If you have been told you have a cataract, your lens has become cloudy, like the bottom lens in the illustration. It is like looking through a foggy or dirty piece of glass. Things look blurry, hazy or less colorful with a cataract.
What are Cataracts?
Inside our eyes, we have a natural lens. The lens bends (refracts) light rays that come into the eye to help us see. The lens should be clear, like the lens in the illustration above. But with age, the lens begins to turn cloudy and eventually interferes with being able to see clearly.
What causes Cataracts?
Aging is the most common cause. This is due to normal eye changes that begin to happen after age 40. That is when normal proteins in the lens start to break down. This is what causes the lens to get cloudy. People over age 60 usually start to have some clouding of their lenses. However, vision problems may not happen until years later.
Other reasons you may get cataracts include
Most age-related cataracts develop gradually. Other cataracts can develop more quickly, such as those in younger people or those in people with diabetes. Doctors cannot predict how quickly a person's cataract will develop.
Dr. Champion & Dr. Crofton will examine and test your eyes to make a cataract diagnosis. This comprehensive eye exam will include dilation. This means eye drops will widen your pupils.
Cataracts can be removed only with surgery. If your cataract symptoms are not bothering you very much, you don’t have to remove a cataract. You might just need a new eyeglass prescription to help you see better. You should consider surgery when cataracts keep you from doing things you want or need to do.
How does cataract surgery work?
During cataract surgery, Dr. Champion will remove your eye’s cloudy natural lens, and then she will replace it with an artificial lens. This new lens is called an intraocular lens (or IOL). When you decide to have cataract surgery, our staff will talk with you about IOLs and how they work.
How Is Laser-Assisted Cataract Surgery Done?
A camera/ultrasound device is placed over your eye to map its surface. It also gathers information about your lens. The device sends the results to a computer that programs the laser. This tells the laser the exact location, size, and depth for incisions. Dr. Champion uses the laser to make the corneal incision and the opening in the capsule that holds the cataract. She also uses energy from the laser to soften the cataract, and make special incisions to correct astigmatism. An ultrasound probe breaks the lens into pieces and suctions them out. She then puts the IOL in the eye. Again, the incision usually does not need stitches.
Using a laser allows us to make precise incisions in less time. It can improve accuracy and consistency. The laser provides more correction than traditional surgery, by being able to correct astigmatism. The laser can also reduce the amount of ultrasound energy needed to soften the lens prior to removal, and therefore is less traumatic to the eye.
How Is Traditional Cataract Surgery Done?
Phacoemulsification is the name for traditional cataract surgery. Dr. Champion creates a small incision in your cornea by hand with a scalpel. She inserts a small instrument through this opening. It goes behind your pupil where the eye’s lens sits in a capsule. She creates a round opening in the capsule. Then your surgeon inserts a pen-shaped probe through that opening. The probe applies sound waves (ultrasound) to break up the cloudy lens. Then she suctions out the broken-up pieces. Finally she replaces your lens with an artificial intraocular lens (IOL). The incision is self-sealing and usually does not need stitches.
What Do You Want From Cataract Surgery?
Replacing a cloudy lens and wearing glasses after surgery is fine for some people. For others, getting the best possible vision without glasses is the goal. We will decide on the best option for you based on your needs. We will be asking you how you use your eyes on a daily basis. After a cloudy lens is removed, a clear Intraocular Lens (IOL) implant is placed in the eye. This lens stays in the eye forever, and because it is made of artificial material, it does not change the prescription of the eye.
IOLs come in different focusing powers, just like prescription eyeglasses or contact lenses. Your ophthalmologist will measure the length of your eye and the curve of your cornea. These measurements are used to set your IOLs focusing power.
What are IOLs made of?
Most IOLs are made of silicone, acrylic, or other plastic compositions. They are also coated with a special material to help protect your eyes from the sun's harmful ultraviolet (UV) rays.
The most common type of lens used with cataract surgery is called a monofocal IOL. It has one focusing distance. Most people have them set for clear distance vision. Then they wear eyeglasses for reading, computer and close work.
Some IOLs have different focusing powers within the same lens. These are called multifocal and extended depth of focus IOLs. These IOLs reduce your dependence on glasses by giving you clear vision for more than one set distance.
These IOLs provide both distance and near focus at the same time. The lens has different zones set at different powers.
Extended depth of focus IOLs
These IOLs are able to deliver excellent distance vision, as well as intermediate vision. Most patients are able to see their computer and phone at arm’s length. Reading glasses are still needed for near work.
What is Monovision
Monovision involves one eye, usually the dominant eye, being corrected for distance viewing, and the other eye being corrected for near viewing.
Monovision is actually a misnomer, since both eyes work together when viewing distance and near. When driving, for instance, the out of focus eye is slightly suppressed by the brain, but it still contributes important visual information regarding the periphery. This degree of teamwork between the two eyes will vary from patient to patient; therefore, a trial with monovision spectacles or monovision contact lenses is strongly advised before choosing monovision via surgery.
Monovision does involve some degree of compromise. The most common complaints can be addressed as follows:
1. Visual fatique or strain due to prolonged near work (such as needlepoint). Part-time reading glasses can be prescribed for the distance viewing eye.
2. Blurred vision may require part-time distance glasses to correct the reading eye.
3. Blurry intermediate vision, such as computer tasks, may benefit from part-time intermediate correction for both eyes.
4. Patients with monovision correction may notice flare, burn and glare with night driving. Again, part-time compensation driving glasses may be prescribed.
What to Expect with Cataract Surgery
Dr. Champion will measure your eye to determine the proper focusing power for your IOL. Also, you will be asked about any medicines you take. You might be asked not to take some of these medicines before surgery. You may be prescribed eye-drop medicines to start before surgery. These medicines help prevent infection and reduce swelling during and after surgery.
The day of surgery:
The surgery center will may ask you not to eat any solid food at least 6 hours before your surgery.
Cataract removal surgery will be done in an outpatient surgery center. here is what will happen:
How Long Does It Take To Recover From Cataract Surgery?
Days or weeks after surgery:
How Much Does Cataract Surgery Cost?
Cataract surgery costs are generally covered by Medicare if you are Medicare eligible. Private insurance usually covers cataract surgery as well. Medicare will cover your costs if your vision tests at a certain level of acuity or clarity. Private insurance plans may have similar vision requirements. Even if your surgery is covered you may still have some costs. Special types of IOLs will cost more. Choosing to have cataract surgery before your vision has deteriorated enough will cost more.
What do you do if you don't have Medicare or private insurance coverage? You may still be able to reduce and manage the cost of cataract surgery. Ask about payment plans through your our office. See if your employer offers flexible spending accounts that can help. We will can help you learn more about costs of cataract surgery.
How can I prepare for my cataract evaluation?
A pre-registration link will be emailed or texted to you prior to your appointment or on the day of your visit. Please take a few minutes to complete this prior to the day of your office evaluation. This will help make your appointment as efficient as possible.
Watch our video that discusses the basics of cataract surgery and the options for lens implants.
If you wear soft contact lenses, you will be asked to discontinue them for 2 weeks prior to your pre- cataract surgery measurements. If you wear hard contact lenses, ask your surgeon about how long to discontinue wear.
If you have dry eyes, please use artificial tears the week prior to your office evaluation as it makes our diagnostic equipment more accurate.
When do I know my cataract is ready for surgery?
Cataract surgery is typically recommended when you can’t function well due to your natural lens becoming cloudy. Common descriptions by patients are “everything is blurry”, “glare is really bothering me at night”, “I can’t read the ticker on the TV”, “I can’t drive at night anymore”, “I need to be right up to the road sign to see it”, “I just got new glasses, but I still can’t see well”.
When does the surgery take place?
On the day you come to the office for a cataract evaluation, if you and your surgeon decide to proceed with cataract surgery, you will meet with a surgical coordinator to schedule surgery.
Does cataract surgery hurt?
It is rare to have pain during cataract surgery. For most patients, what bothers them most during cataract surgery is the numbing medicine. The numbing drops sting and burn for a few seconds.
Will I see what’s happening during the surgery?
Most patients are nervous about seeing instruments. Luckily, you can’t see instruments during the surgery. To perform cataract surgery, your surgeon looks through an operating microscope. The microscope’s light is so bright that you can’t tell what’s going on around you.
Will I be asleep during my procedure?
You will not be under general anesthesia for your surgery. You are given what is called “MAC” anesthesia. This will make you relaxed, but you are still breathing on your own. Some people do fall asleep because they are so relaxed, some stay awake, but relaxed.
Why one eye at a time?
If both eyes need cataract surgery, we typically perform each surgery 2 weeks apart. One reason for waiting 2 weeks is to ensure you don’t develop an infection after surgery. Infections after cataract surgery are very rare but can be severe. We also operate one eye at a time to maximize the accuracy of our results, which translates to a patient as trying to achieve the sharpest vision possible for you. The results of cataract surgery are very accurate to our intended vision goal about 80-90% of the time. This means 10-20% of properly done cataract surgery does not achieve as sharp vision as desired. If a patient’s vision is not as sharp as we hope after the 1st cataract surgery, we can make an adjustment to the focusing strength of the lens implant for the 2nd eye’s cataract surgery to try and get sharper vision for you. Lastly, some patients may not need the 2nd eye done after the 1st surgery is completed. If you feel after the 1st surgery that your daily activities are no longer impacted by your vision, you can hold off on the 2nd surgery.
Why does the 2nd surgery seem different?
Almost every patient says, “I don’t remember any of this from last time” at the 2nd eye cataract surgery. While the surgery is the same, patients think it seems different. The reason for this is that the anesthesia medicines that a patient receives for cataract surgery are designed to relax you, but also have an amnesia effect, which causes most patients to forget the details of the 1st surgery.
What Is A YAG Posterior Capsulotomy For Secondary Cataracts?
Posterior capsulotomy is laser surgery you might need sometime after cataract surgery. It helps you see clearly if your vision becomes cloudy again. When you have cataract surgery, Dr.Champoin removes your eye's cloudy lens. She replaces it with a clear, artificial intraocular lens (IOL). The IOL is held in place in the eye's natural lens capsule. Weeks, months or years later, this capsule can become cloudy or wrinkled, causing blurry vision. This is called a posterior capsule opacification (PCO). It's also sometimes called a "secondary cataract" or "scar tissue." With posterior capsulotomy, a laser is used to make an opening in the cloudy capsule. This allows light to pass through again for clear vision.
What Happens During Posterior Capsulotomy?
The procedure is done in your ophthalmologist's office. It only takes about 5 minutes. Here is what will happen:
What Are the Risks of Posterior Capsulotomy?
As with any surgery, there are possible risks and complications with posterior capsulotomy. Here are some of them: