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Cataract Surgery Co-Management

Senior Woman, Happy and seeing well, after eye surgery for cataracts

Cataracts is a disease of the eye that results in the clouding of the lens of the eyeball. Cataracts prevent clear images from appearing on the eye’s retina; causing mild, moderate, even severe blurred vision.

Typically an eye disorder associated with aging (over half of the people in America over age 80 have either had a cataract or cataract surgery), cataracts generally occur later in life as the lens structure within the human eye changes and gets older. In addition to age, other risk factors that lead to cataracts include smoking, UV overexposure and diabetes.

During the evaluation of your eye health we will carefully examine your lens for signs of cataract formation. If a cataract is noticed and the clouding is causing visual disruption, the optometrist will refer you to a trusted and respected surgeon for surgery, which is the only known cure for cataracts. Our Eye Care Practice will be there for you providing pre and post cataract surgery care.

Cataract Surgery

Cataract surgery is the removal of the natural lens of the eye (also called "crystalline lens") that has developed an opacification, which is referred to as a cataract. Metabolic changes of the crystalline lens fibers over the time lead to the development of the cataract and loss of transparency, causing impairment or loss of vision. During cataract surgery, a patient's cloudy natural lens is removed and replaced with a synthetic lens to restore the transparency of the lens.

Following surgical removal of the natural lens, an artificial intraocular lens implant is inserted (eye surgeons say that the lens is "implanted"). Cataract surgery is generally performed by an ophthalmologist (eye surgeon) in an ambulatory (rather than inpatient) setting, in a surgical center or hospital, using local anesthesia (either topical, peribulbar, or retrobulbar), usually causing little or no discomfort to the patient. Well over 90% of operations are successful in restoring useful vision, with a low complication rate. Outpatient care, high volume, minimally invasive, small incision phacoemulsification with quick post-op recovery has become the standard of care in cataract surgery all over the world.

Q&A About Cataract Surgery
Can people avoid Cataracts & Cataract Surgery?

Cataracts is an age-related type of disease.  It is typically caused by exposure to UV radiation and the effects of the sun.  People can slow the progression of cataracts by wearing sun protection in the form of sunglasses or visors to protect the eyes.  Typically, cataract surgery is commonly done above the age of 65, however, some can develop them earlier and some later. 

What kind of symptoms could develop from a cataract?

Most people will have difficulty at night driving, as well as excessive glare issues with headlights even indoor lighting.  People generally will have more difficulty reading and need more light above to read. 

What are IOLs & how do IOLs help after cataract surgery?

IOL's are known as Intraocular Lens Implants.  These typically take the place of the existing crystalline lens inside the eyes.  This functions much like the way your lens functions within your eye.  

If you have a cataract, does that mean you have to have it removed? When is the appropriate time?

Cataracts do not necessarily have to be removed once diagnosed.  They are usually slow in progression.  It is essential to have yearly eye exams once you have been diagnosed with cataracts.  The slow progression can sometimes not even be recognized at how bad the vision has decreased to some people.  

Would prior medical conditions or medications be a problem for the cataract surgery?

If so, are there any common examples that one should inform their surgeon?  Yes, many conditions can be a problem for cataract surgery.  It is essential that you disclose all medications and current health conditions to your Surgeon prior to surgery.  

If you have cataracts in both eyes, do you operate on both at the same time, or separately? And how much time is there between?

Typically, cataract surgery is done one eye at a time.  Most surgeons prefer to wait a minimum of 2 weeks to a month before they perform surgery on the other eye to ensure that eye has had a successful outcome before doing the other eye.  

What is the difference between topical and retrobulbar surgery?

It is a type of anesthesia that is used during cataract surgery. Most surgeons feel that retrobulbar works best at minimizing the pain and discomfort of the surgery.  

After cataract surgery, what is the typical recovery time?

Also, after cataract surgery and an insertion of an artificial lens, can a person rub or massage the closed eye with a finger to relieve an itch, etc.? Must one be careful doing this for the rest of his life?  The usual recovery time is about 1 month for cataract surgery.  Most patients vision improve a couple days after surgery.  Typically, patients are faced with taking anti-inflammatory drops as well as an antibiotic drop after the surgery for a period of about 1 month.  It is usually required as well to sleep with a metal patch for a week after surgery to ensure that the patient does not rub eyes during sleep.  Rubbing of the eyes and eye drop compliance are usually the two biggest threats to complications after surgery.

Once you have gone through cataract surgery, is the correction permanent, or can cataracts reappear?

It is not uncommon to have what is known as a secondary cataract appear a few years later after surgery.  If this does occur, it usually is a very easy fix for the Surgeon as they usually do a quick laser to clear up the cloudy lens. 

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CataractsThe more you know about cataracts, the better prepared you will be to deal with them – or help prevent them in the first place!