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Cataracts

What is a cataract?

A cataract is usually the result of the natural aging process. As you get older, the natural lens, located behind the iris in your eye, may gradually begin to get “cloudy” and interfere with light and images getting to your retina. As the lens becomes cloudier, your vision slowly becomes more blurred. If allowed to remain, the cataract will progress to the point where there will be a complete loss of vision in your eye. Surgery is the only way to remove a cataract.

What causes cataracts?

Although scientists do not know for sure what causes cataracts, they suspect there could be several possible causes including:

  • smoking
  • diabetes
  • excessive exposure to sunlight
  • steroid use
  • diuretic use
  • certain major tranquilizers

For several of the potential causes listed (i.e., steroids, diuretics, and/or major tranquilizers), additional research is needed to differentiate the effect of the disease from the effect of the drugs themselves.

What are the symptoms of cataracts?

The following are the most common symptoms of cataracts. However, each individual may experience symptoms differently. Symptoms may include:

  • cloudy or blurry vision
  • lights appear too bright and/or present a glare or a surrounding halo
  • poor night vision
  • multiple vision
  • colors seem faded
  • increased nearsightedness – increasing the need to change eyeglass prescriptions
  • distortion of vision in either eye

Often in the disease’s early stages, you may not notice any changes in your vision. Since cataracts tend to grow slowly, your vision will worsen gradually. Certain cataracts can also cause a temporary improvement in close-up vision, but this is likely to worsen as the cataract grows.

 

What are the different types of cataracts?

    • age-related cataracts The majority of cataracts are related to aging.

       

    • congenital cataracts Some babies are born with cataracts or develop them in childhood, often in both eyes. Some congenital cataracts do not affect vision, but others do and need to be removed.

       

    • secondary cataracts Secondary cataracts develop primarily as a result of another disease occurrence in the body (i.e., diabetes). Secondary cataract development has also been linked to steroid use.

       

    • traumatic cataracts Eye(s) that have sustained an injury may develop a traumatic cataract either immediately following the incident, or several years later.

       

 

Cataract Descriptions:

  • nuclear cataractThis is the most common type of cataract, and the most common type associated with aging. Nuclear cataracts develop in the center of the lens and can induce myopia, or nearsightedness – a temporary improvement in reading vision which is sometimes referred to as “second sight.” Unfortunately, “second sight” disappears as the cataract grows.

     

  • cortical cataractThis type of cataract initially develops as wedge-shaped spokes in the cortex of the lens, with the spokes extending from the outside of the lens to the center. When these spokes reach the center of the lens they interfere with the transmission of light and cause glare and loss of contrast. This type of cataract is frequently developed in persons with diabetes, and while it usually develops slowly, it may impair both distance and near vision so significantly that surgery is often suggested at an early stage.

     

  • subcapsular cataractA subcapsular cataract usually starts as a small opacity under the capsule, at the back of the lens. This type of cataract develops slowly and significant symptoms may not occur until the cataract is well developed. A subcapsular cataract is often found in persons with diabetes, myopia, retinitis pigmentosa, and in those taking steroids.

     

How are cataracts diagnosed?

  • Visual Acuity Test – this tests how clearly the individual can see an object. It tests the person’s sharpness of vision. The patient reads letters from across a room.
  • Retinal Examination – eye drops are administered which dilate the pupils, providing a bigger window to the back of the eyes. The specialist examines the lens for signs of cataract

What are the risk factors for cataracts?

Possible risk factors for cataracts include:

  • ageGreatest risk factor for cataracts is age. And, although age-related cataracts may develop between 40 and 50 years old, vision is usually not affected greatly until after age 60.

     

  • excessive sun exposurePerson who spend more time in the sun may develop cataracts earlier than others. The American Academy of Ophthalmology now recommends wearing sunglasses and well shading hat to lessen exposure to ultraviolet rays.

     

How does Cataract Surgery Work?

Cataract surgery in the average patient now takes about 20 minutes or less. The patient is able to resume normal activity shortly after surgery. The incision to remove the cataract is so small that stitches are usually unnecessary and healing is largely completed in a week or two. With the advent of microsurgery and the intraocular lens implant , cataracts no longer have to “ripen” and can be removed at any stage. A cataract is generally removed when it affects quality of life. Cataract surgery is accompanied by insertion of a clear, plastic intraocular lens. (IOL)

Types of IOLs

Dr. Davies will explain which of the different types of IOL may work best for you.

There are two main types of IOL to consider: monofocal and multifocal intraocular lenses.

A multifocal lens implant is designed for the correction of both near and far vision. Your brain must learn to select the visual information it needs to form an image of either near or distant objects, so multifocal lenses may require a period of adjustment. Generally a patient may adjust better to multifocal intraocular lenses if they are placed in both eyes.

Intraocular Lenses – Multifocal and Monofocal Lens Implant

Intraocular lenses – also called IOLs – come in two varieties: monofocal and multifocal intraocular lenses. IOLs are implantable lenses that replace the lens of the eye when it is removed during cataract surgery. Originally, IOLs were monofocal, or corrective of vision at one distance only, whether near, intermediate, or far. Since they correct vision at just one distance, glasses are still needed, especially if the patient suffers from presbyopia (or age-related farsightedness). Newer, multifocal intraocular lenses will correct vision at multiple ranges, without the use of glasses or regular contact lenses. Learn more about Crystalens® IOLs.

ReSTOR®

AcrySof® ReSTOR® multifocal intraocular lenses are uniquely designed to improve vision at all distances, giving cataract patients the opportunity to experience life without glasses. ReSTOR® is modeled after microscope and telescope technology and focuses at both near and far distances, decreasing your dependency on glasses.

ReZoom™

The ReZoom™ intraocular lens is a next-generation refractive multifocal lens implant that provides hyperopic cataract patients with greater independence from glasses than monofocal IOLs.

Crystalens®

Crystalens® is the first intraocular lens for cataracts that also provides accommodation, the ability to adjust focus between near, far, and midrange vision. Crystalens® is designed to mimic the eye’s natural process of accommodation. Other monofocal IOLs are fixed and stationary within the eye. Learn more about Crystalens® IOLs.

TECNIS™

TECNIS™ intraocular lenses minimize glare and have been shown to allow significantly greater detail and contrast than traditional IOLs. TECNIS™ lenses have shown particular effectiveness in patients with reduced contrast sensitivity in low-light situations.

The IOL Procedure

The IOL procedure is performed on an outpatient basis, usually requiring just a few hours to complete. The eye(s) is treated with anesthetic to limit any discomfort. A tiny incision is made at the edge of the eye and the cataract is removed. The monofocal or multifocal lens implant is then inserted through the same tiny incision.

How Is IOL Surgery Different Than Cataract Surgery?

IOL and cataract surgery are very similar and virtually the same. In both instances, the natural lens of your eye is removed through a small incision made in the iris of your eye and replaced by a man-made lens that is designed to remain permanently. The only difference is that IOL is a totally elective procedure done to decrease the need for glasses; removing the cataract in cataract surgery is done for medical reasons (i.e. adequate vision cannot be achieved with glasses).

How do I know if I am a candidate for cataract or IOL surgery?

You may be a candidate for IOL surgery if you

  • are over the age of 50 and having difficulty focusing on objects up close.
  • do not qualify for laser vision correction, such as LASIK, because you are either too farsighted or too nearsighted.
  • are tired of wearing bifocals or progressives lenses for both reading and distance vision

You may be a candidate for cataract surgery if you

  • are noticing decreased night vision, impaired depth perception, and increased color distortion

 

Contact Our Davies Eye Center

 

If you would like more information on Cataract Surgery or need to schedule an assessment, Call us at (760) 729-7101

 

 

 

 

 

 

 

 

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