Modern-Day-Cataract-SurgeryWe are lucky today to live in a world with rapidly advancing technology, and even more so as it has helped improve healthcare, especially in the field of ophthalmology.  Cataract surgery has evolved dramatically in just the past fifty years, changing from a surgery that required hospitalization and bed rest for 3 days to a surgery that can now be done in an outpatient setting with patients returning to most of their regular activities later that afternoon! In addition, we now have the ability to not only remove a person’s cataract, but to also to improve the overall quality of vision and in some cases reduce or eliminate the need for glasses after surgery. In this article, we will discuss the symptoms of cataract, who to see for an evaluation and what to expect during surgery.

What is a cataract?

A cataract is the clouding and hardening of the eye’s natural lens. This lens starts out clear when we are born, and then with time and aging, the lens proteins change and lens turns yellow and then brown. This is defined as a cataract when the vision becomes blurry. While it is important to live a healthy lifestyle, cataracts usually affect everyone and are as natural as gray hair and wrinkles.   Fortunately, we have a permanent solution for removing cataracts and improving vision.

How do I know if I have cataracts?

This is one of the most common questions I receive in my practice every day and it’s important to know the symptoms of cataracts.  Cataracts often start with a gradual worsening of vision, often described as “cloudy” or “hazy” vision.  Colors may also start to become less bright and often times patients will give up driving at night, especially due to the glare or haloes around headlights.  Eventually, a person will still experience blurry vision that can’t be corrected with glasses or contacts, and this is the time to consider cataract surgery

Who should I see if I think I have cataracts?

It’s an important to see an eye care professional, either an optometrist or ophthalmologist, on a routine basis in order to ensure that no eye disease exists.   This applies even if you do not have visual symptoms and even if you do not wear glasses or contact lenses.  The American Academy of Ophthalmology recommends a baseline screening exam for everyone at the age of 40, and then routine annual or biannual exams, depending on your age, from then, even in the absence of eye problems. These routine exams are important to screen for not only cataracts, but also diseases such as glaucoma and macular degeneration. If you believe you are experiencing symptoms of cataracts, it’s important to consult with an eye care professional.  If the examination determines that you would benefit from cataract surgery, then your next step would be to spend time with your cataract surgeon to determine what your goals for surgery will be.

What should I expect when at my first visit with my ophthalmologist?

On your first visit with your eye surgeon, you will receive a comprehensive eye exam, which will include checking your vision, current glasses, eye pressure and also you dilating eye drops will be placed in your eyes. These drops dilate your pupils so your eye doctor can do a thorough exam. You may also receive some special tests in order to prepare for possible cataract surgery or may be asked to return on another date for these tests, depending on surgeon preference.  Your surgeon will review your eye health, and discuss your options for cataract surgery, including your interest in reducing your need for postoperative glasses (even the potential for reducing or eliminating your need for glasses).

What are my options? What is new with cataract surgery today?

The most exciting thing about cataract surgery today is the potential to eliminate the need for glasses for distance as well as for reading, although not all patients are candidates for these technologies.  The reduction in the need for glasses is termed ”refractive cataract surgery.” Refractive cataract surgery means that special techniques are used during cataract surgery to customize the visual result, including special intraocular lens implants, as well as the use of laser to automate part of the procedure.  Prior to this advancement in surgery, the use of glasses after surgery was much more common and widespread, and the specialized customization we have now was not possible. Refractive cataract surgery does not affect the patient experience. It is not painful and the recovery time and healing is the same, if not faster. It is very important that you speak with your eye surgeon about the best option for you, as there are some eye conditions that prevent the use of advanced lens implants. Your eye surgeon will be able to tell determine which options would be best for you.

What should I expect on the day of surgery?

On the day of surgery, you will arrive at the surgery center and dilating drops will be placed in your eye.  You will then be taken to the operating room where the surgery will be performed. An anesthetist will be present to help administer medications for relaxation. The time spent in surgery is about 15 minutes.  Following the procedure, you will be taken to the recovery room.  Since general anesthesia is not required, the health risks are much less and the recovery is faster. After a short time in the surgery center, you will be released to go home. Your doctor will see you either later that day or the next day for a check up. Patients are often seeing much clearer within several hours following surgery and most report there is no pain during or after surgery. Cataract surgery is the most common surgery performed in the United States and can have such a life changing and wonderful impact on patients.  However, as always, it is important to consult with an eye surgeon to know if cataract surgery is right for you.

By Jennifer Loh, MD