Conditions & Treatments
Cataract

WHAT IS A CATARACT?

A Cataract is a clouding of the natural lens inside your eye. This lens, located behind the iris, works just like the lens of a camera- focusing light images on the retina, which sends images to the brain. The human lens can become so clouded that it keeps light and images from reaching the retina.

A cataract can be the reason sharp images become blurred, bright colors become dull, or seeing at night is difficult. It may also be why the reading glasses or bifocals that used to help you read or do other simple tasks no longer seem to help. Vision with cataracts has been described as seeing life through old, cloudy film.

But a cataract is not a “film” over the eyes, and neither diet nor lasers will make it go away, nor can it be prevented. Eye injury, certain diseases, or even some medications can cause the clouding. The best way to treat a cataract is with surgery that removes the old, clouded lens and replaces it with a new, artificial one to restore your vision, and, in many ways, significantly improves your quality of life.

In fact, about 95 percent of patients are able to restore their full pre-cataract distance vision after undergoing the standard intraocular lens (IOL) procedure.

Cataract Surgery Patient Information.docx

Cataract symptoms may include:

  • Blurry vision.
  • Lights seem too bright or have a “halo” effect.
  • Double vision in one eye.
  • Decreased night vision – sensitivity to glare from headlights.
  • Dull or fading colors.

Some people actually experience an improvement in their near vision during the beginning stages of a cataract.  Unfortunately, this effect goes away as the disease progresses.  Early on, a cataract may be treated with increased glasses or contact prescription.  Once the cataract begins to interfere with daily tasks such as reading and driving, surgery is the only remaining option.

Cataract Pre-Surgery Questionaire.doc

 

WHAT CAUSES A CATARACT?

The most common type of cataract is related to the aging of the eye. Other causes of cataract development include the following:

Family History

Medical Problems, such as diabetes

Injury to the eye

Medications, especially steroids

Radiation

Long-term, unprotected exposure to sunlight

Previous eye surgery

Unknown Factors

 

HOW FAST DOES A CATARACT DEVELOP?

How quickly the cataract develops varies among individuals and may even be different between the two eyes in question. Most age-related cataracts progress gradually over a period of years.

Other cataracts, especially in younger people and people with diabetes, may progress rapidly over a short time. It is not possible to predict exactly how fast cataracts will develop in any given person.

 

CATARACT PREVENTION

While many doctors believe that nothing prevents most cataracts from forming, there is some promising research and things you can start doing now for possible cataract prevention (if you don’t have them already) or to slow down the development of a cataract.

Such as:

Wear sunglasses to block out the harmful ultraviolet (UV) rays from sunlight. Too much exposure has been shown to contribute to the development of cataracts. Look for a label from the American National Standards Institute (ANSI) that says that the lenses block both UVA and UVB rays.

Eat foods containing high amounts of antioxidants, meaning fruits and vegetables. People who eat large amounts of green, leafy vegetables, such as kale and spinach, which are rich in the nutrients lutein and zeaxanthin, show lower risk for cataracts.

Have your cholesterol checked by your doctor. It could be that there is a link between high cholesterol levels and cataracts, as some studies suggest that the use of statins, a class of cholesterol-lowering drugs, may help prevent the formation of nuclear cataracts. Anyway, it doesn’t hurt to get your cholesterol levels tested by a doctor at least every 5 years, or more often if you have had high levels in the past or are a man over age 45 or a women over age 50.

 

Confusion is common when it comes to cataracts and whether other eye conditions or diseases contribute to their formation or not. Here is a breakdown of the facts:

If you have diabetes, you are at a greater risk for developing cataracts. This is because the eye's lens can become over-hydrated as deposits form at the front or back of the lens. In some cases, this type of cataract can develop within days and should be taken seriously, since more Americans between the ages of 20 and 74 go blind from diabetes complications than any other disease.

Age-related macular degeneration (AMD) does not cause cataracts, nor vice-versa, but if you suffer from both, your doctor may recommend surgery to treat the damaged retina or back of the eye followed by cataract surgery to remove the cataract and replace with an artificial lens. AMD is the leading cause of vision loss and legal blindness in American adults over 60 and occurs when the center of the retina begins to degenerate.

Because they are both age-related, presbyopia and cataracts can occur simultaneously, but neither one causes the other.

Astigmatism, a common refractive error that can cause blurred vision near or far, doesn't lead to cataracts but can be treated during cataract surgery with a special lens called the AcrySof® IQ Toric IOL.

Cataracts can sometimes cause refractive errors, such as nearsightedness or farsightedness, and rarely, if left to mature, a cataract can even become so large that it triggers a type of glaucoma, a condition in which the eye has difficulty draining. Glaucoma does not cause cataracts and typically, cataracts do not lead to glaucoma, except in rare cases, such as in the result of eye trauma or steroid use.

 

WHAT EXACTLY IS CATARACT SURGERY AND WHAT DOES IT ENTAIL?

It is one of the safest and most successful procedures performed today.

Huge medical advances have been made in the treatment of cataracts. For patients, cataract surgery is generally a simple, outpatient procedure with little discomfort, only requiring the use of a topical anesthetic and about a 15-30 minute window of time.

The operation itself entails making a tiny incision in the eye. Through this incision, the surgeon inserts an instrument about the size of a pen tip. This instrument breaks the cloudy lens into pieces and removes them from the eye. Once the cataract is removed, a cataract replacement lens is inserted through the same tiny incision and set into position to replace the natural lens.

 

WHAT PRE-OPERATIVE PROCEDURES WILL NEED TO BE DONE PRIOR TO CATARACT SURGERY?

Before surgery, the length of your eye will be measured in what is called an A-scan, and the curve of your cornea will be measured in a technique called keratometry. These measurements help your Eye M.D. select the proper lens implant for your eye. You will also discuss the various lens options available to you.

If you plan to have cataract surgery and you have had LASIK or other laser vision correction, provide your Eye M.D. with the vision correction prescription you had before LASIK, if possible. This information will help your Eye M.D. calculate the correct IOL prescription for you.

If you are having cataract surgery, be sure to tell your ophthalmologist about all medications and nutritional supplements that you are taking. If you currently use or have ever used alpha-blocker drugs for prostate problems, such as Flomax®, Hytrin®, Cadura® or Uroxatral® , tell your Eye M.D. These medications may prevent your pupil from dilating properly during surgery, leading to possible complications. If your surgeon is aware that you have had these drugs, he or she can adjust their surgical technique to adapt as needed, allowing for a successful cataract removal procedure. You should also tell your Eye M.D. about any other sedative medications you are taking.

To reduce the risk of infection from surgery, your ophthalmologist may prescribe antibiotic eyedrops for you to use for one or two days before surgery.

 

WHAT ARE SOME OF THE RISKS AND POSSIBLE COMPLICATIONS OF CATARACT SURGERY?

As with any surgical procedure, there are risks associated with cataract surgery.  Risks and complications can include:

    Infection

    Bleeding inside the eye

    Increased pressure inside the eye (glaucoma)

    Swelling of the retina (macular edema)

    Loss of vision (partially or completely)

    Torn or detached retina

 

In some cases, the part of the lens covering that supports the IOL (called the capsule) can become cloudy several months or years after the first cataract was removed. This is called an "after cataract" or "secondary cataract." If this occurs and blurs your vision, your Eye M.D. will make an opening in the center of the cloudy capsule with a laser to allow light to pass through the lens properly again. This procedure, called a posterior capsulotomy, takes about five minutes in the doctor's office and requires no recovery period.

Most people who wear bifocals or glasses may still need to wear glasses after cataract surgery for reading, and, in some cases, even for distance. If you choose to have a multifocal or accommodative IOL, your dependence on glasses may be minimized or, in some cases, eliminated completely.

 

WHAT ARE THE COSTS OF CATARACT SURGERY?

Cataract surgery costs are generally covered by Medicare (if you are Medicare eligible) as well as by most private insurance plans.

Your cataract surgery costs will be covered by Medicare as long as your vision tests at a certain level of acuity or clarity. If you have a private insurance plan, they too may have similar vision requirements that you must meet in order to have your surgery covered. Even if Medicare or private insurance covers your cataract surgery, there may be some costs you would still be responsible for, such as having a special enhanced type of intraocular lens (IOL) implanted instead of a standard IOL, or choosing to have cataract surgery before your vision has deteriorated enough to be eligible for Medicare or insurance coverage.

In certain cases, it might be possible to get insurance or Medicare coverage for cataract removal before you meet the age or visual acuity eligibility requirements. Talk with your ophthalmologist if you are considering having early cataract surgery.

If you don't have Medicare or private insurance coverage, you may still be able to reduce and manage the cost of cataract surgery through other means, such as payment plans through your doctor's office or with a flexible spending account through your employer. Your Eye M.D. can help you learn more about costs of cataract surgery and discuss your options for affording the procedure. 


WHAT CAN I EXPECT FOLLOWING CATARACT SURGERY?

Most patients typically return home the very same day as cataract surgery. Eye drops may be prescribed to guard against infection and help your eye heal. For a few days, you may need to wear and eye patch to keep away irritants. Everyone heals differently, but most patients see well enough to return to most of their routine activities with a few days of recovery.

Laser Cataract Surgery

While our eyes all share the same basic anatomy, your eyes are totally unique when it comes to size, depth, curvature and other key features. Laser Cataract Surgery allows Dr. Shnayder to plan and perform a procedure that’s completely customized for your eyes. For more than a decade, laser cataract surgery has helped surgeons perform this procedure with unparalleled precision and accuracy. Now it is available with cataract surgery. Speak with Dr. Shnayder to determine if laser cataract surgery is the right choice for you.



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