The eye has a clear, transparent lens, which helps focus light onto the retina. This allows the eye to see clearly. Over time the lens becomes cloudy and once the lens loses its transparency, it is called a cataract. An eye with a cataract cannot see as clearly since any and all light must pass through the cloud first, in order to reach the retina. Vision therefore, will be blurred.
In general, cataracts develop slowly and gradually cause loss of vision. Early on, the symptoms of a cataract will be mild. As they progress, the symptoms can include blurred vision, glare from oncoming headlights, double vision, halos around lights, and difficulty driving at night. Some people notice that they increasingly need a stronger light source in order to be able to read even with reading glasses.
Causes and Risk Factors
This phenomenon is mostly due to the natural aging process of the lens. However ultraviolet exposure, such as too much sun, can speed the process. Smoking cigarettes may also increase your risk. If you are on certain medications or have other illnesses such as diabetes, of have had trauma to the eye, the chance for cataracts may be increased.
How Are Cataracts Detected?
A complete eye exam will determine if cataracts are present. Sometimes a change in glasses will be sufficient to improve the vision temporarily. When cataracts become severe enough, a change in glasses will not help at that point. The treatment will be to surgically remove the cataractous lens and replace it with an artificial lens implant.
What is cataract surgery?
Modern cataract surgery is a very safe and effective way of treating this condition. It is performed through an incision measuring only a few millimeters. A small instrument is inserted through this tiny incision, and is used to break the cataract into many small pieces. There are many advantages to a smaller incision, including a faster recovery time, less need for glasses after surgery, and a smaller risk of infections after surgery. Modern cataract surgery can often be performed without any stitches.
After the eye is properly anesthetized and numbed, a small incision is made. Modern day cataract surgery is also called micro-surgery because the incision sizes have become so small. Once the incision is made, a probe is inserted into the eye in order to break up the cloudy cataract. At the same time suction is used to remove the debris that is much smaller in size that the original intact cataract. The capsular bag that encompasses the cataract is preserved in order to place the artificial implant in the same position as the old cataract. The foldable intraocular lens or IOL is then inserted into the eye. The IOL-once inside the eye- unfolds and is gently guided into its proper position. Intraocular lenses will have haptics and “lens arms” to hold it in place. With the cataract removed and the IOL in place, light can once again travel unimpeded to the back of the eye and focus on the retina where the image is interpreted and transmitted to the brain. The end result is clear youthful vision.
After cataract surgery
Most people have excellent results after cataract surgery. Within the first day of cataract surgery it is very important not to rub or press on your eye. It is common that you will have some itching, tearing, and mild discomfort. We will take precautions to prevent infection and swelling. The drops to be used are antibiotics and anti-inflammatory drops to minimize swelling and the possibility of infection. It is very important to take the drops as instructed to help with the healing process. Avoid bumping or touching your eye after cataract surgery. You may see some initial glare and haloes after cataract surgery but this should go away over time. Make sure you get all of your prescriptions filled so you do not have to suddenly have to leave your home. Our practice will provide you with instructions for the prescription medications.
Lens options: What type of lens implants should you opt for at the time of cataract surgery?
During cataract surgery, the cloudy lens of your eye is removed and replaced with a clear lens implant. Patients now have an option of monofocal lens implants for seeing at one distance only or multifocal (also called premium lens implants) that enables vision at near, far, and intermediate distances. During the examination process, we will help you determine what lens implant type would be best for your vision. Some of the premium lens implants offered include: The Acrysof Restor, The Tecnis Multifocal IOL
You now have the option of deciding what type of vision you would like to have after cataract surgery.
Premium Lens Implants - Can I see at multiple distances after cataract surgery?
As we age, presbyopia sets in. Presbyopia is the eye’s inability to switch its focus from one focal plane to another. Aging eyes may also develop cataracts, causing the lens to become cloudy or dark. The only method of correcting an established and progressing cataract is to undergo cataract surgery.
Once you have made the decision to undergo cataract surgery, you will have a series of decisions to make related to the type of artificial lens implant you will have. Up until recently everyone who had cataract surgery received a monofocal lens implant. This lens focuses at one location so either distance or near vision is picked based on your preferences. Both distances cannot be achieved with a monofocal lens. With new innovations a better lens is now available. These lenses are referred to as premium lenses and come in various formats or types.
Multifocal Lens Implants
In order to help cataract patients achieve better outcomes after cataract surgery and reclaim their ability to see we offer the latest in intraocular lens technologies. If you would like to see at multiple distances including far, intermediate and close ranges, we offer three advanced lens technologies. The multifocal lens- as the name implies- can focus at multiple distances so that excellent distance and near visions are achieved with these lenses.
Multifocal IOL Lens Implants enable patients to see at near far and intermediate distances after surgery. With a multifocal IOL the central portion of the lens has a series of steps that are carved in a very precise arrangement with varying step heights and distances between steps. Each step of this diffractive optic bends the incoming light differently; creating a near focus that is quite separated from the distance focus formed by the remaining refractive portion of the lens. This large separation between the two images allows for less artifacts or distortion in either of the images, providing good quality vision at both distance and near.
Toric IOL Implants
Toric Lens Implants are a unique type of lens implant that are used to correct astigmatism. When the cornea- instead of being round- has a more oval shape, this is called astigmatism. With astigmatism, the light that is focused by the cornea is uneven, which is the main optical problem in astigmatism. To individuals with uncorrected astigmatism, images may look blurry or shadowed. Astigmatism can accompany any form of refractive error and is very common. Astigmatism can be corrected with glasses, contact lenses, corneal relaxing incisions, laser vision correction, and special implant lenses. If a cataract patient has astigmatism and has aspirations to be glasses free after surgery the Toric Lens Implant is a good option. Toric Lens Implants are NOT a correction option for presbyopia.
Toric lenses are an excellent way of correcting moderate to high degrees of astigmatism with excellent results.