Are your eyes cloudy? Solve cataracts and correct vision at the same time with artificial lenses! [건강 기상청 : 증상으로 본 질병]

2024-07-25 22:26:20

[인터뷰] Kim Dong-hyun, Professor of Ophthalmology, Korea University Anam Hospital
“Cataract treatment, artificial lens implantation is the most effective”
“The best preventive measure is regular eye exams, as there are no symptoms”

Kim Dong-hyun, Professor of Ophthalmology, Korea University Anam Hospital. Photo by Reporter Park Hae-yoon

What if one day one of your eyes becomes cloudy or blurry and objects appear to overlap? If you also have symptoms of light scattering, there is a high possibility that you have a cataract. If cataracts are left untreated, vision can be severely reduced and complications such as glaucoma, iritis, lens dislocation, and uveitis can occur due to increased intraocular pressure.

Cataracts are eye diseases that are mostly caused by aging, and the number of patients receiving treatment in Korea has increased significantly as we enter a super-aging society. According to data from the National Health Insurance Service, the number of patients, which was about 820,000 in 2010, will reach about 1.4 million in 2020 and about 1.6 million in 2022. This is an increase of nearly 2 times in 12 years. The number of surgeries also increased by about 20% from about 590,000 in 2018 to about 740,000 in 2022, ranking first in the number of surgeries by disease in Korea.

Even more noteworthy is that cataracts, known to mainly occur in people over 60, are seeing a significant increase in the number of patients in their 40s and 50s as regular health checkups expand. In the past five years, the number of patients treated has increased by about 27%, from about 260,000 to about 330,000. In the case of people in their 40s, the number of patients treated in 2020 is expected to be about 90,000, which is about 2.7 times higher than about 34,000 in 2010. What is a cataract and what is the most effective treatment? To find out the answer, we met with Professor Kim Dong-hyun of the Department of Ophthalmology at Korea University Anam Hospital. Professor Kim said, “Since cataracts rarely have any symptoms such as pain, it is important to detect the disease early through regular ophthalmological checkups and receive surgery at the appropriate time through follow-up observation.”

There is no drug with proven therapeutic effect.

Explain the mechanism by which the eye sees objects, comparing it to a camera.



“The light entering our eyes is refracted by the black cornea (lens) and its amount is adjusted by the iris (aperture) and sent to the crystalline lens (convex lens). The crystalline lens adjusts its thickness to see distant or near objects and forms an image on the retina (film) at the very back of the eye. The photoreceptor cells distributed on the retina change these formed images into electrical signals and send them to the brain through the optic nerve. The crystalline lens can form an image accurately by adjusting its thickness on its own, but the convex lens of a camera must be artificially adjusted to adjust the distance between the lens and the film to form an image.”

What is a cataract?


“It is a disease in which the lens of the eye becomes cloudy due to protein denaturation, causing blurry vision. When the lens becomes cloudy, light is not refracted properly, which hinders the formation of images on the retina (seeing objects), and vision deteriorates.”

What are the typical symptoms of cataracts?


“Vision loss. When the lens becomes cloudy, the field of vision can become blurred or distorted. These symptoms vary depending on the location, degree, and scope of the clouding. If the clouding is partial, monocular diplopia (a symptom in which objects appear double when viewed with one eye) can occur, and if the nucleus of the lens hardens and the refractive index increases, myopia can occur, allowing near vision to be seen better than before. However, if the degree of clouding becomes extremely severe, you can no longer see at all, but you can still feel brightness and darkness, light and shadow, which is a characteristic of cataracts. Cataracts are usually painless, so it is difficult to detect. Therefore, if your eyes appear cloudy or blurry, objects appear double, or light spreads, it is recommended that you get an ophthalmological examination immediately.”

What causes cataracts?


“Congenital cataracts mostly have no clear cause, and sometimes they are hereditary or caused by fetal infection in the womb or metabolic abnormalities (diabetes). Acquired cataracts are a type of aging, and the risk of developing them increases with age. In addition to aging, trauma, intraocular inflammation such as uveitis, drugs (steroids, anticancer drugs, psychiatric drugs), radiation therapy, and systemic diseases can also be causes. Lifestyle habits such as smoking and drinking also have an effect, and excessive exposure to ultraviolet rays (sun) and infrared rays in particular is a factor that increases the risk of developing them. In the case of young patients, trauma is the most influential factor.”

Can cataracts be treated with medication?


“It is impossible to make the degenerated lens transparent or to completely stop its progression with medication. In the early stages of cataracts, it is possible to expect an effect that slows down the progression. There is no treatment drug that has proven to be effective yet.”

Correcting nearsightedness, astigmatism, and presbyopia with artificial lenses

How about surgery?


“For advanced cataracts, surgery is a very safe, effective, and most certain treatment. It involves removing the clouded lens and replacing and inserting an artificial lens. There are various types of artificial lenses, so you should choose one that comprehensively considers the structure and characteristics of your eyes, other eye diseases, and your lifestyle.”

How is artificial lens implantation performed?



“This is a surgery that involves making a small hole of 2 to 3 mm in the patient’s cornea, removing the cloudy lens, and inserting an artificial lens to replace it.”

When is a good time to have surgery?


“It is not always the case that the surgery is done quickly. When the patient feels discomfort in his or her eyesight, the appropriate timing for the surgery should be chosen by considering the patient’s physical condition.”

What are the possible side effects or complications of surgery?


“There are cases where it can be completed simply, but it is by no means an easy surgery. There are also cases where the possibility of complications is very high, and there may be side effects such as dry eye or macular edema, so regular follow-up is necessary after the surgery.”

They say that implanting an artificial lens can correct your vision?


“The artificial lens can be adjusted to the degree desired by the patient by calculating the size and curvature of the eyeball, etc. Recently, artificial lenses with various functions have been released, and their functions are gradually improving. Astigmatism correction and presbyopia correction can also be received at the same time as cataract surgery. There are various types of artificial lenses to be inserted, and the price varies greatly depending on whether health insurance benefits are applied. Therefore, after sufficient consultation with the ophthalmologist who will perform the surgery, you should choose the one that is right for you, considering your physical condition and financial situation.”

What if I have cataracts in both eyes?


“Intraocular lens implantation can be performed on both eyes at the same time. However, in extremely rare cases, there is a risk of the surgery being botched due to infection or other reasons, so in most cases, the next surgery is performed after observing the progress for about three days after the surgery on one eye.”

Wearing sunglasses helps prevent cataracts

When can I have surgery on both eyes on the same day?


“If the patient wishes and the eye and other physical conditions are deemed suitable for surgery, it will be performed on the same day. This is because medical technology has advanced in many aspects, including surgical methods, surgical instruments, and antibiotics, and the risk of infection has been significantly reduced compared to the past.”

After surgery on one eye, can I have an intraocular lens implant in the other eye to correct my vision?


“Usually, people in their 40s or 50s or older often have a mild cataract in the other eye. If there are cataracts in both eyes, most people undergo refractive surgery at the same time, inserting artificial lenses in both eyes. However, surgery on the eye without a cataract is not covered by insurance.”

Is there a way to prevent cataracts?


“Since cataracts are a natural phenomenon that occurs during the aging process, there is no clear method of prevention. However, strong UV rays clearly have a negative effect, so wearing sunglasses outdoors is helpful. Cataracts can also be caused by trauma, other eye diseases, or medications, so regular checkups are recommended.”

Do you have any policy suggestions regarding cataract treatment?


“Differential fees should be applied to cases where the cataract patient has a serious underlying disease (cancer, diabetes, heart disease, cerebrovascular disease, dementia) or the difficulty of the surgery is very high. These patients often require general anesthesia, so I hope that the fee for this part is also considered.”

Planning Committee Member Choi Young-cheol [email protected]

2024-07-25 22:26:20