What is cataract?

Cataract is one of the most common eye conditions, especially with advancing age. It refers to the clouding of the lens in one or both eyes, causing blurred and hazy vision. This condition progresses over time until the lens becomes completely opaque, preventing the passage of light rays through it. There are several medical terms commonly used to refer to this disease, such as “white water” (literal translation) and cataract.

What is the difference between white water and blue water in the eye?

One of the frequently asked questions at Dr. Ammar Nasr’s clinic is: “What is the difference between white water and blue water in the eye, and how can we distinguish between them?”

In reality, one condition arises from the other. When the white water condition progresses and is left untreated, it leads to the development of blue water. In the language of ophthalmology, white water refers to the opacity of the lens and the blurred vision caused by the breakdown of the protein fibers and various components of the lens. Over time, these components condense randomly and result in a more severe condition known as blue water, which coincides with an increase in eye pressure and can lead to optic nerve atrophy and partial or complete blindness.

Types of cataracts in the eye

The types of cataracts that affect the eye vary depending on the location of the condition, its severity, and the associated risk factors. They can be classified into three main types that encompass all detailed cases, as follows:

  1. Nuclear cataracts: In this condition, opacity or cloudiness occurs specifically in the central part of the lens. The severity of the opacity indicates the degree of hardness or maturity of the cataract. If left untreated, the nuclear cataract tends to turn into a brown cloudy lens. The progression of the disease leads to a very slow deterioration of distance vision. This condition mainly affects individuals over the age of 75, and surgical intervention is often the definitive treatment.
  2. Cortical cataracts: This type affects the outer layer of the lens, known as the cortex. It occurs due to changes in the lens components, resulting in fissures that extend from the outer part of the lens toward its center. A prominent symptom of this type of cataract is severe discomfort from glare, caused by the refraction of light through the fissures.
  3. Posterior subcapsular cataracts: This is a silent condition that is difficult to detect in its early stages. It manifests as a dark spot in the posterior part of the lens, just beneath the lens capsule. This type is characterized by a significant decrease in vision quality in brightly lit environments and an inability to see near objects clearly. It primarily affects children and young adults more than the two types mentioned earlier.

Other Types of Cataracts

In addition to the mentioned types, there are several exceptional types of cataracts that affect both adults and children, some of which occur in specific cases, while others are more widespread. These include:

Congenital cataracts: In this case, infants are born with cataracts due to various genetic or hereditary reasons.

Mature white cataracts (Morgagnian cataracts): In this condition, the cortical region of the lens becomes highly liquefied, with the nucleus of the lens suspended on the lens capsule. This may result in lens disintegration and liquefaction, leading to complicated surgical procedures.

Mature cataracts: This is a distinct type characterized by the absence of infrared (IR) reflection, partial whitening of the lens cortex, and blurry vision.

Immature cataracts: This type is characterized by the visibility of the retina and the preservation of its ability to reflect infrared radiation from the background of the eye, accompanied by a decrease in vision.

 What are the symptoms of cataracts in the eye?

Each case of cataracts is unique, and each patient’s condition differs based on the extent of lens opacity, its precise location, the progression of the disease, and other factors. However, the most common and widespread symptoms among cataract patients can be listed as follows:

  • Gradual vision impairment without associated pain.
  • Discomfort from bright screens such as TV and mobile devices.
  • Difficulty in recognizing people’s faces and distinguishing them.
  • Inability to read smoothly.
  • Double vision in one eye.
  • Noticing halos around light sources, especially at night.
  • Changes in refractive measurements, such as nearsightedness and farsightedness.
  • Sensitivity to light.
  • Dim and faded perception of colors.
  • Episodes of sudden severe headaches.
  • Partial loss of vision.
  • Change in the color of the lens to white


Causes of Cataract

While age is the most common factor in developing cataracts in the eye, many cases result from various and simultaneous causes. These causes may be overlooked when they occur, but their consequences can be extremely severe. Some of the causes include:


  • Genetic factor: When one or both parents have cataracts, their offspring are more likely to develop them due to genetic or hereditary reasons.
  • Aging: As mentioned earlier, age-related cataracts are common and result from the physiological changes in the human body that affect the protein composition of the lens, leading to the formation of cataracts.
  • Diabetes: One of the most prominent complications of diabetes is ocular damage, which directly affects the optic nerve.
  • Radiation exposure: Certain harmful types of radiation, such as those used in cancer treatment, can contribute to the development of cataracts.
  • Certain medications: Each medication has its side effects, and this applies to corticosteroids as well. Prolonged and high-dose use of corticosteroids can affect the eye and lead to cataracts.
  • Metabolic disorders: Diseases such as congenital rubella syndrome, herpes, measles, and genetic metabolic disorders can contribute to the development of cataracts.
  • Progression of eye diseases: Neglecting the treatment of minor eye conditions such as iritis can result in the accumulation of cataracts.
  • Severe trauma: In cases of fights or accidents, a small incision may occur in the lens capsule, allowing the intraocular fluid to enter the lens and leading to the formation of cataracts.
  • Intentional injuries: These refer to deliberate corneal incisions or surface or deep wounds, which cause disruption of the lens capsule and the interaction of its components with the eye’s fluids, resulting in cataract formation.

When is cataract surgery necessary?

Many patients tend to neglect early-stage cataracts, believing that they do not significantly affect their vision quality and, therefore, do not require immediate treatment. However, cataracts can progress rapidly and cause a sudden decline in vision. At this point, it becomes necessary for the patient to seek medical attention because cataracts have started to interfere with their daily activities. Neglecting cataract treatment can lead to several problems, including:

  • Increased eye pressure, known as glaucoma
  • Dislocation of the lens due to the dissolution of the lens zonules, leading to lens drop and more serious complications

How is cataract diagnosed?

In mild cases and in the early stages of cataract development, advanced diagnostic techniques are used to detect the condition. However, in advanced cases where lens opacity is significant, you can diagnose your own condition and those around you because cataracts are visible and apparent. Of course, this does not replace consulting a doctor and initiating immediate treatment to avoid vision loss. The doctor may use various diagnostic mechanisms, including:


  • Comprehensive eye examination: This involves confirming the presence of cataracts and evaluating vision using an eye chart.
  • Intraocular pressure measurement test: This involves a sudden puff of high-pressure air directed at the cornea to accurately measure eye pressure.
  • Clinical examination: Initially, dilating eye drops are used to examine the health and integrity of the optic nerve and exclude any retinal damage.
  • Slit lamp examination: This device enlarges ocular tissues under a microscope, allowing for the examination and assessment of ocular tissues and their health.
  • Additional tests: The specialist may require additional tests, such as measuring the eye’s response to intense glare and assessing color discrimination ability, among others.

Types of Cataract Surgery

At Dr. Ammar’s center, cataract surgery can be performed using various techniques, including modern and advanced methods, as well as traditional surgery. Each technique has multiple steps and specific details, as follows:

Laser-Assisted Cataract Surgery

This technique is one of the most widespread and globally recognized procedures for cataract treatment due to its high success rates and suitability for most cataract cases. It does not require the use of surgical blades and involves the following steps:

  • Automated laser beams create a precise incision, usually around 2 mm, with controlled timing and direction.
  • The laser beams penetrate the lens through the incision and fragment the accumulated cataract into tiny pieces.
  • The surgeon inserts a probe connected to a device called a “phaco” through the incision, which emulsifies and removes the fragmented particles.
  • An artificial lens is implanted behind the iris and secured in place, completing the procedure.

Phacoemulsification Cataract Surgery

Also known as “lens emulsification surgery,” this technique is less advanced than the laser-assisted method but equally important. The steps involved are as follows:

A highly skilled ophthalmologist performs a very small surgical incision.
Ultrasound waves are directed toward the incision to emulsify the cataract-affected lens.
A new, foldable lens is implanted through the surgical incision.
The lens self-expands and positions correctly, completing the procedure.

Traditional Cataract Surgery

This method, also known as extracapsular cataract extraction, is one of the oldest techniques used for cataract treatment and is still effective to this day. The steps involved are as follows:


  • The surgeon creates a relatively long and deep surgical incision.
  • The cataract-affected lens is manually extracted, either with or without preserving the posterior part of the lens capsule.
  • A healthy artificial lens is implanted in place of the extracted lens.
  • The surgical incision is closed with sutures and medical grafts, and the eye is dressed for several days.




How long does Phaco or Femtolaser cataract surgery take?

Cataract surgery is a relatively simple eye procedure, and it should be noted that the duration of the surgery is inversely proportional to the skill and experience of the surgeon. The more experienced and proficient the surgeon, such as Dr. Ammar Nassar, the shorter the duration of the procedure. On average, cataract surgery takes approximately 5-10 minutes.

Success Rate of Cataract Surgery

According to recent research and statistics conducted in the United States, cataract surgery is classified as one of the most commonly performed surgeries in the human body. The statistical data has shown a success rate of 99% for cataract surgery. However, when performed by an experienced surgeon like Dr. Ammar Nassar at a center that adheres to the highest standards of professionalism and is supervised by a professional medical team, such as Dr. Ammar’s center, the success rate of this procedure reaches 100% by the grace of Allah.

Prevention of Cataracts

Individuals who have already been diagnosed with cataracts or are more susceptible to developing this condition due to genetic or medical reasons should follow a set of preventive measures to reduce the risk and protect their eyes. These measures include:

  • Wearing UV-protective sunglasses.
  • Regularly visiting an ophthalmologist to monitor eye health.
  • Monitoring blood sugar levels in diabetic patients to prevent complications.
  • Managing emotions, reducing stress and anxiety to avoid elevated eye pressure.
  • Consuming fresh fruits and vegetables, particularly citrus fruits, as they are rich in antioxidants that combat free radicals and protect against cataract formation.