The lens of the eye is a clear, rounded structure inside the eye that focuses light on the retina, the tissue that allows us to see the world around us. In a normal eye, light passes through a transparent lens to the retina and the image you see would be clear and in focus. A cataract is a clouding, hazing, or opacity of the previously clear lens that causes the image focused on the retina to be blurred, distorted, or out of focus. A cataract can cause an increase in glare and poor night vision, colors to look desaturated or muted, and sometimes even double vision.
Cataracts are a very common eye condition, especially as we age. According to the National Eye Institute, by age 80 more than half of all Americans have either a cataract developing or have had cataract surgery. It can occur in either or both eyes, but once a cataract is surgically removed, it cannot return in that eye. Certain diseases such as diabetes make you more at risk to developing cataracts, as well as lifestyle choices such as smoking and alcohol use. The environment or area where you live could influence your risk. Cataract prevalence has been shown to increase with proximity to the earth's equator where the population has more exposure to strong ultraviolet sunlight. Cataracts can develop as a result of exposure to some types of radiation and a result of trauma in or around the eye. Additionally, some babies are born with congenital cataracts, which may or may not affect the vision.
Cataracts can be diagnosed during a comprehensive eye exam by your eye care provider. Your visual acuity will be tested and a refraction will be performed to see if your vision can be improved by a new or updated glasses prescription. If your vision can be well corrected with a prescription, it is unlikely that the cataract is very advanced. The doctor will examine your eye using a slit-lamp biomicroscope that allow her to view the structures of the eye under magnification with an intense line of light. The structures are viewed in smaller sections by this slit of light, which make abnormalities to be easily detected. By dilating the pupil, the lens of the eye is more thoroughly viewed and examined for signs of cataract. A small undilated pupil can hinder how much of the lens is seen and the severity of a cataract, therefore dilation is a very important component of the exam.
There are several factors to consider when determining if cataract surgery is right for you. Just because cataracts are beginning to develop does not mean that they have removed right away. We suggest cataract surgery when the condition starts to affect your quality of life or interfere with normal daily activities, such as driving, reading, or working. It’s up to you and you doctor to decide when is the right time for cataract surgery. There is usually no rush because cataracts do not harm the eye if you decide to wait and watch for progression. Some conditions can cause cataracts to develop faster. Your eye care provider may recommend more frequent visits to monitor your cataracts depending on their severity.
During cataract surgery, your own natural lens which is now clouded and yellow where the cataract has developed, is removed and replaced with a clear, synthetic one. This lens implant now becomes a permanent part of your eye and is placed in the same position where your own lens was. Cataract surgery is an outpatient procedure, generally done in a surgery center, and you go home and follow up with your surgeon at their office the next day. Most of the time, a local anesthetic is used instead of putting you under general anesthesia. Before and after surgery you will use eyedrops to prevent infection and inflammation while the eye heals and have several follow ups with your surgeon and regular eye care provider. If both eyes require cataract surgery, the second eye will be performed usually a few weeks after the first eye has healed well. Depending on the kind of lens implant you and your surgeon choose, it is possible to no longer need vision correction for either distance vision, near vision, or even both. Cataract surgery is now a common and generally safe procedure, but like any surgery does have a risk of rare complications such as infection, bleeding, and retinal detachment. Your surgeon will answer your questions and ensure you are well educated on the risks versus benefits prior to surgery.