What is a cataract?
Our eyes each have a lens, similar to the lens in a camera, which focuses light on the retina. As we get older, the lens becomes cloudy, preventing the light from focusing properly. This clouding is called a cataract. Cataracts are extremely common; in fact, cataract surgery is the most commonly performed surgery in the United States. Most cataracts are simply a result of the aging process, but some cataracts may be related to medication use (especially steroids), systemic diseases (such as diabetes) or prior trauma. Additionally, some people are born with cataracts (congenital). Cataracts cause a decline in the clarity of vision that is usually slow and painless, but may be sudden in certain types of cataracts. When the vision can no longer be corrected with glasses or contacts, the cataract is usually significant enough to consider cataract surgery.
What are the symptoms of cataracts?
- Blurry, fuzzy or cloudy vision
- Dulling of colors or a yellowing of images
- Glare and halos around lights (especially at night)
- Difficulty driving at night
- Frequent changes in your glasses prescription
Diagnosing a cataract
The surgeons at Stone Oak Ophthalmology will perform a thorough examination of your eyes, evaluating all of the eye’s intricate structures. It is important to assess any other underlying eye disorders or issues that may be contributing to your change in vision. If you have a very mild cataract, surgery is generally not necessary. Often, a change in your prescription will improve your vision for a period of time. The severity of the cataracts and your resulting vision can be followed with periodic eye exams.
When a change in your glasses prescription no longer improves the vision, and your vision has declined to a point that it is interfering with your desired daily activities, it is time to think about cataract surgery. Fortunately, cataract surgery is an extremely safe, outpatient procedure with very minimal “down time.” As with any surgery, there is a small risk of complications and our surgeons will review these in detail with you at the time of your examination. During the surgery, our surgeons will remove your natural lens (the cataract) through very small incisions in your cornea. The surgery usually takes about 15 minutes. A new, synthetic lens (intraocular lens or IOL) is then implanted in the same location your natural lens used to occupy in your eye. When we are young, our natural lens is able to change shape, changing our focus from distance to near (for reading). The standard IOLs (monofocal IOLs) used in cataract surgery cannot change focus, but they provide excellent vision for either distance or near. The newer “premium IOLs” or multifocal IOLs are a great option for some patients because they can help provide both distance and near vision after cataract surgery. Our surgeons can determine whether you are a candidate for a premium IOL and will help you choose the IOL that is best for you. After your cataract surgery, you will be on a series of eye drops to help your eye heal and prevent infection for several weeks. Most people are able to resume their regular activities in a short time period.
Posterior Capsular Opacification (PCO)
The natural lens is supported by a thin capsule that covers the front (anterior) and back (posterior) portions of the lens. During cataract surgery, an opening is made in the front part of the capsule, allowing the natural lens (or cataract) to be removed. The back (posterior) part of the capsule remains in your eye and supports the new IOL that is implanted during surgery. At some point after cataract surgery, about a third of patients will develop some clouding on the posterior capsule. This is called posterior capsular opacification (PCO). If PCO develops, your vision will become cloudy again, similar to the symptoms you experienced with the cataract. In these cases, our surgeons can use a laser to make a small opening in the posterior capsule, restoring a clear pathway for the light to focus on your retina. This procedure is called a posterior capsulotomy. It is painless and takes about 5 minutes to complete.