What is a cataract?

A cataract is a progressive clouding of the normally clear lens of the eye. The amount and pattern of cloudiness with the lens can vary.

How is a cataract detected?

A thorough eye examination by your ophthalmologist can detect the presence and extent of cataract, as well as any other conditions, which may be causing blurred vision. A Slit-lamp examination of the eye is a common procedure to diagnose cataracts.

What causes cataract?

Cataract is a normal aging change of the eye. Cataracts occur when there is a buildup of protein in the lens that makes it cloudy. This prevents light from passing through a normally clear lens, causing some loss of vision. The cause of the protein buildup responsible for clouding the lens is not known. In addition, cataract can be caused by genetic disorders, medical problems such as diabetes, steroid like medications or injury to the eye.

Types of cataracts include:

  • De-related cataracts: As the name suggests, this type of cataract develops as a result of aging. Approximately 50 percent of people over age 65 have cataracts.

  • Congenital cataracts: Babies are sometimes born with cataracts as a result of genetic influences or maternal illness or injury. Or, the cataracts may develop during childhood.

  • Secondary cataracts: These may develop as a result of other diseases, such as diabetes, or long-term exposure to toxic substances, certain medications (such as corticosteroids), ultraviolet light, and radiation.

  • Traumatic cataracts: These can form after injury to the eye.

Symptoms

  • Cataract can cause blurring of vision, glare or light sensitivity, prescription changes in glasses, double vision in one eye, need for brighter light to read and poor night vision.

Cataracts often form slowly and cause few symptoms. When symptoms are present, they can include:

  • Vision that is cloudy, blurry, foggy, or filmy.
  • Sudden nearsightedness.
  • Changes in the way you see color, especially yellow.
  • Problems driving at night because oncoming headlights are distracting.
  • Double vision.
  • Sudden temporary improvement in close-up vision.
  • Problems with glare

Una mirada cercana a las cataratas…

Fuente: Alcon | Novartis

How is a cataract treated?

In the early stages of cataract development vision may be improved simply by a change in glasses prescription. In time as the cataract increases, blurred vision and other symptoms will not be relieved by the use of glasses; therefore, surgery will become necessary to restore useful vision.

When should surgery be performed?

For the most part, the results of cataract surgery are the same whenever it is performed. Hence, the patient can decide if and when to have surgery based on how the cataract affects his or her lifestyle. Cataract surgery should be considered when the cataract causes enough loss of vision to interfere with daily activities, which are important to the patient. This may be reading, driving or recreational activities such as golf or tennis.

Occasionally cataract surgery will be necessary to evaluate and treat other eye conditions, such as diabetic or age-related changes in the retina. Your ophthalmologist can help you with the decision about surgery under these circumstances.

How is cataract surgery performed?

Cataract surgery is performed on an outpatient basis with local anesthesia. The patient is awake but does not feel the procedure. The procedure usually takes 15 to 20 minutes to perform, but there is additional preoperative and postoperative time. During the surgery the clouded natural lens of the eye typically is broken up and suctioned from the eye by a process called phacoemulsification. The clouded lens is then replaced with an intraocular lens implant in order to restore vision.

How successful is cataract surgery with lens implantation?

98%

If the rest of the eye is healthy, the chance of obtaining a significant improvement in vision is approximately 95%. The chance of making vision worse is remote, in the range of 1%.

catarata_int1

How fast is the recovery from cataract surgery?

Most patients will have good vision in the operated eye the day after surgery. Strenuous activity such as heavy lifting, or activities which might lead to risk of a blow to the eye, should be avoided for several weeks. On the other hand, normal non-strenuous activities including bending, lifting, reading and driving can be resumed the day after surgery.

Is it necessary to wear prescription glasses or contact lenses after cataract surgery with an intraocular lens?

Various types and strengths of intraocular lenses are available leading to options for the patient to choose. It may be possible to see well without eye glasses or contact lenses after cataract surgery, but it is also necessary to balance the vision between the eyes and there may be issues such as astigmatism which limit the ability to avoid glasses completely. The patient and the surgeon should discuss these issues prior to surgery.

Toric IOLs offer patients with moderate astigmatism better vision without glasses. Astigmatism, a common eye condition caused by an irregularly shaped cornea or lens, causes distorted or blurred vision. Other IOLs don’t correct astigmatism, so you might need glasses to correct it after cataract surgery. If you want better vision without glasses, a toric IOL could be for you.

With a toric IOL, you usually wear glasses for reading, computer work, and other close-up activities. It is possible to have toric lenses for near vision (close focus) or to set one eye for distance and one for near. Talk with your Oregon Eye Specialists doctor about your options.

If you only have astigmatism in one eye, you only need one toric lens.

Multifocal IOLs eliminate or reduce your dependence on reading glasses compared to standard IOLs. They are designed to provide both distance (far away) and near (close up) focus at all times.

Multifocal IOLs work differently from bifocal eyeglasses. With bifocals, you look through the top part of the lens for distance and the bottom part for near vision. A multifocal IOL has concentric rings that help your brain select the right focus automatically. Like wearing bifocals, this can take time. Your vision without glasses usually improves gradually over the first year.

The rings of multifocal IOLs can create halos – a glow around lights at night. This depends partly on the size of your pupils, the area where light enters your eye. The amount of light affects halo size. With time, your brain gradually adapts, and most people with multifocal IOLs feel this effect is minor.

In research sponsored by the U.S. Food and Drug Administration, 80 percent of people with this premium IOL never needed glasses.

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