What is a Cataract

What is a Cataract?

A cataract is a clouding of the eye’s natural lens. This lens is responsible for focusing light and producing clear sharp images. Often times, if a cataract has developed you may see double or blurred images. Much like looking through a camera if the camera’s lens is out of focus. The lens is contained in a sealed capsular bag. As the old cells die, they become trapped inside this capsular bag. Over time, the cells accumulate causing the lens to become cloudy, which is what makes images look blurred or fuzzy. Cataracts are usually related to the aging process of the eye. However, radiation, diabetes, systemic diseases, injury to the eye, or certain medications, may also cause cataracts to develop.

Symptoms of a cataract:

The amount of cloudiness within the lens may vary, but common symptoms include:

	Blurred vision
	Glare and reduced vision in bright light
	Halos around light
	Double vision in one eye
	Frequent eyeglass prescription changes
	Poor night vision
	Need for brighter light when reading
	Fading of colors, particularly the inability to see blues and purples

How is a cataract diagnosed?

Your eye surgeon can detect a cataract by examining the interior of the eye with a microscope. Most cataracts associated with the aging process develop gradually over a period of years. The rate at which a cataract progresses varies with each person. Surgical removal of a cataract is recommended when vision problems, due to cataract formation, sufficiently interfere with a person’s daily activities.

How is a cataract removed?

There have been many significant advancements in cataract surgery. At this time, there are no drops or medication to treat, reduce, or eliminate a cataract. Though experimental lasers have recently been used to perform phacoemulsification, they offer no clear advantage over the surgical removal of a cataract.

Cataract surgery is usually performed under local or topical anesthesia. During surgery, the cloudy natural lens, or cataract, is removed and a permanent intraocular lens (IOL) is implanted. In most cases, this brief outpatient procedure restores natural vision. After this new lens is implanted many patients also enjoy less dependency on glasses for the majority of their activities, but may occasionally need glasses for reading. Cataract removal can be accomplished in several ways:

Extracapsular Extraction:

Extracapsular cataract extraction is one of the oldest surgical methods in which the eye’s natural lens is removed through a large 10-12 millimeter incision. The cataract nucleus is manually removed in one piece. Numerous stitches may be required to close the incision.

May take up to three months to achieve return to best vision

More restrictions on post-surgical activities

Higher risk complications

Phacoemulsification:

Phacoemulsification is a technique in which a small ultrasonic probe is used to break the cataract into very tiny pieces and remove it through a small incision. Widely used, this technique provides efficient removal of the cloudy lens, or cataract. A smaller incision, usually no more than 4 to 6 millimeters is used. Minimal sutures or a single "one stitch" suture method is used to close the wound following the surgical insertion of the implant. Phacoemulsification is the most advanced technique for the removal of cataracts.

Can require 2-7 weeks recovery time

Some restrictions on post-surgical activities

Small Incision/No-Stitch

A recent technique, no-stitch cataract surgery, involves removing the cataract through a small, tunnel-like incision with a tiny ultrasonic probe, again using the phacoemulsification procedure. The natural outward pressure within the eye allows the micro-tunnel incision to self seal. Patients may experience a more comfortable recuperation without stitches. This technique significantly reduces the chance of developing astigmatism (distorted vision) because there are no sutures that can alter the shape of the cornea. Though recovery may take up to three weeks, many patients report improved vision even within the first few hours after surgery.

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