What is a Cataract?
A cataract is a clouding of the normally clear lens in your eye. This causes images to appear cloudy, as if you are looking through a foggy window.
Clouded vision caused by cataracts can make it more difficult to read, drive a car (especially at night), or distinguish the details of a face from a distance.
Most cataracts develop and progess slowly. They may not disturb your eyesight early on, but with time, cataracts will eventually interfere with your vision.
At first, brighter lighting and eyeglasses can help you overcome the blurred vision caused by cataracts. However, if glasses don't work and the impaired vision interferes with your usual activities, you might need cataract surgery. Fortunately, cataract surgery is generally a safe, effective procedure.
Why Do Cataracts Form?
The lens is made mostly of water and protein. Specific proteins within the lens are responsible for maintaining its clarity. Over many years, the structures of these lens proteins are altered, ultimately leading to a gradual clouding of the lens. Rarely, cataracts can present at birth or in early childhood as a result of hereditary enzyme defects, and severe trauma to the eye, eye surgery, or intraocular inflammation can also cause cataracts to occur earlier in life. Other factors that may lead to development of cataracts at an earlier age include excessive ultraviolet-light exposure, diabetes, smoking, or the use of certain medications, such as oral, topical, or inhaled steroids. Other medications that are more weakly associated with cataracts include the long-term use of statins and phenothiazines.
Cataracts Facts
- The term cataract is derived from the Greek word cataractos, which describes rapidly running water. When water is turbulent, it becomes white and cloudy.
- Cataract development is usually a gradual process of aging, but can sometimes occur rapidly. Some people may be unaware that they have cataracts because the change in vision was so gradual. Cataracts commonly affect both eyes, but they can progress asymmetrically.
- Cataracts affect ~60% of people over the age of 60, and over 1.5 million cataract surgeries are performed in the United States each year. This leads to over 8 million physician office visits a year in the United States. This number will likely continue to increase as the proportion of people over the age of 60 rises. Worldwide, cataracts are the #1 cause of reversible blindness.
- Cataracts cause difficulty with activities people need to do for daily living or for enjoyment. Some of the most common complaints include difficulty driving at night, reading, participating in sports such as golfing, or traveling to unfamiliar areas.
Cataract Surgery
Cataract surgery is a procedure to remove the lens of your eye and, in most cases, replace it with an artificial lens. Cataract surgery is performed by an eye doctor (ophthalmologist) in an outpatient surgery center, which means you don't have to stay in the hospital after the surgery. Your eye will be anesthetized prior to surgery so that you do not experience any pain. An anesthesiologist will provide intravenous sedatives to help you relax during the procedure. A clear, plastic shield will be taped over your eye to protect it after the surgery. Your vision may be better the following day when you return for a check-up, however, the vision may take a few additional days to clear. You may still need to wear glasses to obtain the very best vision, although new lens technologies make it possible to reduce your dependence on glasses. Cataract surgery is very common and is generally a safe procedure.
Intraocular Lens Options
MONOFOCAL
Monofocal lenses are the most commonly used intraocular lens and this is most likely due to the fact that their cost are covered by Medicare and Insurance as a part of the cataract surgical procedure. Some patients may not need glasses after implantation of a monofocal lens. However, the vast majority of patients still need glasses or bifocals to get the best vision.
MULTI-FOCAL
ReSTOR® intraocular lenses use apodization and refractive and diffractive technology to interpret the amount of light entering the eye and focus it on the appropriate part of the retina. ReSTOR® IOLs allow patients to see clearly at any distance – 4 out of 5 patients who receive ReSTOR® lenses do not need glasses or bifocals.
TORIC
Toric intraocular lenses are used specifically to treat astigmatism in cataract patients. This new development has helped many patients reduce the amount of astigmatism after cataract surgery resulting in better vision. Most patients still need glasses for near.
Surgery Risks & Safety
- While cataract surgery is one of the safest procedures available with a high rate of success, rare complications can arise.
- Complications can include pain, infection, inflammation, bleeding, swelling of the retina, retinal detachment, need for further surgery, loss of vision, or even loss of the eye. Fortunately, modern day cataract surgical techniques and medications make these complications extremely rare.
- Antibiotics and anti-inflammatory medications are typically started before and continued after surgery.
- Blood thinners like aspirin, coumadin, plavix, vitamin E, and fish oil (just to name a few), rarely have to be stopped before surgery.
- Patients should not eat or drink anything 6-8 hours before their surgery.
- Patients should plan to arrive one to one and 1/2 hours before their surgery time.
- Transportation from the surgery center will need to be pre-arranged prior to arriving at the surgical center. Because sedation is administered, operating a motor vehicle is prohibited immediately after surgery.