Cataract

cataract_001A cataract is a common condition that causes vision loss due to a clouding of the lens of the eye. Cloudiness develops as a result of a buildup of protein in the lens that prevents light from reaching the retina. Cataracts affect millions of people each year, including more than half of all Americans 60 years of age and older.

Causes of Cataracts

The lens within the eye clouds naturally as we age, causing a gradual reduction of vision. There are numerous other causes of cataracts, including:

  • Injury
  • Medication
  • Illness
  • Diabetes
  • Excessive alcohol use
  • Prolonged exposure to ultraviolet light
  • Smoking
  • Family history of cataracts
  • Exposure to radiation
  • Eye Surgery

Diagnosis of Cataracts

A series of tests are performed in order to diagnose a cataract. Some of these tests may include:

  • Dilated eye exam
  • Visual acuity testing
  • Measurement of the refractive condition (spectacle correction)

Symptoms of Cataracts

Patients with cataracts often do not experience any symptoms when the condition first develops. As cataracts progress patients may experience one or more of the following symptoms:

  • Blurry or hazy vision
  • Double vision
  • Faded colors
  • Poor vision in bright light
  • Halos or starbursts around lights
  • Poor night vision
  • Yellowish vision
  • Frequent changes in eyeglass or contact lens prescriptions

Non-Surgical Treatment of Cataracts

Early cataracts can sometimes be treated with non-surgical methods which may include:

  • New eyeglass prescription
  • Anti-glare sunglasses
  • Magnifying lenses
  • The use of stronger lighting
If cataracts begin to interfere with the ability to read, work, exercise or drive, cataract surgery may be recommended. During cataract surgery the clouded natural lens is replaced with a new artificial lens or intraocular lens.

Cataract Surgery

Cataract surgery is a minimally invasive procedure that is typically performed on an outpatient basis using local anesthesia. The procedure takes approximately 30 minutes or less to complete and usually includes the implant of an artificial lens to replace the natural lens of the eye. While there are non-surgical methods that can be used to delay surgery, especially when the cataract is fairly new, the only effective cataract treatment is surgery.

Types of Cataract Surgery Provided

Currently, there are two approaches to cataract surgery that are being used. They are:

(Standard and Femtosecond Laser-Assisted)

Phacoemulsification, also known as phaco, involves inserting a probe into a small incision made on the side of the cornea. The probe emits ultrasound waves that cause the lens to break into smaller fragments, which are then removed by suctioning. The thin outer membrane of the lens remains intact. The Femtosecond Laser uses concentrated light energy to make precise cuts before phacoemulsification is initiated. This technology has significantly improved the consistency of the various steps of the cataract surgical procedure.

Extracapsular

Extracapsular surgery is rare and requires a larger incision in the cornea so that the lens may be removed in one solid piece. This procedure is usually performed when it is determined that the cataract is unable to be broken up by the phacoemulsification procedure.

Risks of Cataract Surgery

While rare, some of the risks of cataract surgery may include:

  • Incomplete removal of the lens fragments
  • Infection
  • Bleeding
  • Swelling of the cornea
  • Retinal Detachment

Pre-Surgical Testing for Cataract Surgery

Serious eye conditions and medical history should be discussed with the physician prior to undergoing cataract surgery. Before the surgical procedure, the following tests are essential:

  • Complete eye exam
  • Measuring the curvature of the cornea (topography)
  • Measuring the size and shape of the eye

The Cataract Surgery Procedure

Patients are asked not to eat or drink anything for 6-8 hours prior to surgery. At the surgical facility, drops are placed into the eye to dilate the pupil. Depending on the condition of the cataract, and the desired outcome , standard or Femtosecond Laser-Assisted phacoemulsification will be performed.

Once the natural lens has been removed, an artificial lens, also known as a prosthetic intraocular lens or IOL, is implanted. The IOL is a clear acrylic or silicone lens that focuses light onto the retina. The IOL selection depends on the patients eye and the desire to decrease or eliminate dependence on eye-wear for various visual tasks after cataract surgery. Advancing technology now allows the surgeon to use multi-focal or accommodating prosthetic intraocular lens replacements to improve distance vision while providing near vision capacity.

Post-Operative Cataract Surgery Care

Patients return home on the same day, but need an escort. Medication will be prescribed to prevent infection, inflammation and,  in rare cases, eye pressure rise. We urge you to call the office at any time if there are any questions or problems. Please avoid rubbing the eye, swim, or get exposed to air-borne contaminants after surgery.

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