What is a Cataract?

A cataract is a clouding of the normally clear lens of the eye. It can be compared to a window that is frosted or steamed. There are many misconceptions about cataracts. It is not a film over the eye nor is it caused by overusing the eyes. It is not a cancer and does not spread from one eye to the other. It does not cause irreversible blindness. Symptoms related to cataract include a painless blurring of vision associated with glare and light sensitivity. Patients frequently have to change their eyeglass prescription and on occasion will even notice double vision in one eye. They frequently need brighter light to read and have poor night vision. They may even complain of fading or yellowing of colors. The amount and pattern of this cloudiness varies within the lens itself. If the cloudiness is not to the center of the lens, you may not be aware that a cataract is present.

What Causes Cataracts?

The most common type of cataract is related to aging of the eyes, but other causes include a positive family history, other medical problems including diabetes and inflammatory eye diseases, injury to the eye, and perhaps medications such as steroids. Long term unprotected exposure to sunlight and previous eye surgery have all been implicated in the origin and progression of cataracts. The only way a cataract can be detected is by a thorough examination by your ophthalmologist (medical eye doctor). He or she can detect the presence and extent of the cataract as well as any other condition that may be causing blurred vision or discomfort.

Cataracts develop differently in individuals and may even develop differently between the two eyes. Most cataracts are associated with the aging process and gradually get worse over a period of years. Other cataracts, especially in younger people and people with diabetes, may progress rapidly over a few months causing a worsening of vision. It is not possible to predict how fast cataracts will develop in any given patient. Surgery is the only way your ophthalmologist can remove a cataract, however, if symptoms from the cataract are mild, a change in glasses may be all that is needed for you to function more comfortably.

What Can be Done?

There are no medications, exercise, or optical devices that have been shown to prevent or cure cataracts. Some recent studies have shown that protection from excessive sunlight may help prevent or slow the progression of cataracts. Sunglasses that screen out ultraviolet light and regular glasses with a clear anti-UV coating offer this protection. Cataract surgery should be considered when cataracts cause enough loss of vision to interfere with daily activities. It is not true that cataracts need to be ripe before they can be removed. Cataract surgery can be performed when your visual needs require it. Many patients relate that it is like driving a car with a dirty windshield. You must decide if you can see to do your job and drive safely, if you can read and watch TV in comfort. Also, can you perform daily tasks such as cooking, shopping, yard work, and taking medications without difficulty.

Based on your symptoms, you and your ophthalmologist should decide together when surgery is appropriate. Over 1.4 million people have cataract surgery each year in the United States. 95% of these are without complication. During cataract surgery, which is usually performed under local anesthesia as an outpatient procedure, the cloudy lens is removed from the eye. In most cases, the focusing power of the natural lens is restored by replacing it with a permanent intraocular lens implant. Your ophthalmologist performs this delicate surgery using the microscope, microsurgical techniques and other modern technology. Although it is a common misconception, lasers are not used to remove cataracts at this time. In approximately one-fifth of people having cataract surgery, the natural capsule that supports the intraocular lens will eventually become cloudy. Laser surgery is then used to open this cloudy capsule to restore clear vision. After cataract surgery, you may return almost immediately to all but the most strenuous activities. You will have to take eye drops as your ophthalmologist directs for several weeks. Several post-operative visits are needed to check the progress of the eye as it heals.

Cataract surgery is a highly successful procedure. Improved vision results in over 95% of cases unless there are other disease processes going on in the eye. It is important to understand that complications can occur during and after surgery, some of which may be severe enough to limit vision. As with any surgery, a good result cannot be guaranteed, but the odds are greatly on your side of having a good end result. In conclusion, cataracts are a common cause of poor vision, particularly in the elderly, but they are quite treatable. We can tell you whether cataract or some other problem is the cause of your loss of vision or discomfort, and can help you decide if cataract surgery is appropriate for you.

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