CATARACT SURGERY
What
is a cataract?
What are symptoms of a cataract?
Why do cataracts form?
How is a cataract detected?
How are cataracts treated?
What is cataract surgery like?
Do I have to wait for my cataract to be "ripe"
before surgery?
What are the risks?
How soon can I get back to my regular activities?
Does a cataract come back?
What is a cataract?
Normal
Lens vs. Cloudy Lens |
A cataract is
a clouding of the eye's normally clear lens. The lens is behind
the iris (the colored part of the eye), and helps to focus the image
for clear vision. With age, and sometimes as a side effect of some
medications, the lens becomes clouded with deposits. This clouding
in the lens results in blurred vision.
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What are symptoms of a cataract?
Cataracts result
in:
- Painless
loss of vision
- Changes
in eyeglass prescription needs
- Glare
and light sensitivity
- Reduced
night time vision
- A
need for brighter light to read
- Loss
of color vision clarity
Cataracts are
not:
- A
film over the outside of the eye
- A
result of eye overuse
- Untreatable
While cataracts
often affect both eyes, sometimes only one eye is affected. It is
common for one cataract to be more dense, resulting in poorer vision
in one eye compared to the other.
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Why do cataracts form?
Most often,
cataracts occur as a natural consequence of aging. Opacities form
to a greater or lesser degree in everyone with age. A family history
increases the risk of cataracts. Cataracts are also caused by:
- Some
medical problems, like diabetes
- Direct
injury to the eye
- Medications,
such as eye drop, inhaled or oral steroids like prednisone
- Lifetime
ultraviolet light exposure (sunlight)
- Previous
internal eye surgery
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How is a cataract detected?
A comprehensive
eye examination by an eye care professional (ophthalmologist or
optometrist) can detect the presence and extent of a cataract. There
can also be other reasons for worsened vision. Optic nerve disease,
such as glaucoma, and retinal diseases, such as macular degeneration,
can be evaluated during your exam. If another disease is present
with a cataract, perfect vision may not be restored after removal.
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How are cataracts treated?
At first, it
may be possible to simply change your glasses prescription to enjoy
some improvement in vision as a cataract worsens. Eventually, a
cataract can progress enough that surgery is necessary for better
sight. Cataract surgery is done when you can no longer see well
to do activities that you need or want to do. When driving or reading
becomes difficult, or when recreation activities or employment is
impaired due to cataracts, it is reasonable to have surgery. It
is not possible to treat cataracts with medication.
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What is cataract surgery like?
Cataract surgery
is done as an outpatient procedure. It can be done in a hospital
or free-standing surgery center. While the surgery itself rarely
takes more than 30 or 40 minutes it is typical for a patient to
spend an hour in preparation before surgery at the center, and an
hour recovering afterwards. A three hour total stay is probably
typical. During the surgery you will receive some sedative medication,
so you will feel relaxed and
not anxious, and pain controlling medication.
Your eye will be treated with drops, or possibly an injection of
medication around the eye to insure it is well numbed. The cataract
is removed with a tiny incision and an ultrasonic instrument. Once
the cataract is safely removed an intraocular implant is placed
in the eye. This lens implant makes up for focusing power lost when
your biologic lens is removed.
Intraocular
Lens Implant
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Do I have to wait for my cataract to be "ripe"
before surgery?
The concept
of a "ripe" cataract is based on older surgery techniques.
Surgery is done when your vision is reduced enough that you need
help to see better.
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What are the risks?
This is important
to discuss with your doctor before surgery. Any surgery can result
in problems that can leave you with the same or worsened vision.
In general, the chance of problems is probably around 4-5%. This
means that 95% of patients have some (or a lot of) vision improvement.
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How soon can I get back to my regular
activities?
Some surgeons
suggest you not lift heavy objects or engage in strenuous activity
for a while after surgery (typically three to four weeks). Many
surgeons do not restrict your activity in any way, except maybe
to limit swimming for a few days. It does take a few weeks to accurately
tell what glasses will work best to supplement vision for distance
and/or reading, but during that time you can resume virtually all
of your regular activities.
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Does a cataract come back?
Once a cataract
is removed it is not physically possible for it to reform. A membrane
left inside the eye and around the implant can become clouded at
times, however. It is estimated that 20 to 50 % of patients have
membrane clouding after surgery which can reduce their vision, much
like the original cataract. Fortunately, this can be easily solved
with a special laser that can open a hole in the membrane and restore
their vision.
Phacoemulsification
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