their social responsibility. We have appreciated their honesty and we have approved them for cashless facility at our hospital. You can enquire about the approval for cashless facility of your insurance provider with us at the time of the initial consultation. If we have approved them, we will offer you cashless facility. However, if we have not approved them for cashless facility, we strongly urge you to utilize the medical reimbursement facility wherein you can pay upfront at any registered hospital in India and claim settlement from your insurer later within a period of 15 days.

FAQ: What is the cost of Cataract Surgery at your Hospital?

The cost of Cataract Surgery by Phacoemulsification varies according to the type of Intra Ocular Lens Implanted inside the eye.

                                   Basic Package: Indian Rigid Lens Rs 20000/-

                                     Foldable Package: Foldable IOL Rs 25000/-

                                        Aspheric Package: Aspheric IOL Rs 30000/-

                                           Multifocal Package: Indian Rs 45000/-

                                                                                 Imported Rs 75000/-

If you wish to know more about Multifocal Package  you can read about them here Multifocal IntraOcular Lenses after Cataract Surgery

The preoperative investigation charges, Anaesthesia Charges, Post Operative Medicines, and Glasses will be charged extra and will be as per actuals.

Some patients may require additional procedures like Limbal Relaxing Incisions, Astigmatic Keratotomy, Pterygium Surgery, Mitomycin C Application, Conjunctival Grafting, Glaucoma Surgery along with Cataract surgery. Such patients will be charged additionally for the associated procedure and the cost will be communicated on a case by case basis.

All packages are on a single eye basis as one eye only is done at a time. If both eyes are to be done, package rates will be double as mentioned above.

In some cases, where cataract surgery by phacoemulsification cannot be done due to advanced stage, preoperative discussion on the achievable results will be conducted and Manual surgery may be done. The cost of manual surgery will be lesser than phacoemulsification and such calculated cost will be communicated to the patient on a case by case basis.

FAQ: How much reimbursement can be expected in an average policy issued to the policy holder

              The normal reimbursement rates are around 20% of the total sum assured. This means that if the insurer has issued to you a policy for 1 Lakh, You are eligible to claim around Rs 20000/- per eye.  However nowadays most insurers have a upper limit capping  of claims for cataract surgery pegged at Rs 25000/-. This means that if you are insured for 5 Lakhs also, you can claim only Rs 25000/- maximum instead of Rs 1,00,000/- as was previously the case. Hence Most patients spending more than 25000/- per eye, will have to be prepared to partly contribute to their surgery to the extent of Rs 5000-10000 per eye.

 

Website: www.srivenkateshwaranethralaya.com
              SRIVENKATESWARA NETHRALAYA           
                                     *** Advanced Eye care Hospital***

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