Most developing
countries are now challenged with the problem of blinding Cataractous
lens disease which is one of the diseases of the Lens inside the eye.
India with its large population has perhaps the largest blind and
potentially blind population in the world due to diseases of the lens.
About 80% of this blindness is due to cataract which can be easily
cured by modern eye lens removal 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 cataractous
Lens removal surgery, costs, complications, recovery time and cope up
with your problem slightly better.
Commonly asked questions include
What are diseases of the lens inside the eye,
What are the symptoms,
How do diseases of the lens affect Vision,
How do they remove a diseased lens such as 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 Lens removal 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 Lens removal surgery complications, cataract surgery
steps, and types of lens removal 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 Lens removal Surgery:
Myth: Can I
avoid surgery since I’m already very old? Fact
:Unoperated Cataract lens lead to complications such as
hypermature cataract and lens-induced glaucoma which may lead to
irrecoverable Blindness.
Other diseased lens such as Lenticonus(abnormal shape), Presbyopic Lens
( Loss of Focussing Power), Glaucomatous Lens ( Thicker lens causing
Optic Nerve Decompensation and Visual field loss) also require Lens
removal surgery) followed by IntraOcular Lens Implantation.
Hi
Myth: Is there any eye drop to cure
Lens Diseases? 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
Lens removal 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 further harden and advance the cataract and progression of other
lens diseases while causing more vision loss and handicap as well as
more difficulty in its removal by phacoemulsification. Besides,
Further deterioration of vision will alter your ability to legally
drive independently without a high degree of risk, it will also create
additional complications like Phacomorphic Glaucoma, Weaker Zonules,
Thinner capsules, and senile miosis altering the success rates of
routine cataract surgery.
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.**
FAQ: Can
Lens removal Surgery and IOL implantaton be recommended
without development of Cataract?
Answer: Yes,
Lens removal surgery and IOL implantation is done for all diseases
of the lens such as cataract, Presbyopia, Index/Axial Hyperopia,
Glaucoma in Axial Hyperopia, and other diseases resulting in
abnormal shape of the lens such as lenticonus, or abnormal size such
as Lentiglobus or microspherophakia.
FREQUENTLY ASKED QUESTIONS
FAQ: Can I expect clear vision
after surgery? Lens
removal 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 other lens diseases 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 thevisual prognosis of your
condition.
We
aim to be the best eye hospital in bengaluru or bangalore for people
to undergo lens removal 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,
Rajarajeshwarinagar, Bangalore is a top, leading eye care
hospital in India providing comprehensive eye care services including
Lasik laser treatment, Phacoemulsification Lens removal 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 20 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/
Trifocal / Symphony EDOF Lens )
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 the newer 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
& other lens diseases 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 Lens removal operations with
IntraOcular lens implantation 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, lens diseases progress. Among Lens
diseases, the most common cataract, Presbyopic lens, Glaucomatous lens
etc 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 lens diseases who have delayed
surgery against medical advice fail to recover completely as advanced
lens diseases 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 Lens Diseases 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 Lens removal surgery & IntraOcular Lens Implantation?
If you
choose not to have Lens Removal surgery & IntraOcular lens
implantation,
the lens disease 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.
Lens diseases such as
presbyopic lens, Glaucomatous lens also progress to Cataractous lens
with time has a higher risk of complications if the disease
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, lens
diseases rarely cause blindness. Todays Lens removal 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 25000/-per eye
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, MMC 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/- to
Rs 60000/-. This means that if you are insured for 5 Lakhs also, you
can claim only Rs 25000/- to Rs 60000/- maximum instead of Rs
1,00,000/- as was previously the case. Hence Most patients spending
more than their insurance capped amount for Cataract Surgery, will
have to be prepared to partly contribute to their surgery if they
wish Advanced Lenses in Multifunctional premium packages.