Determining if you need cataract surgery

What you should know about …

 Dr. Robert Scharfman of Atlantic Medical Eye Care Dr. Robert Scharfman of Atlantic Medical Eye Care What is a cataract?

The lens of the eye is normally a clear, transparent structure that is located just behind your pupil. Every eye has a lens, just like every camera has a lens. The lens of the eye focuses incoming light onto the retina.

A cataract is a cloudy lens which distorts light that passes through the retina. A cataract is not a growth over the surface of the eye.

What causes a cataract?

People can get cataracts as they get older. In fact, 60 percent of people 60 years old have cataracts. Ninety percent of people 70 years old have cataracts. So cataracts occur with age, but no one knows why. Most people who get cataracts, however, never need cataract surgery.

People with diabetes can get cataracts more frequently. And patients on high doses of steroids can get cataracts more frequently. The rare family with a tendency for cataracts in members less than 50 years old (even in babies) is said to have hereditary cataracts.

What are the symptoms of cataracts?

Generally your vision will become blurred, hazy or out of focus. Doing simple tasks like reading, sewing or even watching TV will become increasingly difficult. Cataracts do not cause pain, redness or sudden loss of vision. This change in vision normally is of slow onset, usually over months to years. Occasionally, patients with cataracts will note this blurry vision to be exaggerated at night (when car lights or street lights can be blurred and have halos around them) or when the sun is bright during the day (glare from the sun can also exaggerate blurriness).

Who needs cataract surgery?

Most people who get cataracts never need cataract surgery. Cataracts do not have to be removed. Cataract surgery is elective; that is, the patient can choose to have it if they want to see better, but generally they do not have to have surgery. It is usually recommended that cataracts be removed at the point where visual impairment interferes with the daily activities of living, such as driving a car or reading.

How are cataracts treated?

There is no proven medication that will reduce the development or progression of cataracts. The only treatment for cataracts is surgical removal of the clouded lens.

Cataract surgery is outpatient surgery

Cataract surgery is performed on an outpatient basis. You will arrive at the surgery center an hour or so prior to surgery. The procedure itself takes about 30 minutes and is performed under a local anesthetic. A sedative is used with the anesthetic so that you do not experience any discomfort during the administration of the anesthetic or during the procedure. You will remain in the surgery center for about an hour following the surgery.

Following cataract surgery

You may return to normal activities the day of surgery. There are no longer any restrictions on bending over or lifting after the surgery. There are only two limitations:

1. The patient needs to wear glasses during the day and a shield at night in order to keep they eye from being accidentally bumped. This is for three weeks.

2. The patient needs to put eye drops in the eye for six weeks after the surgery.

The lens implant

Once the cataract is removed, a plastic lens implant is used to replace it. The latest lenses can correct both distance and reading vision, reducing or eliminating the need for glasses.

No stitch surgery

The most scientific, advanced technique to remove cataracts is called phacoemulsification, or phaco for short. This technique allows the surgeon to make a very small incision to remove the cataract and implant the lens. Through the very small incision the surgeon inserts an ultrasonic probe to actually break up the cataract and remove it.

If a patient needs astigmatism correction, the surgeon usually uses one or more stitches at the time of cataract surgery to eliminate the astigmatism.

Are there risks to cataract surgery?

There are risks to every type of surgery, but cataract surgery is one of the most risk-free procedures. Inflammations is possible, but very unusual and usually treatable.

If there is nothing else wrong with the eye prior to surgery, cataract surgery almost always successfully restores good vision.