Cataract surgery has made extraordinary and exciting advances over the past 20 years. Last year, approximately 2.7 million Americans underwent cataract surgery. Greater than 95% of those patients now enjoy improved vision. State-of-the-art cataract surgery is now a safe, effective and comfortable procedure performed almost exclusively on an outpatient basis.
Most cataract surgeries are now performed using microscopic size incisions, advanced ultrasonic equipment to fragment cataracts into tiny fragments, and foldable intraocular lenses (IOLs) to maintain small incision size. Cataract surgery today is the result of extraordinary technological and surgical advancements that allow millions of people to once again enjoy crisp and clear vision. A true marvel of modern medicine, cataract surgery may restore vision to levels you may have never thought possible.
What is a Cataract?
A cataract is an opacity or cloudiness in the natural lens of the eye. It is still the leading cause of blindness worldwide and represents an important cause of visual impairment in the United States. The development of cataracts in the adult is related to aging, sunlight exposure, smoking, poor nutrition, eye trauma, systemic diseases and certain medications such as steroids. A single study has suggested that use of oral Vitamin C may help delay the progression of cataracts.
Just as a smudged or dirty camera lens may spoil a photograph, opacity in the natural lens of the eye can result in a blurred image. Patients with cataracts usually complain of blurred vision either at a distance, near or both. This may interfere with tasks such as driving or reading. Other common complaints include glare, halos and dimness of color vision.
Decision for Cataract Surgery
The decision for cataract surgery is reached only between the EyeMD and the patient. In general, this decision is based on the degree to which the patient’s vision is impaired and the impact that impairment has on his or her quality of life. When a patient is significantly bothered by symptoms of cataracts, cataract surgery is usually offered. Many patients will ask if a cataract must be “ripe” before surgery. The answer with today’s technology is “no.”
Before the development of small incision cataract surgery and intraocular lens implants, outcomes with cataract surgery were far inferior to outcomes today. Therefore, ophthalmologists would typically wait until a cataract was very advanced before offering surgery. Today, with advanced surgical techniques and equipment, cataract surgery can be offered at a much earlier stage. In fact, most ophthalmologists will agree that it is safer to proceed with cataract surgery at an earlier stage of development rather than waiting until the cataract is advanced and very dense.
A diagnosis of cataracts can only be made by a thorough eye examination including slit lamp (microscopic) evaluation. Other devices are sometimes used to determine if glare interferes with vision. If cataract surgery is being considered, an ophthalmologist will also examine the posterior aspect of the eye, which will include evaluation of the retina and optic nerve. If a cataract is mature (extremely dense) or hypermature (white), an ultrasound device known as a B-scan may be used to rule-out retinal detachment and ocular tumors prior to proceeding with cataract surgery.
The progression of cataracts is highly variable; however, they will invariably worsen in severity. Changing glasses may sometimes be useful in improving vision as the cataract progresses since cataracts may induce relative nearsightedness. This is the answer as to why some patients with hyperopia (farsightedness) will actually have better vision without glasses in the early stages of cataract development. For most patients, however, changing glasses has minimal impact on overall visual quality. Besides changing glasses, the only other option for treatment of cataracts is cataract surgery.
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