What are cataracts?
 "Cataract"
is the name used to describe a condition
wherein the lens of the eye becomes
opacified or cloudy blocking some light
from reaching the retina and interfering
with vision. Cataracts are
multi-faceted. We don't know all the
causes, but we do know that time, aging,
and hereditary factors all play a role
in cataract development. Cataract
formation can be accelerated by trauma,
diabetes, sunlight, and certain
medications. Typically, cataracts occur
in adults ("adult onset"), but may occur
as a congenital disorder.
What are the symptoms of cataracts?
 Early
signs of cataracts include blurred or
cloudy vision; frequent changes in
eyeglass or contact lens prescriptions;
night glare and hazy vision; and colors
that seem to fade. An ophthalmologist
must determine if these symptoms are
really caused by a cataract or by some
other eye problem that may need
treatment.
 For an
adult, a cataract should be removed only when it interferes with lifestyle
and makes it difficult to continue normally enjoyable activities. Generally,
there is no such thing as a cataract being "ripe" or "not ripe" for removal.
What matters is whether or not the problem interferes with vision. In rare
instances, a "hyper-mature" cataract may cause elevated eye pressure or
inflammation of the eye. In this case, it must be removed immediately.
Otherwise, removal of a cataract is at the patient's discretion.
What are the different types of cataracts?
- Age-related cataract: Most cataracts are related to aging.
- Congenital cataract: Some babies are born with cataracts or develop them in childhood, often in both eyes. These cataracts may not affect vision. If they do, they may need to be removed.
- Secondary cataract: Cataracts are more likely to develop in people who have certain other health problems, such as diabetes. Also, cataracts are sometimes linked to steroid use.
- Traumatic cataract: Cataracts can develop soon after an eye injury, or years later.
What can one expect during cataract surgery?
 Cataract surgery is the most frequently performed surgery in the United States - and the most successful. Over 95 percent of those who have cataract surgery regain vision levels between 20/40 and 20/20.
Cataract surgery usually lasts less than one hour and is almost painless. Many people choose to stay awake during surgery and have an anesthetic to numb the nerves in and around the eye.
 A lens implant (intraocular lens) inserted during cataract surgery gives the surgeon an opportunity to correct nearsightedness or farsightedness. Current research on intraocular lens implants also may provide high quality correction for astigmatism and for both bifocal and multi-focal vision. Bifocal implants are currently used, but physicians have yet to achieve consistently satisfactory outcomes.
The time required for recuperation after cataract removal depends on the type of procedure performed and the patient's individual rate of healing. The decision as to which procedure is best for an individual's eye is made by the patient's ophthalmologist.
One technique ophthalmologists use is phacoemulsification. This procedure involves making a tiny incision, about 2.5 to 3.5 millimeters in length. A pencil-like instrument, inserted through the opening, is used to emulsify (breakdown in to tiny pieces) and aspirate the clouded lens material. Then the intraocular lens is inserted into place.
Other techniques include:
- Phacofracture cataract surgery - the lens is removed through a small incision by "fracturing" it into several small segments
- Extracapsular cataract surgery - the lens is removed in one piece through a larger incision
- Intracapsular surgery - the lens and capsule are completely removed, a rarely used procedure
In some cases after cataract surgery, a
haziness develops in the membrane or
capsule supporting the intraocular lens
implant. When this happens, a laser is
sometimes used to create a small opening
in the membrane (a capsulotomy) through
which the patient can see clearly.
Lasers are used because they are able to
make a small, very precise opening.
|
