CATARACTS

written by Dr. William McSwain

WHAT ARE CATARACTS?

We are all born with a lens inside our eyes that functions just like a lens in a camera to focus light onto the retina. When the lens becomes cloudy or opacified, it is called a cataract. Cataracts can be caused by trauma, metabolic diseases, or certain medications. But the vast majority are due to the normal aging process which causes the lens to become harder and cloudier. This process usually starts in your 50’s and progresses each day as you get older. Symptoms of cataracts include blurry vision, double vision, light sensitivity, glare, halos around lights, difficulty driving at night, dulled color vision, and decreased night vision.

WHAT CAN BE DONE TO TREAT CATARACTS?

Trying a new pair of glasses or contact lenses is usually the first option if the cataracts are mild. As cataracts develop, they can rapidly change your glasses prescription. A new glasses prescription may improve your vision enough that you do not require surgery. Even with a new pair of glasses, the cataracts are going to continue to get worse each day so new glasses may only delay surgery.

Cataract surgery with placement of an intraocular lens is the only permanent solution. During the surgery, two small incisions are made through the cornea (the clear front part of the eye). A circular incision is made in the capsular bag that surrounds the lens. The cloudy lens is then broken up into small pieces which are removed from the eye. An artificial intraocular lens implant (IOL) is then placed within the capsular bag. These implants are usually well tolerated and stay in your eye the rest of your life.

During the surgery, you are usually awake and breathing on your own without general anesthesia. You are given a relaxing medication through an IV in your arm. There is usually little to no pain or discomfort and the entire surgery takes 10-15 minutes. The surgery is performed on one eye at a time, usually 2 weeks apart. You will usually be seen 1 day, 1 week, and 1 month after the surgery. You have to take it easy for 1 week after the surgery and are usually on eye drops for 1 month.

In most cases, cataract surgery is only recommended when your vision loss is interfering with your daily life to the point you feel it is worth it to go through the risk of surgery in order to try to improve your vision. You must also weigh the risk of having decreased vision from cataracts that may lead to an increased incidence of accidental injuries, falls, or car accidents. Cataract surgery is usually an elective surgery. However, there are occasional instances when delaying surgery could cause permanent damage to your vision (example: narrow angle glaucoma) or make the surgery higher risk in the future.

While cataract surgery is relatively low risk compared to other types of surgeries, complications do occur. Make sure you read the consent form closely. Feel free to bring up any questions or concerns you may have.