What Is A Cataract?
A cataract is nothing more than the natural lens inside the eye. Normally the natural lens is clear, but if it becomes cloudy, it is called a cataract. The word, which is derived from both Greek and Latin, describes the white appearance of a waterfall. Why? Because a very advanced cataract can give the eye a white appearance through the pupil which is usually black. In fact, there are several whitewater rapids in the Nile River called the "cataracts of the Nile", and a challenging portion of the Colorado River referred to as "Cataract Canyon". A cataract usually causes significant vision changes way before the pupil turns white. Therefore, it is uncommon nowadays for people in the U.S. to wait until they progress to such an advanced stage of clouding and vision loss before having corrective surgery.
- Blurred vision
- Increasing difficulty seeing at night
- Sensitivity to light and glare
- Seeing "halos" around lights
- Frequent changes in your eyeglass or contact lens prescription (cataracts frequently cause more nearsightedness)
- Fading or yellowing of colors (often, this is not noticed until after the cataract is removed, when the difference is very apparent)
- Double vision (less common)
- Functional vision problems, such as more trouble reading, driving, or seeing the TV clearly
With most cataracts, there is a steady trend of worsening. However, the rate varies. Some remain relatively stable for years, while others progress rapidly. Early on, you may be able to make small changes to manage your cataracts, including:
- Use brighter lights at work and/or home
- Wear anti-glare sunglasses
- Use magnifying lenses
- New glasses or contacts prescriptions
- Your doctor may recommend cataract surgery once they start interfering with daily activities such as reading, driving and watching television
Treatment depends on the severity of the cataract. In milder cases, a non-surgical option is to change the patient’s glasses prescription. However, as a cataract progresses, it often gets to the point where vision remains impaired, even with a change in glasses. That being said, the most definitive way to treat a cataract is with surgery. As an elective procedure, the surgery is scheduled in advance and is not considered an emergency.
Cataract surgery is an elective procedure. The mere presence of a cataract does not mean that surgery is necessary. The decision to have surgery depends on how the vision impairment is affecting your lifestyle. If you barely notice any change in your vision, then surgery may not be necessary. However, if the vision impairment is bothersome, and you find it more challenging to do visual tasks (reading, driving, watching TV, etc.), then surgery should be considered.
In a very small percentage of cases, delaying cataract surgery might cause permanent damage to the eye. For people who also suffer from diseases such as glaucoma or diseases of the retina, an untreated cataract may interfere with treatment of these other eye conditions. However, for most people who put off cataract surgery, there is no risk of damage to the eye, but they may be depriving themselves of the opportunity to see better.
Cataract surgery is performed in an outpatient setting, meaning there is no need for an overnight hospital stay. The surgery is performed in an operating room using an operating microscope and sterile instruments. Precautions are taken to reduce the risk of infection.
Prior to surgery, drops are administered to dilate the pupil, and most commonly, to numb the eye. Intravenous medication is typically given for relaxation during the surgery. Occasionally, injections around the eye (not in the eye) are done for deeper anesthesia. Rarely, some patients are put to sleep for the surgery.
A speculum is inserted to keep the eye open, so the patient does not have to worry about blinking. Occasionally, a laser is used to start certain steps of the surgery. Patients may see lights and vague shapes, but are not able to see any details of the surgery. A small incision is made, and an instrument inserted into the eye to break up the cataract using ultrasound. The small cataract pieces are then sucked out of the eye.
Once the cataract (the cloudy natural lens) has been removed, a new clear artificial lens is inserted. This is the implant, otherwise known as the intraocular lens or IOL. The implant is usually folded in order to go through the small incision, and then unfolds inside the eye. Most of the time, no stitches are needed.
Many people are anxious about getting surgery. To help alleviate stress about the decision-making process, we have put together some basic FAQ's for you to review.
How Common Are Cataracts?
They are quite common, and the chance of having at least one increases with age. In fact, cataract surgery is one of the most common surgeries performed in the United States (more than 3.8 million per year).
How Do I Know I’m A Candidate For The Surgery?
Your optometrist and/or ophthalmologist will perform a comprehensive eye exam to check the overall health of your eyes and evaluate if you a good candidate for surgery.
Does Cataract Surgery Have Any Risk?
Every surgery has some risk, and cataract surgery is no exception. Some of the risks include delayed recovery due to swelling of different parts of the eye, bleeding, infection and vision loss. Fortunately, permanent vision loss from cataract surgery is rare. When deciding whether or not to have cataract surgery, consider the risks and the benefits. Your surgeon will discuss the risks of surgery with you during your pre-operative consultation.
Will my cataract come back?
No, once a cataract is removed, it cannot come back. In the months and years following the cataract surgery, you may develop a posterior capsular opacity (PCO). This means the capsule, the membrane behind the implant, becomes hazy. If this happens, the surgeon can perform a safe, quick, painless laser procedure called a laser capsulotomy to clear up your vision.
What Limitations Are There Post-Surgery?
- No driving at least until after the first post-op visit, which is usually within 24 hours
- Do not rub your eye or put any pressure on the eye
- No swimming in pools or hot tubs during the first 2 weeks week of recovery
- No gardening or yard work for 2 weeks after the surgery
- Avoid irritants such as dust, dirt, wind and pollen
How Soon Will I Notice Results?
Typically, you will notice an improvement within 48 hours, often within 24 hours. Although, it is possible that your vision could take one to two weeks to adjust and settle.
To assist with your understanding, we have provided answers to some frequently asked questions about cataract surgery. Do not hesitate to call us with any other questions you may have - 704-365-0555.
Does Cataract Surgery Hurt?
Anesthetic drops are placed on the surface of the eye so that it is numb throughout the entire procedure. Additionally, a mild sedative is given to cause relaxation during the surgery. Most patients report feeling only mild pressure around the eye, but no pain, and say the experience was much easier than they had anticipated. If necessary, to achieve a deeper anesthesia, the surgery team can give injections around the eye. In rare cases, patients are put to sleep for the surgery.
Are There Different Implants To Choose From?
Yes. Cataract surgery is also an opportunity to take care of other problems at the same time, such as nearsightedness, farsightedness, astigmatism and presbyopia. Implants that correct astigmatism and presbyopia are considered "premium" implants since they are not covered by insurance. These implants are designed to reduce dependency on glasses or contact lenses after the cataract surgery. Many factors go into determining if you are a good candidate for a certain type of implant, and this should be discussed with your referring eye doctor and your surgeon.
Is Surgery Done On Both Eyes, Or One At A Time?
The current standard is to perform surgery on one eye at a time. The second eye surgery is usually done within a few weeks of the first eye. This method allows the first eye to recover and your vision in that eye to stabilize prior to surgery being performed on your other eye.
Where Is The Surgery Performed?
The cataract surgeons at Horizon Eye Care use multiple surgery centers in the Charlotte area. Your surgeon will let you know where your surgery will be scheduled.
Prior to surgery, many patients want to know about the recovery process. To help you, we have provided a list of frequently asked questions and answer below.
What Will My Recovery Be Like?
Your vision will be temporarily impaired following surgery, and you may feel tired from the sedatives. The surgeon will prescribe drops for you to use after surgery to prevent infection and swelling, and to help your eye heal. You may have a mild foreign body sensation, like you have an eyelash in your eye. This usually subsides very quickly.
Will I Be Able To Drive Myself Home?
Plan on someone else driving you to and from the surgery, as well as to your first post-operative visit.
How Long Do I Need To Wait To Have The Operation On My Second Eye?
Each patient is unique. However, if you have a cataract in both eyes, the surgeries are typically performed within a few weeks of each other.
How Soon After Can I Drive?
Most patients can resume driving within 24 hours. However, each patient is different. We recommend not driving until after your first post-op visit.
When Will I Be Able To Go Back To Work?
The answer to this question depends on multiple factors, including your occupation. Many patients are able to return to work as early as two days after surgery.
Will I Be Able To Wear Contact Lenses?
Many people find that they are much less dependent on glasses or contact lenses than they were prior to cataract surgery. Sometimes, to achieve less dependency on glasses, certain "premium" implants are used. However, if contact lenses are still desired, patients should wait until they are cleared by their doctor.
Will my insurance company cover post-op glasses?
Each plan is different, so we always recommend reaching out to your provider to learn exactly what your's will cover. For more information on insurance, head over to our Costs & Insurance page.
Make an appointment
Horizon Eye Care has been a leader in cataract and refractive surgery in the Charlotte area since 1998. Schedule an exam to determine your best treatment. Online, use our Request An Appointment form or Horizon Eye Care’s Patient Portal. Or call 704-365-0555 during regular business hours (Monday-Friday, 8 a.m. to 5 p.m.).