Cataract: The Condition and Treatment

Cataracts affect the majority of women and men over 65, but this may be prevented with proactive care that may easily fit into your lifestyle without a burden. A cataract is like a haze that develops on your eye’s natural lens, much like having haze on your car’s windshield. Your lens is located behind the iris colored portion of your eye and is composed of water and protein. Your lens focuses light for your retina to see clearly.   Initially, you may not notice cataract signs unless you receive a professional eye exam. During a professional eye exam,  diagnostic tests may reveal what is not visible to your eyes yet. Over time, cataracts progress, appearing as an increased cloudy shade over your eye’s natural lens, if left untreated. In time, cataracts may become thick and appear white, yellow or brown. As less light reaches the retina, blurred vision results and people experience glare at night time around street lights and car tail lights. Ultimately, legal blindness may result which can be treated with cataract surgery. Though cataracts affect many seniors, people of any age may encounter a cataract, including:

•    Congenital Cataracts; appear by one year of age and must be treated promptly to prevent impairment of vision development.
•    Nuclear Cataracts, inhibit central vision.
•    Cortical Cataracts, located on the rim of the lens.

Cataract Surgery Offers Restored Vision
Cataract surgery offers a means to potentially restore reading, intermediate and distance vision, while restoring overall vision.So, the vast majority of people that receive prompt treatment may be able to drive, read papers, improve color visibility and see fine details in images more clearly, with potentially less glare from sunlight or bright lights at night.

Cataract Treatment Overview
Depending upon the progression of your cataract, there are several options for treatment. Early stage cataracts may be managed with eyeglasses. Early to mid-stage cataracts may be treated with traditional surgical or advanced microsurgical techniques, including: the placement of an intraocular lens which may reduce or eliminate the need for glasses, depending upon the type of lens, such as, Refractive Lens Exchange.

Cataract surgery is typically performed on an outpatient basis in a fully accredited surgical facility which may be located at your Ophthalmologist’s   surgical center or a hospital in which your Cataract Surgeon has earned privileges to perform cataract surgery. There are a variety of techniques that may be used to perform cataract surgery, depending upon the stage of the cataract, the preferred technique of the cataract surgeon, and the types of technology the cataract surgeon prefers to use in treatment.

The good news is that preventative steps can be taken to ensure you are comfortably sedated for the procedure and anesthetics help ensure you experience little discomfort over the 15 to 30 minutes time required to perform the procedure. Often, patients comfortably relax following treatment and return home within an hour or so. You will be provided with a list of pre and post-operative instructions which assist in optimizing recovery and healing. You may return to most normal activities very quickly, depending upon the technique used in the procedure and your condition.

Most ophthalmologists use state-of-the-art computer assisted and ultrasound technology to measure and calculate the appropriate power of the lens to best support your vision. The type of intraocular lens used in treatment also plays a role in the outcome of your procedure. In fact, you may need to qualify for specific types of lens based on your condition.  There have been great advancements in intraocular lens implants that have been approved by the FDA, based on clinical study results demonstrating safety and efficacy. The decision for the appropriate lens depends upon the type of improvements you would like to see, your lifestyle and your ophthalmologist’s professional recommendation based on your eye condition.

Lens Choices
There are lenses that focus on restoring focus power, but may still require you to use reading glasses for all reading activities. There are lenses that reduce or eliminate the need for reading glasses, known as monofocal or multifocal lenses. There are lenses that offer advantages for near, intermediate, and distant vision. Others still offer advantages for clearer vision in light and distances. There are other intraocular lenses that may also correct your astigmatism.  In the end, there may be as little as a 20% chance you’ll need to wear glasses and focus ability may be optimized when both eyes are treated. If both eyes do not require treatment simultaneously, you may learn ways to adapt to your new focus power with both eyes until the second eye requires cataract surgery.

Cataract Surgery Techniques
Your Cataract Surgeon may select a specific technique based upon the severity of your eye condition, your cataract surgeon’s expertise and the technology that he or she prefers to use in treatment. There are primarily two techniques that may be used cataract surgeons, as follows:

Phacoemulsification

Phacoemulsification offers a micro-surgical technique that typically takes 15 minutes to perform. During the procedure, your cataract gently dissolves due to sound waves produced by an ultrasonic probe. This technique offers the opportunity for your own eye to hold the intraocular lens in place.  Patients often comfortably return for most all activities the day after the procedure.

Extracapsular Cataract Surgery

Extracapsular cataract surgery is an approach available in practices that do not have micro-surgical technology. This approach may also be used for advanced cataracts in which the cataract is dense and must be surgically removed. This technique requires suturing the treatment area and then, intraocular lens placement. Patients may need to rest for the first days following treatment and may not resume normal activities for up to a week following the procedure. This is due in part, to the eye patch that is required to be worn following surgery.   This technique is primarily used in complicated cases.

Q and A with Your Cataract Surgeon
When you meet with your cataract surgeon to learn more about the appropriate technique and technology for your situation, it’s certain to be an eye opening experience.  Your experience will be similar to your regular comprehensive eye exam which always involves screening for cataracts and other eye conditions. Your consultation with your eye doctor will include, but is not necessarily limited to:
•    Review your medical history, including any medical conditions, as well as, pharmaceutical drugs and/or over the counter supplements you may be taking.
•    Reading the eye chart and having a visual acuity test.
•    Undergoing a Glare Test to measure the degree of glare you experience in different types of light.
•    Screening for your quality of vision in contrasting lighting and shading with a contrast sensitivity test.
•    Measuring your eye fluid pressure to screen for glaucoma with a Tonometry Test.
•    Analyzing the health of your eyes’ lens and retina by having your eye dilated which will rule out eye conditions.
•    Quantifying your degree of astigmatism and the appropriate power for your intraocular lens implant with enhanced computer assisted technology, offered in some practices.
•    Identifying your goals for enhancement, such as, whether you would like to reduce or eliminate your need for reading glasses.
•    Identifying what type of treatment and technology is appropriate for your condition.
•    Learn about alternatives to treatment and why they may not be appropriate for your situation.

The Questions for Your Cataract Surgeon
Reasonable expectations are always important in vision care. The results of cataract surgery generally lead to a satisfactory overall improvement in vision and an enhancement in lifestyle, but perfection cannot be the goal since your eyes were affected by a condition.  The following represents a list of questions you can ask your eye surgeon to help set reasonable expectations for the outcome of your cataract surgery.

•    What specifically is wrong with your eyes, including quality of vision in different lighting, near vision, intermediate vision and distance vision?
•    What is the proposed technique and how will be performed, such as, a microsurgical technique?
•    What is the proposed type of lens and how long has the technology been available?
•    How many times have you performed the procedure using the technology?
•    Why is this approach the best for me when compared to other alternatives?
•    What will this treatment plan not be able correct?
•    What types of outcomes have you witnessed in patients who select this lens and technique?
•    What type of compensation skills may I require if I experience a suboptimal outcome from treatment?
•    If I am only having one eye treated, when will my eyes adjust to my new vision and is there anything I can do to assist in this process? When do you suspect that I’ll be able to have my other eye treated to assist with balancing overall focus power?
•    If I require a touch up over time, will you be the one performing the treatment?

Next Visit, How to Choose Your Eye Doctor

 

It is important to recognize that all information contained on this website cannot be considered to be specific medical diagnosis, medical treatment, or medical advice. As always, you should consult with a physician regarding any medical condition. Your Health Access disclaims any liability for the decisions you make based on this information.