Bladeless, stitch-free micro-incision cataract surgery performed as day-care by Dr. Charu Mithal — with unhurried counselling on which intraocular lens actually suits the way you live, not the one with the biggest margin.
The natural lens inside your eye sits behind the iris and focuses light onto the retina. With age, the proteins in that lens clump together and it turns cloudy — that cloudiness is a cataract. Light scatters instead of focusing, and vision becomes hazy, faded and increasingly difficult in low contrast conditions.
Cataract is the single largest cause of reversible blindness in India, and it is almost entirely age-related, though diabetes, long-term steroid use, eye injury, high myopia and prolonged unprotected sun exposure all bring it on earlier. There is no eye drop, tablet or exercise that dissolves a cataract. The only definitive treatment is surgical removal of the cloudy lens and its replacement with a clear artificial intraocular lens (IOL).
The old advice to wait until a cataract is fully mature is outdated and, frankly, harmful. A hard, over-ripe cataract needs more ultrasound energy to break up, stresses the delicate corneal endothelium, and carries a higher risk of complications. Modern practice is to operate when the cataract begins to interfere with what you want to do — reading, night driving, recognising faces, working at a screen.
Equally, not every cataract seen on examination needs an operation today. If your vision is still comfortable for your daily activities, monitoring is entirely reasonable. Dr. Mithal will tell you plainly which situation you are in.
Cataracts develop slowly, and most people adapt without realising how much vision they have lost until it is measured. These are the common complaints:
The commonest form, usually after age 55. Nuclear sclerotic, cortical and posterior subcapsular subtypes each progress differently — posterior subcapsular cataracts in particular cause disproportionate glare and can affect people much younger.
Diabetes accelerates cataract formation by years. These eyes also need careful retinal assessment before surgery, because diabetic macular oedema left untreated will limit the visual result no matter how perfect the cataract surgery.
Following blunt or penetrating eye injury, sometimes years later. Often accompanied by weak zonular support, which needs a capsular tension ring and a surgeon comfortable with complicated cases.
Present at birth or developing in childhood. Requires urgent attention because the visual pathway is still forming and delay causes permanent amblyopia.
Following uveitis, retinal surgery or long-term steroid use. These eyes behave differently on the table and benefit from a surgeon with vitreo-retinal training.
A long-neglected, rock-hard or liquefied cataract. Still operable, but technically demanding and better managed before it reaches this stage.
Modern cataract surgery is phacoemulsification — the cloudy lens is broken into fragments with ultrasound and aspirated through an incision small enough that it seals itself without a stitch. Here is the pathway from first visit to final review:
Vision testing, slit-lamp assessment of the cataract's density and type, intraocular pressure, and a dilated retinal examination. If the retina cannot be seen through a dense cataract, a B-scan ultrasound confirms it is healthy underneath.
Precise measurement of your eye's axial length and corneal curvature calculates the exact lens power. This is where accuracy matters most — a good measurement is the difference between needing glasses afterwards and not.
An honest discussion of monofocal, toric, EDOF and trifocal options against your work, hobbies, driving habits, budget and tolerance for night-time glare. No pressure to take the premium option if a monofocal serves you better.
Blood sugar, blood pressure and cardiac fitness are confirmed. Antibiotic drops start a day or two before. You may eat a light meal — general anaesthesia is not used.
Under topical anaesthetic drops, a 2.2 mm incision is made, the front capsule opened, the lens emulsified and aspirated, and the folded IOL injected into the capsular bag where it unfolds into position. Fifteen to twenty minutes per eye, and you go home the same day.
A protective shield is placed. You will be given a drop schedule and a review appointment for the next morning. Most patients notice clearer vision within hours as the drops wear off.
Day one, week one and around week four. The second eye is usually operated one to three weeks after the first, once the surgeon is satisfied with the first eye's healing.
Recovery is quick and generally comfortable. Mild grittiness, watering and light sensitivity for a few days are normal. Vision is usually functional the very next day, and settles fully over four to six weeks as the eye stabilises and the final spectacle prescription is given.
The drops matter more than the rest — antibiotic and anti-inflammatory drops on a tapering schedule prevent the two things that spoil an otherwise perfect surgery: infection and inflammation.
The single largest variable in cataract surgery cost is the intraocular lens. The surgery itself is broadly the same; what changes is what you implant and what the hospital tariff is. Indicative ranges in Delhi NCR:
Indicative ranges for Delhi NCR as a guide only. Your written estimate is given after examination and depends on the technology, lens or drug used, hospital tariff and insurance cover. Most procedures are supported by cashless insurance at Max hospitals.
Retina, cataract, glaucoma and LASIK evaluations at Max Smart Saket, Max Panchsheel Park and Synergy Eye Care.
