Cataracts

A cataract is a clouding of the natural lens inside our eye. As we age, changes occur to our lens which cause discoloration of the lens, as well as thickening of the lens. These changes cause our eye to lose the ability to clearly focus light on the retina in the back of our eye, which leads to blurry vision.

Most often, cataracts are just a part of the normal aging process. However, sometimes cataracts can be congenital, caused by trauma, associated with a medical condition (i.e. diabetes), or even associated with certain medications (i.e. corticosteroids).

Your vision may become blurry, even with glasses. We may not be able to correct it with new glasses. The vision you have may seem more muted, and things like colors may not be as vibrant. You may experience more difficulty seeing fine print or details. You may require more light for activities, like reading, needlework, or puzzles. Driving may become more difficult, especially at night, and you may have trouble seeing street signs or have problems from glare or starbursts from headlights. Other visual phenomenon like ghost images and even double vision can occur.

Sometimes updating a glasses prescription is all that needs to be done. However, when that will not work, cataract surgery is performed. With cataract surgery we remove the natural lens which has clouded and replace it with a clear artificial lens implant called an intraocular lens.

An ophthalmologist.

We make small incisions in the cornea, which is the front clear part of your eye. Ultrasound energy called phacoemulsification is used to break up the cataract and remove it from the eye. Then your lens implant, called an intraocular lens implant, or IOL, is placed inside the eye. This implant is usually made of acrylic. Once that is done the incisions are closed and often no stitches are needed.

In general, there are 3 different types of lens implants: monofocal, toric, and multifocal. Insurance covers monofocal lenses and the other two lens types are considered “premium lens implants,” because insurance will not cover the extra cost of the lens and the patient is required to pay for it “out of pocket.” The goal of a monofocal lens implant is to give you good vision at either distance or near. Toric lens implants help correct for astigmatism but otherwise function the same way a monofocal lens does. With both of these lens implants, glasses will likely be needed for whichever target you do not choose. The goal of a multifocal lens implant is to give you good vision at distance, intermediate and near. Multifocal lens implants will reduce your dependence on glasses for most activities, however you may still need them for your best vision.

In general, cataract surgery will help improve your vision. However, you need to remember that all patients are unique and some patients have conditions that may limit their vision even after cataract surgery has been performed. All ophthalmologists strive to make your vision as good as possible after surgery. Remember that after surgery you may still need glasses to have your best possible vision.

After you and your doctor have decided to proceed with surgery, you will need to get measurements of your eye so that we know the appropriate lens power of your lens implant. You will have a folder with a checklist of items to complete and to help guide you through the process up until the day of surgery. Please read over these materials carefully and do not be afraid to ask questions.

On your surgery day, you will arrive to the surgery center 60-90 minutes before your scheduled surgery time. This will allow you time to check in, do any necessary paperwork, and allow time for the nursing staff to prepare you for surgery. Your doctor and an anesthesiologist will meet with you in the pre-op area to discuss the plan for your surgery. You will receive some light sedation as well as some numbing medication for the eye either through drops, injection, or a combination of both. Surgery will then be performed. Once surgery is finished you will go to the recovery area before you head home.

Generally, it will take a few days for your vision to clear up. Depending on certain patient factors, it can be faster than this or it can take a little longer. Your surgeon will discuss restrictions you have after surgery. You will have eyedrops to use. You will likely have a period of time where your eye is sensitive to the light, as well as having a foreign body sensation (i.e. feeling like you have an eyelash in your eye). You will have several post-operative appointments to make sure your eye is healing appropriately. A glasses prescription, if needed, can be prescribed several weeks after surgery.