Cataracts
What is a cataract?
A cataract is a clouding of the natural lens in the eye that affects the clarity of visual images on the retina. Proteins in the lens tissue decompose over time making aging the most common cause of cataracts but cataracts also occur as a result of trauma, diabetes, steroid use and previous eye surgery.
Do cataracts spread from one eye to the other eye?
No. In age related cataracts, the clouding effect is directly related to the development and clumping of decomposing proteins in the lens tissue of a specific eye. This process can be different in each lens of each eye so the cataracts may develop sooner in one eye, later in the other. Most age related cataracts gradually develop over a number of years.
If a cataract is the result of trauma, only the affected eye will have a cataract. Cataract formation from diabetes or steroid use is usually found in the lenses of both eyes as they are with age related cataract development.
What are symptoms of cataracts?
The common complaints of patients with cataracts include blurry vision, hypersensitivity to glare and lights, poor night vision, difficulty with street sign images and words on a television screen and believing areas and objects, like a book page, always need more light.
Cataract complaints will vary among different patients who experience different symptoms of varying degrees. If the cloudiness from the cataract is not at or near the center of the lens, you may not experience any symptoms at all.
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Can cataracts be prevented?
There are no eye drops, medicines, dietary supplements or eye exercises that can prevent or cure cataracts. However, limited exposure to ultraviolet light and always protecting your eyes when outside is highly recommended. If you are developing cataracts, this will slow the progression.
How are cataracts treated?
Initially, patients with cataracts are prescribed glasses to improve their vision. If vision loss becomes significant, surgical removal of the clouded lens is recommended. After the cloudy lens is removed, a clear, plastic intraocular lens is implanted which then becomes a permanent part of the eye. This new intraocular lens can either be a traditional, monofocal lens or a new option - a multifocal lens implant.
What are the advantages of having a multifocal intraocular lens?
Multifocal intraocular lenses which are sold as ReSTOR, ReZoom and Crystalens focus light more like a healthy eye. Unlike the standard monofocal lens which provides clear vision only at a single, predetermined distance, the multifocal lens allows the eye to focus fairly well at near, intermediate and far distances. As a result, 80% of patients who request these new lenses do not have to wear glasses following cataract surgery.
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Are there any disadvantages associated with a multifocal intraocular lens?
Halos and glare are more common with multifocal lenses than standard monofocal lens implants. Medicare and some insurance companies will not pay for multifocal lenses. Patients who request these intraocular lenses are responsible for the additional cost.
Does a cataract have to be “ripe” before it is removed?
In the past, cataracts were removed only if they were ripe or totally opaque and the patient was almost blind. However, with modern surgical techniques, including ophthalmic microscopes and lens implantation, a cataract does not have to be ripe before it is surgically removed. If you have cataracts and are dissatisfied with the quality of your vision, the appropriate time for cataract surgery has arrived.
Do you do cataract surgery in both eyes at the same time?
If a patient needs cataract surgery in each eye, surgery on the eye with the worst vision should be preformed first. After this eye is completely healed, cataract surgery is performed on the second eye. If the second eye has limited or no cataract symptoms, surgery is delayed until the vision in that eye worsens.
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Is cataract surgery done with a laser?
No. The cloudy lens is disintegrated with ultrasound waves and removed through a small incision. A laser can be used several months or years after the original cataract surgery if clouding of the posterior lens capsule appears. This procedure is known as posterior capsulotomy. A laser creates an opening in the cloudy lens capsule to restore normal sight.
What is the difference between cataract surgery and LASIK?
Cataract surgery completely removes a cloudy lens of the eye. LASIK is a surgical procedure reshaping the cornea to correct nearsightedness, farsightedness or astigmatism. These are two completely different types of surgery that accomplish a goal of improved vision.
If my ophthalmologist recommends cataract surgery, what can I expect?
Over one million cataract surgeries are performed annually in America with a very low rate of complications. The procedure requires an hour or less. It is performed at an ambulatory surgical center where an ophthalmologist has state of the art micro-surgery technology. The patient is awake during the procedure. Local anesthesia is applied. Intravenous sedation may be given to ensure complete comfort. Eye medications are required until the eye is healed. During follow-up examinations, your surgeon will check your eye to be certain it is healing properly. When the recovery process is complete, you will be measured for a prescription for glasses if they are necessary.
Cataract surgery is a very successful procedure. More than 95% of all patients have improved vision.
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