A cataract is a common condition that causes a clouding of the eye’s natural lens and affects millions of people each year. Cataracts cause a progressive, painless loss of vision. The lens naturally clouds with age, and by the age of 60 most people have started to develop a cataract. The exact cause of cataracts is unknown, although it may be a result of injury, certain medications, illnesses (such as diabetes), prolonged exposure to ultraviolet light and smoking.
Your doctor may perform a series of tests in order to diagnose a cataract. This includes a detailed assessment of your vision, glasses and overall eye health. A dilated eye exam will be performed to carefully examine the lens for signs of cataract and to assess for any other eye diseases. Once a cataract is diagnosed, it will progressively worsen. However, this is often a slow process and it make take years for you to notice any of the symptoms listed below. During this time, an annual eye exam is important to monitor cataracts and your overall eye health.
Symptoms of Cataracts
Cataracts can cause a variety of symptoms including:
- Blurred or hazy vision
- Double vision
- Poor vision in bright light
- Seeing halos around lights
- Poor vision at night
- Yellowish tinged vision
- Frequent changes in eyeglasses or contact lens prescription
Treatment of Cataracts: Cataract Surgery
When cataracts do begin to interfere with your ability to drive, read, work or do the things you enjoy, it is time to consider having cataract surgery. Cataract surgery is currently the only way to treat cataracts that are affecting your vision. Fortunately, the surgery is a minimally invasive, low risk, outpatient procedure with a success rate of 98%. Due to the extremely high prevalence of cataracts, it is the most commonly performed surgical procedure in the US.
The goal of surgery is to remove the natural lens which has become cloudy due to cataract. The natural lens serves a very important function of focusing images in the eye, so after it is removed, a new, clear artificial lens is placed into the eye to replace this focusing power. There are several options for these lens implants, which are described below. Often, this lens implant can reduce the reliance on glasses after cataract surgery.
We perform all cataract surgeries in our surgery center, housed at the Mansfield office. Cataract surgery is an outpatient procedure that requires only light sedation. Surgery is done through micro-incisions on the surface of the eye, making the risks involved with surgery very low. Some of these risks may include pain, infection, swelling and bleeding. Most patients undergo this procedure without any complications.
Traditional vs Laser Assisted Cataract Surgery
We are happy to offer both traditional cataract surgery as well as Femto-second Laser Assisted Cataract Surgery (FLACS) at Ohio Eye Associates. The two types of cataract surgery differ only in the first few steps of surgery.
Traditional surgery uses micro-blades to manually make precise, self-sealing micro-incisions on the surface of the eye, while a laser is utilized to make these same incisions in FLACS.
A well centered, circular opening in a capsule surrounding the natural lens is then needed to be able to access and remove the cataract. In traditional surgery, this is done in a manual fashion while a laser is utilized for FLACS. The laser in FLACS can also be used to “soften” the cataract prior to removal.
After these steps, the cataract is removed and the new lens is implanted in the same fashion for both traditional cataract surgery and FLACS.
FLACS offers an exciting new technology which we are excited to offer, but it must be noted that several large clinical studies have not shown any increase in safety or success rates with FLACS vs traditional cataract surgery. FLACS is not covered by insurance and federal law requires it only be used when also treating astigmatism or when placing a premium lens implant, both of which are described below.
Astigmatism is a term used to describe an error in focusing caused by changes on the surface of the eye. This results in blurred vision when not corrected. Options for treating astigmatism include glasses, contact lenses and surgery.
At the time of cataract surgery, astigmatism can be corrected in two ways, depending on its severity. For small amounts of astigmatism, a small incision can be made on the surface of the eye with either a micro-blade or, more precisely, with the laser used in FLACS. If larger amounts of astigmatism are present, a premium lens implant called a toric lens can be used.
Premium Lens Implants
The goal of a premium lens implant is to reduce the need for glasses after cataract surgery. Premium lens implants are ideal for patients who have presbyopia, astigmatism or both.
Toric Lens Implant: A toric lens implant is used to correct significant amounts of astigmatism as described above. It can easily be placed at the time of either traditional cataract surgery or with laser-assisted cataract surgery.
Multifocal Lens Implant: Presbyopia is a condition which occurs with aging, where the natural lens can no longer change focus as we try to look from far to near. Most people notice this around the age of 40 and compensate for it with reading glasses or bifocals. Specialty Multifocal lens implants now allow us to surgically correct presbyopia. These lens implant provides a full range of clear vision, reducing or eliminating the need for reading glasses. Combination toric and multifocal lenses are also available.
We offer several different options for premium lens implants available for cataract patients. Your doctor will work with you to decide which lens is best for your individual eyes to help you enjoy long-lasting, clear vision at near, intermediate and far distances. To speak with one of our doctors and discuss your options for cataract replacement lenses, please call us today to schedule a consultation
Secondary Cataract and Laser Correction
After cataract surgery, some people experience a gradual recurrence of cloudy vision or glare symptoms. This is most often the result of a film or membrane forming on the lens implant placed at the time of cataract surgery, a condition known as secondary cataract or secondary membrane. Fortunately, an easy solution is available to treat this condition.
A procedure called a posterior capsulotomy, using an Nd: YAG laser, can be performed to remove the cloudy membrane, restoring clear vision.
The procedure is quick, painless and does not require any anesthesia. It is done as an outpatient and has minimal risks or side effects. Most people with this condition notice a restoration of clear vision within hours following the procedure.