Cataracts prevent clear images from appearing on the eye’s retina; causing mild, moderate, even severe blurred vision.
Typically an eye disorder associated with aging (over half of the people in America over age 80 have either had a cataract or cataract surgery), cataracts generally occur later in life as the lens structure within the human eye changes and gets older.
During the evaluation of your eye health, we will carefully examine your lens for signs of cataract formation. If a cataract is noticed and the clouding is causing visual disruption, the optometrist will refer you to a trusted and respected surgeon for surgery, which is the only known cure for cataracts. Our Eye Care Practice will be there for you providing pre and post cataract surgery care.
Cataracts Q&A with Dr. Tawni Cashon
Q: What are warning signs for cataracts? Is there anything I can do to avoid getting cataracts? Does diet play a role? Lifestyle?
Dr. Cashon: Beginning signs of cataracts may be blurred or cloudy vision, monocular (one-eyed) double vision, muted colors, or increased glare and halos, often made worse at night or in low light. Unfortunately and eventually, everyone will develop cataracts as it is a consequence of the natural aging of the lens in our eyes.
Typical diet does not play a major role, but studies have shown that increased exposure to UV light, smoking tobacco products, and long-term use of systemic medications (e.g., steroids) may induce cataracts or accelerate them at an earlier age. Cataracts are more commonly found in those with certain diseases or conditions such as diabetes. Cataracts may be caused by direct trauma to the eye or head, and may even occur as a result of other eye conditions such as uveitis.
Q: If I detect my cataracts early, can I avoid the surgery?
Dr. Cashon: If cataracts are detected early, the best thing that you can do to avoid cataract surgery is to prevent the progression or worsening of cataracts. Wearing UV protection when outdoors, avoiding the consumption of tobacco products, and managing other systemic conditions such as diabetes with your optometrist and primary care doctor are the best ways to prevent further changes in cataracts.
Q: Can people avoid Cataracts & Cataract Surgery?
Dr. Cashon: Cataracts are unfortunately a natural consequence of aging and everyone, if we live long enough, will develop some form of a cataract. The best way to avoid cataract surgery is to prevent the progression and be sure to keep your glasses or contact lens prescription up to date.
Q: What kind of symptoms could develop from a cataract?
Dr. Cashon: Symptoms of a cataract include blurred vision, cloudy vision, double vision from one eye, muted colors, glare, and halos in your vision.
Q: What are IOLs & how do IOLs help after cataract surgery?
Dr. Cashon: IOL stands for Intraocular lens. Cataracts form in the natural lens in our eye, which sits directly behind our iris, the colored part of your eye, and is largely responsible for making our vision clear. During cataract surgery, our natural lens is extracted and an artificial lens, the IOL is put in its place.
Q. If you have a cataract, does that mean you have to have it remove? When is the appropriate time?
Dr. Cashon: Not all cataracts must be removed. Everyone can develop cataracts at different rates, but we typically do not consider cataract surgery until there is a marked decrease in vision in which a new glasses prescription does not improve your vision, or glare and halos are drastically decreasing your quality of vision.
Q: Would prior medical conditions or medications be a problem for the cataract surgery? If so, are there any common examples that one should inform their surgeon?
Dr. Cashon: Cataract surgery may not be recommended if you have other conditions such as macular degeneration, detached retina, or other conditions affecting your visual potential or health of your eyes. Each patient and each eye is evaluated individually to assure a favorable outcome. All ocular history and medications should be discussed and reviewed with your optometrist and eye surgeon to prevent any unnecessary complications.
Q: If you have cataracts in both eyes, do you operate on both at the same time, or separately? And how much time is there between?
Dr. Cashon: Cataract surgery is done one eye at a time. In most cases, the surgery is first performed on one eye, and, if needed, the second eye is operated on at least 10-14 days later. Cataracts may develop at different rates, so a patient may not necessarily require cataract surgery on both eyes. In certain cases, patients can wait months and even years to have the other eye done.
Q. After cataract surgery, what is the typical recovery time? Also, after cataract surgery and an insertion of an artificial lens, can a person rub or massage the closed eye with a finger to relieve an itch, etc.? Must one be careful doing this for the rest of his life?
Dr. Cashon: Vision after cataract surgery is typically much better after only a few days, but as the eye heals, it may take up to a month for vision to fully stabilize. After the surgery, you may be given an eye patch or guard to prevent rubbing, itching, or bumping the eye and is often worn, at least at night while you sleep. Rubbing or itching the eye in the first 1-2 weeks is normal.
Q: Once you have gone through cataract surgery, is the correction permanent, or can cataracts reappear?
Dr. Cashon: Cataract surgery is a permanent procedure, but a secondary cataract may form in the back capsule that the artificial lens was placed in. This incidence of a secondary cataract may occur in 5-50% of eyes after the initial cataract surgery. Most often though, the secondary cataract can be treated with a very short, out-patient, laser procedure.
Q: What type of treatment does a patient need post-surgery? Who can provide such treatment?
Dr. Cashon: After cataract surgery, a patient is given eye drops to treat inflammation and also given antibiotic eye drops to prevent any infection. There are also follow-up visits required after surgery, typically after 1 day, 1 week, and then 1 month to monitor the healing and vision. The 1-day post-op visit is most often done by the Ophthalmologist who performed the surgery, but your post-op care may be co-managed by your referring Optometrist. If you have any questions, feel free to ask me or one of our other eye doctors today!
Symptoms of Cataracts
Maybe you have noticed your vision getting a little blurry? Sort of like looking through a smudged piece of glass or a cloudy lens? Have you noticed that when driving at night, the oncoming headlights seem bright or glaring? Do colors not appear as bright as they used to?
These are all symptoms of cataracts. There are different types of cataract and the type of cataract you have will affect the symptoms you experience.
Different Types of Cataracts
There is a type of cataract called a nuclear cataract that can actually bring about a temporary improvement in your near vision called ‘second sight’. Unfortunately, this effect doesn’t last long and will disappear as the cataract gets worse.
Another type of cataract is called a subcapsular cataract. A subcapsular cataract may produce no symptoms at all until it is nearly fully developed.
Cataracts can cause permanent damage to your eyes if they go untreated. The important thing is, that if you think you may have a cataract, contact your eye doctor as soon as possible and find out if you do.
Cataracts Treatment
Treatment for cataracts involves surgery, but being diagnosed with a cataract does not mean that you need to have surgery immediately, or maybe ever. You may be able to live with symptoms of early cataracts for a while by using vision aids such as glasses, anti-glare sunglasses, magnification lenses, strong bifocals or brighter lighting to suit your needs.
Surgery should be considered when the condition begins to seriously impair your vision to the extent that it affects your daily life such as reading or driving, playing golf, playing cards, watching TV, etc. Sometimes surgery is also necessary if the cataracts are preventing treatment of another eye problem.
The good news is that cataract surgery is typically very successful in restoring your vision. Together with your eye doctor, you will decide if and when the time for surgery has arrived.
Cataract Surgery
Cataract surgery is one of most common surgeries performed in North America and has a 90% success rate (meaning the patient has improved vision, between 20/20 and 20/40 vision, following the procedure).
Cataract surgery is the removal of the natural lens of the eye (also called "crystalline lens") that has developed an opacification, which is referred to as a cataract. Metabolic changes of the crystalline lens fibers over time lead to the development of the cataract and loss of transparency, causing impairment or loss of vision.
The surgery involves removing the clouded natural lens and usually replacing it with a clear, plastic intraocular lens (IOL) that becomes a permanent part of the eye. It is a relatively quick and painless procedure and you will not feel or see the IOL after the implant.
Following surgical removal of the natural lens, an artificial intraocular lens implant is inserted (eye surgeons say that the lens is "implanted"). Cataract surgery is generally performed by an ophthalmologist (eye surgeon) in an ambulatory (rather than inpatient) setting, in a surgical center or hospital, using local anesthesia (either topical, peribulbar or retrobulbar), usually causing little or no discomfort to the patient.
Day care, high volume, minimally invasive, small incision phacoemulsification with quick post-op recovery has become the standard of care in cataract surgery all over the world.
Preventing Cataracts
While development of cataracts is largely associated with age, there are other factors that can increase the risk of developing the condition. By knowing these risk factors, there are steps you can take to delay or prevent the development of cataracts:
- Sun Protection: Ultraviolet radiation can be a factor in the development of cataracts. It is recommended to protect your eyes from ultraviolet sunlight by wearing 100% UV protective sunglasses and a hat with a brim when you are exposed to the sun.
- Stop Smoking and Limit Alcohol Intake: These habits have been shown to increase the chances of developing cataracts, so if you smoke or regularly consume large amounts of alcohol – stop these habits.
- Proper Nutrition: Research shows that maintaining good health and nutrition can also reduce the risk of age-related cataracts, particularly by eating foods rich with vitamins A (beta-carotene), C and E and other antioxidants found in green leafy vegetables, fruit and a diet rich in Omega-3s.
- Regular Eye Exams: Once you reach the age of 50, or if you have diabetes or other eye conditions, it is important to have a comprehensive eye exam every year to check for signs of cataracts and other age-related eye conditions such as age-related macular degeneration or glaucoma. Early detection and treatment for many of these eye and vision disorders is often essential to save your vision.