What is a cataract?

A cataract is a clouding or opacification of the naturally clear lens inside the eye that causes blurred or foggy vision or glare. It is not a visible film or growth over the outside of the eye. The word "cataract" actually means "waterfall" - as if one were looking through a waterfall.

Patients with cataracts may notice one or more of the following symptoms:

• a painless decrease in vision
• light sensitivity or glare with decreased vision in sunlight, or from oncoming headlights
• frequent eyeglass prescription changes
• double vision in one eye
• needing brighter light to read
• poor night vision with glare, halos, or starbursts
• fading or yellowing of colors

There are two basic types of cataracts; the slower growing "nuclear" type in which the entire lens turns yellow-brown, and the faster growing "subcapsular" type which affects younger people, those with diabetes, and patients taking cortisone.

What causes cataracts?

No one knows exactly what causes cataracts. Although cataracts can occur at any age, most are associated with aging. Other causes (especially of the faster growing type) are:

• diabetes
• medications such as cortisone
• injury to the eye
• previous eye surgery
• long-term exposure to sunlight or other sources of ultraviolet or infrared
• a family history of cataracts in early adulthood

How do I know if I have a cataract?

You will probably notice a decrease in vision and/or glare and halos.  You may be unable to perform the tasks that you need or want to do. Changes in your eyeglass prescription will no longer improve your vision.  

A thorough eye examination by your optometrist and our surgeons can detect the presence and nature of a cataract, as well as other conditions that also may be causing altered vision. Other reasons for visual loss in addition to the cataract may involve problems with the cornea, the retina, the blood vessels in the back of the eye, or the optic nerve. If these other conditions are present in addition to the cataract, you will likely experience an improvement in vision, but not perfect vision following cataract surgery.  We will explain to you and your family the details of your situation after a thorough exam.

How is a cataract treated?

Surgery is the only way that a cataract can be treated. There are no pills or drops, vitamins, exercises, or lenses that have been shown to prevent or cure cataracts. However, if symptoms from a cataract are mild, a change of glasses may be all that is necessary for you to function more comfortably as the cataract progresses.  Protection from excessive sunlight may help prevent or slow the progression of cataracts. Sunglasses that screen out ultraviolet (UV) light rays or regular eyeglasses with a clear, anti-UV coating offer this protection. If surgery is required, it is comforting to know that cataract surgery is safe and extremely effective in restoring vision. In fact, cataract surgery has the highest success rate of any surgery!

When should I have surgery?

Cataract surgery should be considered when cataracts cause enough loss of vision or disturbing glare to interfere with your daily activities.  It is no longer the case that cataracts must be "ripe" before they can be removed. In fact, with today's modern techniques, it is undesirable to wait until the cataract is "ripe".
Cataract surgery can be performed when your visual needs require it. Only you can decide if you can see well enough to do your job or drive safely, or if you can read and watch TV in comfort. Can you see well enough to perform daily tasks, such as cooking, shopping, yard work, or taking medications without difficulty? Can you see well enough to sew, knit, play cards, golf, or bowl?  Sometimes we remove the cataract in order to follow chronic conditions within the eye such as diabetic retinopathy or other retinal or optic nerve conditions such as glaucoma.
 
Based on your symptoms and daily visual needs, as well as other underlying eye conditions, you and your family, along with your optometrist and Optima surgeon’s guidance will decide when surgery is appropriate.

What can I expect from surgery?

About 2 million people a year have cataract surgery in the United States. Our surgeons are among the most experienced in the country. Cataract surgery is performed under local anesthesia at our Federally-certified and State-licensed ambulatory surgery center located within our office. Our center was the first outpatient surgery center in the United States to be certified by Medicare and has been in continuous operation since 1981. Because our center specializes in eye surgery, our highly-trained staff is dedicated to ensuring the highest level of care. We use only state-of-the-art equipment in our warm and comfortable environment.  Before surgery we communicate with your primary care physician.

During surgery you will be awake, but relaxed.  An anesthesiologist will be at your side. We perform this intricate surgery using a microscope, microsurgical instruments, and the latest technology employing radar waves through a small incision. The focusing power of your eye is restored by replacing the cataract with a permanent intraocular lens implant. We can even use multifocal implants that allow both distance and near, or distance and intermediate vision if the patient desires. In most cases, sutures are not needed. 

After cataract surgery, you may return almost immediately to all but the most strenuous activities. We will provide you with written instructions and a helpful guide on the use of eyedrops following your surgery.  Several post-operative visits are needed to check on the progress of the eye as it heals. 

Cataract surgery is a highly successful procedure. However, it is important to understand that complications can occur during or after the surgery, some severe enough to limit or lose vision. Fortunately, in our hands, improved vision is the result in over 99% of cases unless there is a pre-existing problem with the cornea, retina, or optic nerve.

In approximately 15% of people having cataract surgery, the natural capsule that supports the intraocular lens will become cloudy within 6 to 24 months following surgery.  In these cases where part of the cataract grows back, the YAG laser is used to painlessly open this cloudy capsule, restoring the clear vision. This is performed as an outpatient procedure at our office.

Conclusion

Cataracts are a common cause of poor vision, particularly for the elderly, but they are treatable. Our experienced surgeons can tell you whether a cataract or some other problem is the cause for vision loss, and help you decide if cataract surgery is appropriate for you. If you elect to undergo surgery, you have an extremely high chance of experiencing greatly improved vision.