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| A cataract is a clouding of the normally clear lens of the eye. The lens, which lies behind the pupil, helps the eye to focus. When the lens becomes clouded, it partly blocks light from passing to the back of the eye (retina). reduces a person’s sight. It can be compared to a window that is frosted or yellowed. | ||||||
Most people with cataracts are older adults. Almost everyone over age 75 has a cataract in one or both eyes that may interfere with vision. Smokers tend to have a higher rate of cataracts than non-smokers. Other things increase the risk of cataracts in adults:
Cataracts may take years to form, or they may get worse in a few months. A person can have cataracts in both eyes at the same time, but they may develop at different rates. |
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| People with cataracts often have one or more of these symptoms: | ||||||
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| By performing a thorough eye examination, your ophthalmologist can detect the presence of a cataract. A careful evaluation will also rule out any other conditions that may be causing blurred vision or other eye problems. Problems with other parts of the eye (such as the cornea, retina or optic nerve) can be responsible for vision loss and may prevent you from having much or any improvement in vision after cataract surgery. If improvement in your vision is unlikely, cataract removal may not be recommended. | ||||||
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| Cataracts do not go away on their own or with drugs. The only way to remove cataracts is surgically. Sometimes a simple change in your eyeglass prescription may be helpful. No medications, dietary supplements or exercises have been shown to prevent or cure cataracts. Protection from excessive sunlight may help slow the progression of cataracts. Sunglasses that screen out ultraviolet (UV) light rays or regular eyeglasses with a clear, anti-UV coating offer this protection. | ||||||
| Many people with a mild cataract do not need an operation. But a cataract may begin to interfere with your ability to do daily tasks-for instance, reading or driving. When a cataract becomes a problem, it is time to discuss the option of a cataract operation with your ophthalmologist. The decision to remove a cataract depends on factors such as your lifestyle, age, and job. Your surgeon may recommend you to have a cataract operation right away to avoid other eye complications. Immediate removal hasn’t always been the standard treatment for cataracts. Years ago, surgeons advised patients to let the cataract “ripen”—totally obscure vision— before they would remove it. Now, with surgical advances, surgeons no longer suggest waiting to remove a cataract, which can make the procedure harder to perform. Also, today’s cataract removal procedures are safer and more successful than those in the past. Cataract surgery is a highly successful procedure. Improved vision is the result in over 95% of cases, unless there is a problem with the cornea, retina, optic nerve or other structures. |
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| A cataract operation involves removing the cloudy part of the lens. There are several ways in which the operation can be performed- phacoemulsification surgery/ extracapsular surgery. Discuss with your surgeon which option is best for you. In the most common method of cataract removal, the patient typically first gets an injection of anesthetic solution around and behind the eye. A new technique being used in some patients is injection-free anesthetic placed on or into the eye. Next, after the eye is numbed, the surgeon looks through an operating microscope and makes a small incision (cut) with a microsurgical blade in or near the front of the eye. Then the surgeon makes an opening through the capsule, or outer membrane, of the lens. Using ultrasound waves (phacoemuslification), the surgeon breaks up and removes the cloudy contents of the lens. Surgeons are studying new ways of breaking up the lens using laser or sound waves. Rarely—less than one percent of the time—the surgeon may remove the whole lens and capsule. Removal of part or the entire lens requires a substitute lens. Almost all patients have an artificial lens, called an intraocular lens (IOL), implanted at the time of their cataract removal. IOLs implanted inside the eye have a permanent life and are not degraded or require removal. Nearly all cataract operations are done on an outpatient basis. When patients have cataracts in both eyes, their ophthalmologists usually recommend that they wait a few weeks between operations. An operation on the second eye is not always needed. Most modern cataract incisions use no sutures (stitches). These procedures are often called “no-stitch” or “stitchless” cataract surgery. | ||||||
| Your eye area may swell after the operation. If so, your doctor may treat you with eyedrops containing anti-inflammatory medicine. You may receive eyedrops or antibiotic ointment to put on your eye for a few weeks to prevent an infection. Fortunately, infection is rare after a cataract operation. Soon after the operation, you should be up and walking. However, you will need a ride home from the surgery center or hospital. Your activity level depends on your surgeon’s instructions. Usually, you can resume normal, non-strenuous activity the next day. You may find you are sensitive to bright light. Sunglasses and eyedrops can relieve most of this discomfort. To protect your eye, you may be asked to wear eyeglasses for seven to 10 days after the operation. You may also need to sleep with a protective eye shield for a while to prevent scratching or irritating the healing wound. |
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As with any operation, complications may occur during or after cataract removal. Complications are rare, but the most common are:
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| A cataract cannot return. But if the lens capsule remains, it may become cloudy months or years after cataract removal. A painless laser procedure can clear this cloudiness and improve vision in most cases. This problem is becoming less common with improved surgical techniques and IOLs. | ||||||
| O nce a cataract is removed, light can again pass undistorted to the retina. But your vision will not be clear unless the light is focused directly on the retina. Eyeglasses provide that focus, so you may need to wear glasses to see more clearly. Also, the artificial lens cannot change shape the way the eye’s natural lens did when you were younger. If you don’t already, you may need to wear bifocal lenses or reading glasses to see clearly at close range. This may, however, not be necessary with newer, multifocal IOLs, which better correct near vision. If you already wear glasses, your eyeglass prescription may change after your cataract operation. At times, a cataract is completely removed but vision does not improve because of other eye conditions or diseases. One such disease is macular degeneration. This condition damages the macula, the central part of the retina that is crucial for seeing fine detail. Often, this disease cannot be diagnosed before a cataract removal because the cataract blocks the ophthalmologist from seeing the macula in enough detail. Other pre-existing eye conditions that can limit vision after the operation include diabetic eye disease and glaucoma. Because cataract removal has a high success rate, your vision will most likely improve after your cataract operation. You can then do tasks that were difficult to perform before your operation. |
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