Thank you for consulting Maryland Eye Associates regarding your cataract care. The purpose of this page is to educate the reader about cataracts and their treatment. If you have questions after viewing this information, please consult your ophthalmologist or Eye-MD, or email us below.
A cataract is a cloudiness or haze in the natural lens of the eye. More than 50 percent of individuals over the age of 60 will have some degree of cataract, and quite a few younger than that, especially in diabetics, following trauma, or with the use of certain prescription drugs such as prednisone. The progressive clouding of the lens causes symptoms such as blurred distant and/or near vision, halos and glare with lights, difficulty driving or reading, double vision, and decreased vision in either dim or bright light. Frequent changes in eyeglass prescriptions may also be a sign of cataract formation.
To date, there is no medical treatment to reverse or arrest cataract formation, either in oral or eyedrop medications. The only successful current treatment is surgical removal of the clouded natural lens. When the natural lens is removed, an artificial lens is inserted in its place: an intraocular lens, also known as an "IOL", or lens implant.
When your grandmother had cataract surgery she probably stayed in the hospital for two weeks with sandbags around her head to prevent movement. As late as 1980, a three-day hospitalization was in order. Today, with the modern technique of cataract removal using a small (1/8 inch) incision and a method called "phacoemulsification", cataract extraction and IOL placement is safely performed as an outpatient, with a brief pre- and post-operative monitoring period.
The surgery is comfortably performed under local or topical anesthesia and takes from 10-25 minutes. With this technique, the cataract is fragmented into microscopic particles using high energy sound waves, and gently aspirated from the eye. Following phacoemulsification, the tiny incision is determined to be self-sealing, or is closed with a single suture. Most cataracts can be removed utilizing phacoemnulsification, although this technique is not appropriate for all cataracts. Your ophthalmologist will discuss your particular surgical plan with you.
The lens implant inserted at the conclusion of the procedure is designed to provide clear vision, with fine-tuning usually required in eyeglasses for your best distance and near vision. A survey conducted by the American Society of Cataract and Refractive Surgeons found that more than 98% of cataract patients had their vision significantly improved following cataract surgery, and Maryland Eye Associates' statistics follow this national survey result.
Patients frequently ask if we use a laser to remove their cataract. It is a broad misconception that lasers are used to remove cataracts. Although there is much research being pursued to use laser technology for cataracts, there is currently no laser available which will remove a cataract. The most up-to-date method of removing a cataract involves a technique called "phacoemulsification" in which pulsed ultrasound energy is used to gently break up the cataract into microscopic fragments which are then aspirated from the eye. This is the technique used by Maryland Eye Associates surgeons.
Patients frequently ask: "When should I have my cataract removed?" Cataracts develop at variable rates, usually over years, although some may progress over a few short months. The time to have your cataract removed is when you feel that you are unable to comfortably perform your daily visual tasks, and when you feel your blurred vision is interfering with your quality of life. After a thorough eye exam, if your ophthalmologist determines that all or most of your visual discomfort is due to a cataract, and that your eye is otherwise healthy, then "go for it".
Your doctor and eyecare team will give you step-by-step instructions following surgery, but recovery is usually quite easy. Immediately after surgery you will likely wear an eye patch for approximately 24 hours, until your first post-operative office visit the day after surgery. During the first few weeks of recovery, you will have a simple schedule of eyedrops to instill, usually an antibiotic to prevent infection, and an anti-inflammatory drop to control the normal postoperative inflammation. Restrictions on your activity are few with these modern techniques of surgery. No more: "don't bend over or lift or sleep on that side" you may have heard in the past. Your Doctor will give you your specific instructions, depending on your eye's response to surgery. Visual acuity in the first several weeks is variable from patient-to-patient, and may be very clear or somewhat blurred. You are using your new vision from the day the patch is removed, and may pursue normal activities, including driving, when your common sense tells you it is safe. After 4 to 6 weeks, the eye has healed and stabilized sufficiently to prescribe any change in eyeglasses which may be necessary to "fine-tune" your vision.
Another frequently asked question is: "Will my cataract grow back?" No, removal of a cataract, or clouded natural lens, is permanent. However, vision may become gradually diminished months or years after cataract removal due to a clouding of the lens capsule, a portion of the natural lens left in place intentionally at cataract surgery. This clouding causes symptoms similar to early cataract formation: blurred vision, glare, problems reading or driving.
This is a relatively common occurrence, and is safely and simply taken care of with a laser treatment. The laser, known as a "YAG" laser, creates a small clear opening in the cloudy capsule, returning vision to the clarity achieved following the initial cataract surgery, as long as the eye is otherwise healthy. This is an office procedure, after which activity is unrestricted, and visual recovery is rapid.