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Dr. James Doherty
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What is a Cataract?
(cataract) A cataract is the clouding of the crystalline lens in your eye. This opacity obstructs the passage of light resulting in a reduction of clear vision. Normally, light passes through the clear lens and is focused onto the Retina. However, the natural aging process can cause the lens to become cloudy, or milky. The cataract blocks the passage of light through the eye and causes distorted or blurred vision, glare, or difficulty seeing in poor lighting conditions.
There are three types of cataracts:
A nuclear cataract
forms in the lens. Those over 65 are more prone to develop this type of cataract. More than half of all Americans over the age of 65 will develop a cataract.
A cortical cataract
forms in the lens, then grows from the outside to the center of the lens. Diabetics are more prone to develop this type of cataract.
A subcapsular cataract
forms in the back of the lens. Those with diabetes, high hyperopia (Far-sightedness) or retinitis pigmentosa may be at a higher risk to develop this type of cataract.
What are the symptoms of a Cataract?
You may not notice a slight change in your vision, as cataract starts out very tiny, but as it grows from the size of a pin head, you may notice that your vision is becoming blurry, and you may feel you are looking through dirty lenses. Object edges may appear to fade into one another and colors may not appear as bright as they should.
The most common symptoms of a cataract are:
» Cloudy or blurry vision.
» Problems with light, headlights that seem too bright, glare from lamps or very bright sunlight.
» Colors that seem faded.
» Poor night vision.
» Double or multiple vision.
» Frequent changes in glasses or contact lenses.
» Optical aids such as eyeglasses or contact lenses are no longer effective.
How is a Cataract treated?
Cataract surgery is a selective and successful solution to restoring vision when the cataracts seriously impair your vision and affect your daily life. Cataract surgery is the most frequently performed surgery in the United States, with millions of surgeries done each year. Cataract surgery is a routine and relatively painless procedure.
Cataract surgery is generally performed on an out patient basis. You will not need to be hospitalized or put to sleep for your doctor to perform your surgery. The procedure normally takes less than 15 minutes and you can return home shortly after your procedure. Most people will enjoy improved vision by the day after surgery or within a few days following the procedure.
To begin, your surgeon will administer a light sedative which will relax your nerves and keep you comfortable during the procedure. Anesthetic eye drops will be used to completely numb the eye. The entire procedure is performed through an incision that is smaller than 1/8 of an inch and does not require stitches to heal.
Once the cataract is removed, an intra-ocular lens (IOL) is placed where the cataract lens was removed, to restore your sight. Most patients will not require an eye patch and will not have any discomfort.
Most can return to their normal daily routines; including reading, driving, and exercise, the day after surgery.
What causes a Cataract?
It is not known why cataracts occur in all instances but studies on the cause of cataracts will soon teach us how to more successfully treat and prevent them. The most commonly known type of cataract is age related.
Ultraviolet light is a known catalyst for the formation of cataracts, so we recommend wearing 100% UV blocking sunglasses which will lessen your exposure over time. Other studies point to people with diabetes as a higher risk group for cataract development than those who do not suffer from diabetes. Cigarettes, air pollution, heavy drug usage and severe alcohol consumption may also contribute to your chances of developing cataracts.
Can I be too young or old for Cataract surgery?
Any patient who can undergo a thorough eye examination can undergo surgery if the procedure is performed with topical anesthetic-drops alone.
How do I decide whether to have surgery?
Fortunately, cataracts are not life threatening so most people have plenty of time to decide about cataract surgery. However, we cannot make your decision for you, but talking with us can help in your decision. Together, we can ascertain how your cataract affects your vision and your life. If any of the below applies to you, then please contact us for a consultation.
The most obvious symptoms may include:
» I need to drive, but I see too much glare from the sun or headlights.
» I do not see well enough to do my best at work.
» I do not see well enough to do the things I need to do at home.
» I have trouble trying to read, watch TV, sew, play cards, etc.
» I am afraid I will bump into something or fall.
» Because of my cataract, I am not as independent as I desire.
» My glasses do not help me see well enough.
» My eyesight interferes with many of my daily functions.
» You may also have other specific problems that we will discuss with you.
Is Cataract surgery right for me?
Most people who have a cataract recover with no problems and improved vision. This type of surgery has a success rate of 98% in patients with otherwise healthy eyes. If you have a cataract in both eyes, we believe it is best to wait until your first eye heals before having surgery on the second eye. If the eye that has a cataract is your only working eye, we will weigh very carefully the benefits and risks of cataract surgery.
You will be able to make the right decision for yourself if you know the facts. We are more than happy to explain anything you do not understand. There is no such thing as a "dumb" question when it comes to your health.
How soon can I drive after the surgery?
We will require that you have someone drive you home following your procedure. However, you may drive when you feel comfortable enough to drive safely, possibly the next day.
Do I have to avoid all activities post-operatively?
We typically demonstrate to our patients that they can bend over immediately after surgery, pick up 20-30 pounds, and shower provided they don't get water into their operative eye.
We do ask that they wear an eye shield at bedtime for the first few weeks after surgery so they do not inadvertently rub the eye during sleep. Typical follow-up evaluations are scheduled at 1 day, 1 week, 3 weeks, and 6 weeks with glasses being prescribed between the 3rd and 6th week visit.
Does Cataract surgery hurt?
The treatment is painless. We will place a numbing drops in your eye(s) to make you more comfortable.
What else should I know about surgery?
We will discuss in the greatest detail your options before choosing the best technique for your surgery. We will also explain how to prepare for surgery and how to take care of yourself after it is over.
Cataract surgery is outpatient. You do not need to stay overnight in a hospital. However, you will need a friend or family member to take you home. You may need someone to stay with you for a day to help you follow your doctor's instructions.
With modern cataract surgery, most patients have fast visual recovery. Some patients are even able to drive themselves to see doctor for follow-up the day after surgery. Remember that the follow-up is very important. We will thoroughly check your progress and make sure you have the care you need until your eye recovers fully.
Will I still need glasses or contact lenses?
You may need glasses or other corrective lenses after the procedure on a temporary or permanent basis. Cataract surgery will not prevent, and may unmask, the need for reading glasses.
Do regular glasses protect my eyes from the sun?
Plastic lenses do not protect your eyes. You need to have UV protection from UV rays, which are not inherent in a plastic lens. You can have a UV protective coating applied to a plastic lens, but polycarbonate lenses have built-in UV protection.
Glass lenses protect your eyes from harmful UVB rays but not from UVA. Some experts think UVA rays might have long-term, damaging effects to your eyes and skin.
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