A cataract is a clouding of the crystalline lens inside the eye, preventing light from properly focusing on the retina in the back of the eye. It is estimated that approximately 20.5 million Americans, or one in every six people age 40 or older, have cataracts. By the age of 80, more than half of all Americans will have a cataract. Cataracts are a significant cause of blindness in some parts of the world, but technological advances mean that for most Americans, cataracts don't lead to vision loss. If you have a cataract, you don't have to live with it.

Most cataracts are related to age. Although cataracts usually develop with age, they can also result from eye trauma, certain diseases like diabetes, genetic inheritance, smoking, certain medications, and frequent unprotected exposure to UVA light.

The clouding of the natural clear lens in the eye results in blurred vision near and far, decreased color contrast, increased glare and/or halos around lights at night, and frequent changes in glasses prescriptions. When a cataract is small, the cloudiness affects only a small part of the lens, and you may not notice any changes in your vision. Cataracts tend to grow slowly, so vision gradually gets worse over time.

No medications can prevent or reverse cataracts, but they can be removed through a simple outpatient procedure that takes only minutes. Cataract surgery is the most commonly performed outpatient surgical procedure in the United States, with more than 1.6 million surgeries performed each year. There are no needles, no stitches, and no patches involved, and most medical insurance companies including Medicare will usually cover the cost of surgery.

A cataract can be detected through a comprehensive dilated eye exam. You can protect yourself against vision loss by working with your eye doctor and maintaining annual exams.


FREQUENTLY ASKED QUESTIONS

What is a cataract?
A cataract is the clouding of the natural lens inside the eye. The lens is a clear part of the eye that helps focus light onto the retina in the back of the eye. The lens must be clear for the retina to receive a sharp image. If the lens is cloudy from a cataract, the image you see will be blurred. A cataract can occur in either or both eyes. It cannot spread from one eye to the other. When a cataract is small, the cloudiness affects only a small part of the lens and you may not notice any changes in your vision. Cataracts tend to grow very slowly.

^ top


How do cataracts develop?
Age-related cataracts develop in two ways. Sometimes clumps of protein develop in the lens, or sometimes the clear lens slowly changes to a yellowish/brownish color. The lens consists mostly of water and protein. When the protein clumps up, it clouds the lens and reduces the light that reaches the retina. Most age-related cataracts develop from protein clumpings. Sometimes the clear lens slowly colors with age, and your vision may gradually acquire a brownish shade. At first, the amount of tinting may be small and may not cause a vision problem, but the tinting may increase over time and make it more difficult to read, perform routine activities, or identify blues and purples.

^ top


Who is at risk for cataracts?
The risk of cataract increases as you get older. Other risk factors include certain diseases such as diabetes, smoking, steroid or alcohol use, or prolonged exposure to ultraviolet sunlight. Cataracts can also form after surgery for other eye problems, such as glaucoma, or after an eye injury, sometimes years later. Some babies are born with cataracts or develop them in childhood. Cataracts can also develop after exposure to some types of radiation.

^ top


What are the symptoms of a cataract?
The most common symptoms are cloudy or blurred vision, colors that seem faded, glare or halos around headlights or lamps, poor night vision, double vision or multiple images in one eye, frequent prescription changes in your eyeglasses or contacts.

How is a cataract detected?
A comprehensive eye exam will help detect a cataract. A visual acuity test utilizing an eye chart can measure how well you see at various distances. A dilated eye exam using drops to widen (dilate) the pupils will allow your doctor to use a special magnifying lens to see inside the eye. Other tests may include equipment that uses ultrasound to measure the length of the eye and the thickness of your natural lens.

^ top


How is a cataract treated?
Symptoms of early cataracts may be improved with new eyeglasses, brighter lighting, anti-glare sunglasses, or magnifying lenses. If these measures do not help, then surgery is the only effective treatment. Surgery involves removing the cloudy lens and replacing it with an artificial lens. A cataract needs to be removed only when vision loss interferes with your everyday activities, such as driving, reading, or watching TV. You and your eye care professional can make this decision together. Sometimes a cataract should be removed even if it does not cause problems with your vision. For example, a cataract should be removed if it prevents examination or treatment of antoher eye problem, such as age-related macular degeneration or diabetic retinopathy.

^ top


Is cataract surgery effective?
Cataract removal is the most common outpatient operation performed in the United States. It is also one of the safest and most effective types of surgery. In about 90 percent of cases, people who have cataract surgery have better vision afterward.

^ top


How is surgery performed?
After being given an IV sedation along with numerous numbing, antibiotic, and anti-inflammatory eye drops, your surgeon will create a tiny incision (about 3mm, or the size of the tip of a writing pen) on the side of the cornea. A tiny probe is then inserted through the incision to emit ultrasound waves that soften and break up the natural lens so that it can be removed by suction. After the natural lens is removed, it is replaced by an artificial lens. The clear, plastic lens requires no care and becomes a permanent part of your eye. Light is focused clearly by the implant onto the retina, improving your vision. You will not feel or see the new lens inside the eye. The entire procedure takes about ten minutes.

> Click here to learn more about the various lens implants available.

^ top


Is the surgery painful?
This procedure is essentially painless. You will be given an IV sedative and your eyes will be numbed with anesthetic eye drops. You will be awake for the procedure, but in a sleepy, dream-like state. Some patients may experience a feeling of light pressure from the lid speculum (the instrument used to hold your eyelids open), but you should not experience any pain. If you should feel uncomfortable during the procedure, you may be given more IV sedation.

^ top


Will you be cutting the cornea?
Cataract surgery requires that a very tiny incision, roughly 3mm in length, be made on the outer edge of the cornea. Your surgeon may also elect to make micro-incisions, called limbal relaxing incisions (LRIs), on one or two sides of the cornea in order to reduce astigmatism. Since the incision is "self-sealing" it usually requires no stitches. It remains tightly closed by the natural outward pressure inside the eye. This type of incision also heals quickly and comfortably.

Are both eyes treated on the same day?
No. Cataract surgery is typically performed on one eye at a time, generally one week apart. The surgery heals very rapidly in most people and vision can be excellent even on the first day, but sometimes vision will be blurry for a few days. Most patients see well enough after the first surgery to function without glasses for the week in between. Contact lens wearers can wear their contact on the untreated eye up to three days before the second surgery.

^ top


When will my vision be normal again?
You can return quickly to many every day activities, but your vision may be slightly blurry. The healing eye needs time to adjust so that it can focus properly with the other eye, especially if the other eye has a cataract. After surgery, you may notice that colors are very bright. This is because the implant is clear, unlike your natural lens that may have had a cloudy, yellowish tint that gradually worsened with time.

^ top


What are the risks of cataract surgery?
As with any surgery, cataract surgery poses risks, such as infection and bleeding. Before surgery, your doctor may ask you to temporarily stop taking certain medications that increase the risk of bleeding during surgery. After surgery, you must keep your eye clean and use the prescribed medications to help minimize the risk of infection and inflammation. Cataract surgery slightly increases your risk of retinal detachment, which is a medical emergency and must be treated immediately.

^ top


Are there certain restrictions following the procedure?
Most patients are able to return to work and other normal activities one to three days after surgery. You should be prepared to use eye drops for a few weeks after surgery to prevent infection and help the healing process. Although recovery is fairly quick, it is advisable to be careful with your eyes and avoid any strain. We also request that patients avoid lifting heavy objects, bending below the waist, and getting water in the eyes for two weeks following surgery.

^ top


Will I have to wear eye patches following the surgery?
You will not have to wear eye patches or bandages. However, you will be required to wear a clear, plastic eye shield over your treated eye when sleeping for two weeks following surgery. The eye shield is necessary to protect the eye from pressure and rubbing until the incision is fully healed.

^ top


Does the surgery need to be repeated periodically?
One of the best things about cataract surgery is how stable your vision is following the procedure. One of the primary reasons why your glasses prescription changes later in life is because of changes that naturally occur in the crystalline lens of the eye. When the natural lens is replaced, vision is much more stable. You will never develop a cataract later in life since the natural lens has been removed. In some cases, however, laser vision correction, Conductive Keratoplasty, or astigmatism surgery may need to be performed to help fine-tune results.

^ top


Can problems develop after surgery?
Sometimes the eye tissue that encloses the implanted lens becomes cloudy and may blur your vision. This can develop months or years after cataract surgery. The condition is treated with an in-office laser. Your surgeon will use a laser to make a tiny hole in the tissue behind the lens to allow light to pass through. This outpatient procedure is called a YAG laser capsulotomy. It is painless and rarely results in increased eye pressure or other eye problems. As a precaution, however, your doctor may give you eyedrops to lower your eye pressure before or after the procedure.