By Ernst Lamothe Jr
As you get older your eyes age as well. The most common eye ailment is cataracts, a prevalent vision-related issue which causes clouding of the eye’s lens. In an eye without a cataracts, the lens of the eye is clear, allowing light to pass through to reach the retina, facilitating clear vision. However, with age and various other factors, the lens becomes cloudy and opaque. The World Health Organization estimated 95 million people worldwide are affected by cataracts.
“Cataracts are the leading cause of blindness worldwide and are treatable with a minor surgical procedure that has a high success rate and safety profile,” said Desiree Albert, an ophthalmology specialist at the Rochester Regional Health Eye Care. “Having routine complete eye exams is important to monitor for the presence and progression of cataract.”
While symptoms of cataracts can vary, they often include blurry or cloudy vision, light sensitivity, difficulty seeing in dim or low-light conditions, seeing halos around lights and changes in one’s perception of color. It is important to remember that symptoms of cataracts can occur gradually.
Albert discusses five things you need to know about cataracts.
1 — Causes
Age is a primary factor in the development of cataracts. As individuals age, the proteins in the lens of the eye clump together, causing cloudiness. In many cases, this cloudiness starts small and gradually increases over time, significantly impacting visual quality.
Other factors that contribute to the development of cataracts include prolonged exposure to ultraviolet radiation from the sun, certain medical conditions such as diabetes, medication usage, smoking and excessive alcohol consumption.
Treatment for cataracts typically involves surgical removal of the cloudy lens, replacing it with an artificial lens. Cataract surgery is a very common and successful surgical procedure that is performed worldwide. In fact, advancements in cataract surgery techniques have greatly improved outcomes and recovery times.
“The most common reason why people need cataract surgery is a noticeable and bothersome decrease in quality of vision. Often patients notice difficulty with night vision, such as trouble reading street signs at night or excessive glare from oncoming headlights,” said Albert. “Others may notice difficulty reading small print or seeing subtitles on the TV. If you feel there has been a change in your vision and you are struggling, schedule a complete eye exam with an ophthalmologist or optometrist to be evaluated.”
2 — Misconceptions
Patients are often surprised to hear they have early signs of cataract when they are in their 50s, but this is usually when cataracts begin. Cataracts progress over time but this change occurs slowly. It takes years, sometimes even decades, between the early signs of cataract and when it becomes visually bothersome. Some people think that cataracts are hereditary. But the truth is that all people develop cataracts eventually.
“People often fear the idea of eye surgery. They are understandably uncomfortable with the idea of their eye being operated on. The reality though is that cataract surgery is the most common operation performed in the United States. It is one of the easiest operations to undergo as a patient,” said Albert. “The operation is quick and painless and anesthesia is utilized to ensure the patient is comfortable and relaxed throughout the whole process.”
3 — Cataract surgery
The process of cataract surgery begins with a pre-operative visit done in the office a few weeks prior to surgery in order to take measurements, review cataract surgery instructions and finalize the surgical plan with your surgeon. The surgery itself is performed as an outpatient at an ambulatory surgery center.
“When surgery is needed for both eyes, we always operate on the two eyes on separate days for safety purposes and these two surgeries are usually spaced apart by about two to four weeks,” Albert explained. “The surgery itself is a painless procedure done under mild IV sedation. Except in rare cases, general anesthesia isn’t needed. The procedure takes about 10-15 minutes in most cases.
“We place an implant lens at the time of cataract surgery. This is considered standard of care everywhere that cataract surgery is performed in the world. The implant lens is a clear artificial lens that is placed securely inside the eye. This lens does not degrade over time and will not need to be replaced in the future,” she added.
4 — Recovery
Fortunately, the recovery period after surgery is usually a very comfortable one and vision often improves rapidly. While there are some exceptions, most patients notice within one or two days of surgery that the vision is already a little bit better than before surgery. The vision tends to improve each day from there until it reaches its final clarity.
“Pain in the postoperative period is not expected, though some patients feel a mild scratchy sensation for about a day or two after surgery. We instruct patients to limit activity after surgery for one week with no heavy lifting or strenuous exercise,” said Albert. “There is a medicated eye drop that is taken for approximately one month after surgery for each eye that helps with healing and helps to prevent infection.”
In addition, there are a series of post op visits performed in the office after surgery, including one day after surgery for each eye. If a new prescription for glasses is needed after surgery, this will be provided about one month after surgery.
5 — Surgery side effects
Possible side effects immediately after surgery include blurred vision, halos in the vision, light sensitivity, eye redness and mild eye irritation or foreign body sensation. Some patients experience none of these; others experience multiple of them. In most cases these side effects are mild and improve over the course of the first few days after surgery.
The most common complication after surgery is development of an “after cataract” which is a cloudiness occurring on a natural structure called the capsule which remains in the eye after surgery. When this occurs, it may cause a return of blurred vision months or years after your surgery.
“The most serious risk of surgery is fortunately also the rarest, eye infection. Infection inside the eye is possible after surgery and when this occurs it can cause permanent damage to the eye if not treated quickly. The frequency of this happening is far less than one percent,” said Albert.