A cataract is a clouding of the eye’s natural lens. Depending on the degree of cloudiness, a cataract can cause a little blurring or severe loss of vision. The rate at which a cataract progresses is highly variable. It is not a tumor or growth. It is not a film over the eye that can be peeled away. Vision can only be restored by surgical removal of the lens. One out of every fifty people will find it necessary to have this cloudy lens removed. More than three million cataract operations are done each year in the United States.
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The majority of cataracts form later in life as part of the aging process. Some people develop cataracts earlier than others without any other eye problems. Cataracts can develop as a result of injury, eye disease, systemic problems (such as diabetes), side effects from certain medications, and in some rare cases babies are born with them. Cataracts are not caused or worsened by reading, watching too much television, sewing, or any other visual activity. Limiting your visual activity will not slow down the progression of a cataract.
The only treatment at present for cataracts is surgical removal. There are no medications that can be taken to stop cataract formation. There are several ways of removing a cataract. Today, due to advances in microsurgical instrumentation and techniques, phacoemulsification is the preferred method in most instances. This type of operation retains the thin clear capsule surrounding the cataract to help protect the retina and support an intraocular lens, which is placed at the time of surgery.
In phacoemulsification, ultrasound energy gently fragments the large hard center (nucleus) of the cataract and allows it to be aspirated through a small instrument. Because the incision is very small (about 2-3 mm), it can be surgically constructed as a self sealing valve. Often no stitches are required to close the incision. The small incision greatly speeds up the rate of healing after surgery and permits a rapid, full recovery. Recently, the femtosecond laser has been approved to perform parts of the cataract surgery along with the ultrasound machine to improve safety and outcomes.
Once the natural lens is removed, a new artificial intraocular lens (IOL) must replace it to focus the eye and provide clear vision. In the last 40 years, tens of millions of implants have been implanted. Under normal circumstances, an intraocular lens never needs to be replaced. It affords vision that is closest to natural and is used for the vast majority of our patients. However, even with an IOL, most patients still need to rely on spectacles or contact lenses for some distances.
For more detailed information on Cataracts and Cataract Surgery click here to read our Cataract Surgery booklet