CATARACTS

WHAT IS A CATARACT AND WHAT ARE THE SYMPTOMS?
A cataract occurs when the normally clear lens of the eye becomes cloudy. As the cataract develops, the cloudiness no longer allows the lens to properly focus light on the back of the eye. This unfocused light causes the vision to look blurry or hazy because light cannot pass freely through the lens to be focused on the back of the eye. In addition to blurred vision other symptoms of cataract include glare, ghost images, and difficulty with vision under very bright or very dim lighting conditions. The only way to remove a cataract is to remove the lens itself.

HOW IS CATARACT DIAGNOSED?
A cataract usually cannot be seen by the naked eye. An eye doctor can diagnose a cataract by dilating the pupil and examining the lens using a special microscope to determine whether a cataract is present.

WHAT CAUSES CATARACTS AND HOW CAN THEY BE PREVENTED?
In developed countries like the United States, cataracts are most often related to age. Other factors that can contribute to cataract formation include heredity, certain medications, and previous eye surgery, injury or inflammation. There is also some evidence that the cumulative lifetime exposure to ultraviolet (UV) light as well as cigarette smoking may play a role in the subsequent development of cataracts. However, there is no evidence that the wearing of UV-blocking sunglasses can prevent or slow the progression of cataracts.

CAN A PERSON BECOME BLIND IF CATARACT SURGERY IS DELAYED?
Although vision can become severely impared from advanced cataracts, vision can usually be restored after cataract surgery is performed. However, removing an advanced cataract from the eye can be more difficult and can lead to post-operative complications.

WHAT IS LENS IMPLANT AND WHY IS IT USUALLY RECOMMEMDED?
After a cataract is removed, the eye lacks the lens that is needed to focus light. To restore this function, a plastic lens implant (also known as an intraocular lens) is inserted.

HOW IS THE IMPLANT SELECTED?
Your surgeon will order a simple and painless test, known as an ultrasound or A-scan, which measures the size of the eye and helps determine the correct power of the implant.

WHAT NEEDS TO BE DONE IN PREPARATION FOR CATARACT SURGERY?
You will receive a complete eye examination, after which your eye care provider will counsel you about surgery and answer any questions you may have. If you wish to go ahead with surgery, a surgery date will be selected and your ultrasound test will be scheduled. You may be required to see your internist or family physician for a check-up or have the doctor provide the results of a recent physical. On the evening before surgery you will be asked to not eat or drink anything after midnight. It is helpful to get a good nightís rest prior to surgery.

HOW IS A CATARACT REMOVED?
Cataract surgery is a procedure that removes the cloudy lens from the eye. Today this procedure can be accomplished very quickly and in most cases no stitches are needed. A local anesthetic is used and the surgeon makes a small incision in the outer covering of the eye. Then a technique is used called phacoemulsification that removes the lens through the small incision.

IS THERE ANY RISK?
Cataract surgery and IOL implantation are quite safe. As with any surgery, complications can occur. There is a possibility of hemorrhage or infection. Your eye doctor will discuss potential complications of cataract surgery and IOL implantation with you.

WHAT TYPE OF ANESTHESIA IS USED?
Surgery is done under local anesthesia. To help you feel relaxed and comfortable, an anesthesiologist will administer light sedation through an intravenous (IV) line. You will not notice any discomfort during the time of injections or during the operation.

WILL I BE HOSPITALIZED?
Generally 99% of cataract surgery is done on an outpatient (come and go) basis. The entire process from check-in to departure is usually completed in several hours.

WHAT WILL I EXPERIENCE IN THE IMMEDIATE PERIOD AFTER SURGERY?
You may be slightly groggy during the first 24 hours after recovering from sedation. For this reason, you will need to ask a friend or relative to accompany you home on the day of your surgery. Most patients experience very little pain at all. If there is discomfort, it is usually mild and can be managed with Tylenol. It is common for the eye to feel scratchy and irritated for the first several days. Your vision may be blurry for a few weeks after the surgery, improving steadily thereafter.

WHAT IS THE SUCCESS RATE OF CATARACT SURGERY?
Assuming that there in no other problems that may limit vision, the chance of improved vision after cataract surgery is very high.

ARE THERE ANY RESTRICTIONS ON DAILY ACTIVITIES?
You may resume "light" activities immediately. You may read, watch television, sleep, walk and eat without restriction. After the first day you can resume "moderate" activity with the exception of strenuous/aerobic exercise. After six weeks you can return to your active lifestyle.

DO I STILL NEED GLASSES AFTER CARARACT SURGERY?
The majority of individuals will need reading glasses after cataract surgery. A distance correction may also be needed in certain circumstances.

WHEN CAN I RETURN TO WORK?
If you have a job that does not require heavy lifting or bending, you can usually resume work in 3-5 days after surgery. More strenuous types of work can be resumed within a few weeks.