What are Cataracts?
A cataract is a clouding of the natural lens inside the eye. Cataracts are the leading cause of treatable blindness in all areas of the world, especially in adults 55 and older.
Contrary to popular belief, a cataract is not a "film" over the eye. Rather it is a gradual thickening of the lens that causes the lens to become so clouded that light is either distorted or cannot reach the back of the eye (the retina) for transmission to the brain. When left untreated, cataracts will eventually cause blindness. The most common cause of cataract is aging. Other causes include trauma, medications such as steroids, systemic diseases such as diabetes and prolonged exposure to ultra-violet light. Occasionally, babies are born with a cataract.
Reducing the amount of ultraviolet light exposure by wearing a wide-brim hat and sunglasses may reduce your risk for developing a cataract, but once developed there is no cure except to have the cataract surgically removed. Outpatient surgical procedures can remove the cataract through either a small incision (phacoemulsification) or a large incision (extra capsular extraction). The time to have the surgical procedure is when your vision is bad enough that it interferes with your lifestyle.
Your eye works a lot like a camera. Light rays focus through your lens on the retina,
(a layer of light sensitive cells at the back of the eye). Similar to film, the retina allows the image to be "seen" by the brain. But over time the lens can become cloudy and prevent light rays from passing clearly through the lens. This cloudy lens is called a cataract.
The typical symptom of cataract formation is a slow, progressive and painless decrease in vision. Other changes include: blurring of vision; glare, particularly at night frequent eyeglass prescription changes; a decrease in color intensity; a yellowing of images; and in rare cases, double vision.
Ironically as the lens gets harder, farsighted or hyperopic people experience improved distance vision and are less dependent on glasses. However, nearsighted or myopic people become more nearsighted or myopic, causing distance vision to be worse. Some types of cataracts affect distance vision more than reading vision. Others affect reading vision more than distance vision.
What are the Options?
Once a cataract has formed, there are no medications, diets, glasses or exercises that can reverse the process. Surgical removal of the clouded lens is the only way to completely restore lost vision.
What is Cataract Surgery?
Cataract surgery is a simple operation where a surgeon removes the eye's clouded natural lens and replaces it with an artificial, intraocular lens (IOL). The entire procedure is generally done on an outpatient basis and usually lasts between 10 and 20 minutes. Patients may experience little to no pain and can usually return to their normal activities the following day.
Your surgeon will make a small incision at or near your cornea and insert an instrument about the size of a pen tip to break up and remove the cloudy lens. Once the natural lens is removed, the IOL is inserted through the same incision and set into its permanent position.
Cataract surgery is considered one of the safest and most effective medical procedures. Cataract surgery is a very successful operation. One and a half million people have this procedure every year and 95% have a successful result. As with any surgical procedure, complications can occur during or after surgery and some are severe enough to limit vision. But in most cases, vision, as well as quality of life, improves.
Depending on the severity of your vision loss, you may be able to take some simple steps to delay surgery. Options include getting a new pair of prescription eyeglasses and increasing your home lighting. You may also reduce glare indoors by repositioning lights or outside by wearing polarized sunglasses.
But before deciding to delay surgery, you'll need to consult your eye care professional and ask yourself how much your cataract is affecting your safety or quality of life.
What is an Intraocular Lens (IOL)?
Types of IOLs
Until fairly recently, nearly everyone who had cataract surgery was fitted with a standard intraocular, or monofocal, lens. Monofocal lenses allow you see objects in the distance clearly but require that you wear glasses to see objects that are closer. Monofocal lenses can also be selected to see objects at near, but would then require a patient to wear distance glasses. However, recent advancements in lens technology have made it possible to not only treat the cataract but reduce or eliminate dependence on glasses as well. The type of IOL you need depends on your particular situation. Your doctor will work with you to determine which lens is best for you.
There are three basic types of intraocular lenses (IOLs).
- Monofocal Lenses, also known as standard lenses, provide clear vision but only at one fixed focal point, usually at a distance. If you are fitted with a monofocal lens, you will most likely need glasses to see up close.
- Multifocal Lenses have special features that correct your near, intermediate, and distance vision in the same lens. Multifocal IOLs provide your best chance at being free of glasses for the majority of activities. Learn more about how an multifocal IOL works. For an example of a multifocal lens, visit www.acrysofrestor.com.
- Toric Lenses. Toric lenses are designed for people with astigmatism, reducing or virtually eliminating the need for glasses for distance vision following surgery in people with astigmatism.
- Limbal Relaxing Incision (LRI) instead of Toric Lenses may be performed in order to reduce the amount of astigmatism in patients with mild to moderate amount of astigmatism.
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Giselle Martin, MD
Mimi Groom, MD
Robert Sherman, MD
3455 Pine Ridge Road
Naples, Florida 34109
Formerly Groom Eye Center