Cataract

Overview

Cataracts can interfere with your vision and quality of life. Thankfully, cataract surgery has become a much easier, less invasive procedure than it was years ago with better outcomes for most patients. Our highly specialized cataract surgeons are recognized as leaders in their field. They offer the most advanced treatment procedures and provide you with the highest quality care. Our patients often experience life-changing improvement in vision.

A cataract is a clouding of the eye’s natural lens that can interfere with your vision and is considered the most common cause of vision loss around the world. If you have a cataract, your vision may become blurry, cloudy and you may experience increased glare. Having cataracts has been described as looking through a foggy window. 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. A cataract is not a tumor or growth. Vision can only be restored by surgical removal of the natural lens. More than three million cataract operations are performed each year in the United States.
Many people who have undergone cataract surgery at one of our ambulatory surgery centers find that their vision is not only better than it was prior to surgery, but better than it has been throughout their lives.

If you are experiencing symptoms of a cataract or you are at risk for developing cataracts, schedule a comprehensive eye exam today.

Who is at risk?

Aging is the biggest risk factor for cataracts. In fact, cataracts are considered a natural part of the aging process.  As we age, the lens inside the eye, which is made mostly of water and protein, becomes cloudy and hardens. The protein part of the lens may clump together, preventing light from coming through the lens causing cloudy vision.  Aging changes vary from person to person. Some people may develop cataracts as early as 40, while others are much older. By the age of 80, most Americans either have a cataract or have had cataract surgery, according to the National Eye Institute.

You may be at risk for developing cataracts at an earlier age if you:

  • have diabetes
  • have a family history of cataracts
  • extensive exposure to sunlight
  • smoke
  • are obese
  • have high blood pressure
  • have had a previous eye injury or surgery
  • have used steroid medications long term

Cataracts cannot be prevented. However research shows that you may be able to slow down the progression of a cataract, by taking certain measures such as wearing sunglasses and a hat or visor to protect your eyes from the sun’s ultraviolet rays. Quitting smoking may also help.

Symptoms & Diagnosis

As a cataract begins to develop, you may not notice any changes in your vision at first. People often notice glare as one of the first symptoms.  Other common symptoms of cataracts:

  • Vision becomes cloudy, colors are dull
  • Glare while driving at night or in the bright sun
  • Halos or lines of light around a point source such as headlights
  • Increased light sensitivity
  • You may need brighter lights to read, see faces or enjoy your hobbies

Cataracts are diagnosed during your dilated eye exam. Your OCB eye doctor will see clouding of your lens on physical examination.  Testing will include checking visual acuity, refraction and sensitivity to glare. With glare testing, you will look at an eye chart and lights are introduced that simulate nighttime glare or sunlight.

Treatment

In the beginning stages, when symptoms are mild, treatment may involve a change of prescription for glasses. But once you find cataracts interfering with your day to day life, your OCB eye doctor will likely recommend that you consider cataract surgery, which is the only treatment for cataracts. There are no medications or eye drops that will cure cataracts.

At OCB, educating patients about cataracts play an important role in our approach to treatment. Decisions surrounding when and at what stage cataract surgery is most appropriate vary from patient to patient depending on symptoms they experience, and their individual needs and concerns. We take the time to understand your unique situation and provide you with the information you need to make a decision you are comfortable with, that will give you with the best possible outcome.

New technology and advances in treatment methods for cataracts have turned what was at one time a lengthy in-patient operation into an outpatient procedure with a significantly swifter recovery and significantly better outcomes for patients.

Cataract surgery has become a much easier, less invasive procedure than it was years ago. The procedure we use to remove cataracts is called phacoemulsification. In phacoemulsification, ultrasound energy gently fragments the large hard center (nucleus) of the cataract and allows it to be aspirated through a small instrument. Once the natural lens is removed, a new artificial intraocular lens (IOL) is placed to focus light on the back of the eye providing clear vision. The incision is very small (about 2-3 mm) and self-sealing so sutures are generally not required. The small incision greatly speeds up the healing process after surgery and improved visual outcomes.

In the last 40 years, tens of millions of IOLs have been implanted.  IOLs affords vision that is closest to natural.

Risks of cataract surgery

An element of risk exists in any surgical procedure and complications can occur during surgery or in the healing phase after surgery, despite the best care.

Complications associated with cataract surgery can include blockage of blood vessels, retinal detachment, corneal swelling, macular swelling, bleeding and infection. A very rare complication is the possibility that the intraocular lens will require removal or repositioning. After cataract surgery, well over 90% of patients see significantly better. If patients who are known to have retinal disease are excluded from this group, the success rate is even higher, approaching 98%. Your doctor will discuss with you risks specific to your care prior to surgery.

At OCB we strive for excellence in every aspect of your care. We have highly experienced Board Certified cataract surgeons with complication and infection rates that are well below the national average.

Intraocular Lenses (IOLs)

What is an IOL and how does it work?

An IOL replaces your natural lens that contains the cataract. An IOL focuses light that comes into your eyes through the cornea and pupil onto the retina, the sensitive tissue at the back of the eye that relays images through the optic nerve to the brain. Most IOLs are made of a flexible, foldable material and are about one-third of the size of a dime.

How will my doctor know which IOL is best for me?

Your IOL will contain the appropriate prescription, or lens power, to give you the best vision possible, much like a prescription you would have for glasses. The appropriate IOL lens power is determined by measuring the curvature of your cornea and the length of your eye. The technology we use to obtain these measurements has improved tremendously in recent years. The information gathered is entered into an in-office computer programmed to calculate your correct implant power. These advances and computer formulations enable our highly experienced surgeons to be more precise in accuracy than ever before in determining IOL implant power.

What are the different types of IOLs available?

The type of IOL implanted will affect how you see when you are not wearing eyeglasses. Glasses may still be needed by some people for some activities. In certain cases, cost may be a deciding factor for you if you have the option of selecting special premium IOLs that may reduce your dependency on glasses.

The following are the different types of IOLs that are available:

Monofocal lens: This common IOL type has been used for several decades. Monofocal IOL, a singular focus lens, are set to provide best corrected vision at near, intermediate or far distances. Most people who choose monofocals have their IOLs set for distance vision and use reading glasses for near activities. On the other hand, a person whose IOLs were set to correct near vision would need glasses to see distant objects clearly. Insurance covers monofocal  IOLs.

Multi-focal and accommodative lenses. These newer IOL types may reduce or eliminate the need for glasses or contact lenses.  Multifocal IOLs are designed with a series of focal zones or rings.  When incoming light focuses through the zones, you may be able to see both near and distant objects clearly. The design of the accommodative lens allows certain eye muscles to move the IOL forward and backward, changing the focus much as it would with a natural lens, to see both at near and distance vision. Each person’s success with these IOLs may depend on the size of his or her pupils and other eye health factors. The ability to read and perform other tasks without glasses varies from person to person. However, in recent years, with improvements in technology that enable us to more accurately predict lens power, we have been able to get more and more patients independent from glasses. These premium lenses are not covered by insurance. Talk to your OCB eye doctor about your unique situation and whether these lenses are an option for you.

Toric IOL. This is a monofocal IOL, with astigmatism correction built into the lens. Astigmatism distorts or blurs the ability to see both near and distant objects. The cornea of a person with astigmatism is oval in shape and requires more optical correction. People with significant degrees of astigmatism are usually very satisfied with toric IOLs. Insurance does not cover this type of IOL. There are other alternatives to correcting astigmatism such as glasses or contact lenses after surgery that your OCB eye doctor can discuss this with you.

OCB’s Cataract Team