Cataracts and Cataract Surgery

What are cataracts?

Cataracts are a clouding of the natural lens which leads to poor vision.

top, normal clear lens

Illustration comparing two lenses from eyes. The top lens is clear, like a healthy, normal lens. The bottom lens is clouded by a cataract.

bottom, cloudy/cataract lens.

What causes cataracts?

  • Birthdays!       Everyone, no exceptions, will develop a cataract if they live long enough.
  • Diabetes contributes to cataracts forming at a younger age and progressing more quickly.
  • Trauma, such as a hard hit to the eye can cause a cataract to develop rapidly.
  • Medication, primarily oral steroids for long periods of time (months), rarely inhaled steroids or injectable steroids.
  • UV or sun exposure contributes to faster devolopment of age related cataracts. If you are putting on sun screen you should be putting on a hat with a visor and wearing sunglasses also.
  • Prior eye surgery, in particular retina surgery when a vitrectomy is performed (removal of jelly sac from eye)
  • Unfortunately, some infants are born with cataracts known asCongenital cataracts.

What are the symptoms of cataracts?

 

                           Image result for starburst cataracts

  • Decreased vision in general.
  • Poor night vision, especially with glare off of oncoming headlights.
  • Trouble reading especially in low light.
  • Seeing halos around lights
  • Fading color perception
  • Rarely double vision in one eye.

What is the Treatment for cataracts?

  • Sometimes, all that is needed is an update in your glasses. Changing a glasses prescription may make a dramatic improvement in one's vision negating the need for surgery.
  • If changing glasses doesn't help and your impaired vision interferes with your usual daily activities you might need cataract surgery.
  • Surgery is typicallly recommended when you can't read normal newsprint with glasses and/or you can't pass a driver's license exam with glasses. Usually, this means best corrected vision of 20/40 or worse. Surgery may be offered at an earlier point if the patient has glare symptoms with night driving.

What is Cataract Surgery and what does it entail?

  • Modern cataract surgery is one of the most common and safest surgeries performed in the US today.
  • Cataract surgery is a 10 to 15 minute out patient procedure perfomed with eye drop anesthesia and IV sedation.
  • The cataract (cloudy lens) is removed through a very small incision with an ultrasonic instrument.
  • A new artificial lens is placed in the eye in the same position the natural lens occupied. This lens is permanent and should last a lifetime.
  • Most patients will see better within a few days athough it can take up to one month and change in glasses to achieve best vision
  • You will be on a combination of drops for 4 to 5 weeks after surgery to prevent infection and ensure proper healing.

What are the Risks of cataract surgery?

  • Cataract surgery is one of the safest operations performed today, but like any surgery there are still risks.
  • Bleeding, infection, swelling, decreased vision are very rare. Even more uncommon is lens dislocation or retinal detachment.
  • Statistically the chance of losing even a small amount of vision with cataract surgery is less than one in 2500 surgeries.
  • Your surgeon is committed to doing everything possible to minimize risk but we can never say there is no risk with any surgery.

When should I have surgery?

  • There is not a magic point where every cataract has to be removed.
  • Cataract surgery may be recommended when the patient is having difficulty with perorming routine daily activiities such as driving, reading, cooking, hobbies et.... This is usually at a vision of 20/40 or worse. Significant glare symptoms with night driving can also warrant cataract surgery.
  • The final decision is always up to the patient. Whether cataract surgery is done immediately or 6 months to a year later the result should be the same. Delaying cataract surgery typically does no harm to the eye. In rare circumstances such as a very advanced cataract in a glaucoma paitent surgery may need to be done sooner rather than later.

What type of cataract surgery and lens implant are the best?

  • All modern cataract surgery requires a small incision and use of an ultrsonic instrument (phacoemulsification) to remove the cataract.
  • Laser assisted cataract surgery is available but is not covered by insurance because it has not been proven to be any better than standard cataract surgery.
  • Alamo City Eye Physicians have chosen not to offer "Laser assisted" cataract surgery because of the additional cost to our patients and the lack of clear evidence that it is a better procedure.
  • Premium or high technology lenses