What are cataracts?
Cataracts are a clouding of the natural lens which leads to poor vision.
top, normal clear lens
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?
- 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