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Cataracts: Overview, Vision Impact, and Detection

A cataract is a common eye condition where the lens of the eye becomes progressively opaque, resulting in blurred vision and glare. The lens, situated behind the iris and pupil, functions like a camera lens, focusing light onto the retina at the back of the eye to produce clear images. It also adjusts the eye’s focus, allowing us to see things clearly both up close and at a distance.

How Cataracts Affect Vision

The development of cataracts primarily affects vision by clouding the lens. This cloudiness occurs due to the clumping of proteins in the lens, a process associated with aging and other factors such as diabetes, smoking, prolonged exposure to ultraviolet sunlight, and previous eye injuries. Early symptoms might include slightly blurred vision, akin to looking through a frosty or fogged window. As the cataract progresses, the clouding becomes more extensive, progressively impairing vision.

Vision changes caused by cataracts include:

  • Blurring or dimming of vision.
  • Increased difficulty with vision at night.
  • Sensitivity to light and glare, often with halos appearing around lights.
  • Need for frequent changes in prescription glasses.
  • Fading or yellowing of colors.

Detection of Cataracts in an Eye Exam

Cataracts are most commonly detected through a comprehensive eye exam by an optometrist or ophthalmologist. Several tests can be used to diagnose cataracts and assess their impact on vision:

  1. Visual Acuity Test: This test uses an eye chart to measure how well a person can read a series of letters. The letters become progressively smaller on each line, which helps in determining how clearly a person can see at various distances.
  2. Slit-lamp Examination: The slit lamp allows the eye doctor to see the structures at the front of the eye under magnification. The lamp can be adjusted to shine a beam of light shaped like a small slit through the eye. Cataracts can be seen as clouded areas in the lens.
  3. Retinal Exam: Drops are placed in the eyes to dilate the pupils, which expands the viewing area in the back of the eye. This dilation and imaging, allows the doctor to examine the retina and the back of the lens, where cataracts form.
  4. Glare Sensitivity and Contrast Sensitivity Tests: These tests assess how well a person can see in bright conditions and distinguish between shades of light and dark. Both abilities can be compromised by the presence of cataracts.

The detection of cataracts is crucial for timely intervention, which can prevent a significant loss of vision. The most effective treatment for cataracts is surgical removal of the cloudy lens, which is then replaced with an artificial lens. This surgery is one of the most common and successful medical procedures performed today, offering a restoration of vision in the majority of cases. Early detection through regular eye exams can lead to interventions that significantly improve quality of life and maintain optimal vision health.


Cataract Surgery

What You Need to Know

How is a cataract treated? The symptoms of early cataract may be improved with new eyeglasses, brighter lighting, anti-glare sunglasses, or magnifying lenses. Also, 500mg of vitamin C on a daily basis will slow the progression of cataracts. If these measures do not help, surgery is the only effective treatment. Surgery involves removing the cloudy lens and replacing it with an artificial lens. Sometimes a cataract should be removed even if it does not cause problems with your vision. For example, a cataract should be removed if it prevents examination or treatment of another eye problem, such as age-related macular degeneration or diabetic retinopathy. If you have cataracts in both eyes that require surgery, the surgery will be performed on each eye at separate times, usually a week or two apart.


Is cataract surgery effective? Cataract removal is one of the most common operations performed in the United States. It also is one of the safest and most effective types of surgery. In about 90 percent of cases, people who have cataract surgery have better vision afterward. There is  the possibility of a secondary or after cataract which is different from the first cataract and is easily lasered and is an in office procedure. 


What are the risks of cataract surgery? As with any surgery, cataract surgery poses risks, such as infection and bleeding. Before cataract surgery, your doctor may ask you to temporarily stop taking certain medications that increase the risk of bleeding during surgery. After surgery, you must keep your eye clean, wash your hands before touching your eye, and use the prescribed medications to help minimize the risk of infection. Serious infection can result in loss of vision. 


What happens before surgery? At the surgical consultation, your doctor will do some tests. These tests may include measuring the curve of the cornea (the front surface of the eye) and the size and shape of your eye. This information helps your doctor choose the right type of intraocular lens (IOL or implant). You may be asked not to eat or drink anything 12 hours before your surgery. 

The surgeon will discuss different options for your implant lens. I have recommended the following implant option:


  • Basic Cataract Implant – this lens is typically covered by medical insurances. This lens gives very good vision, often even without glasses, for either far or near. Glasses will still be needed for at least part time use.
  • Toric Cataract Implant – this lens corrects for astigmatism and should be considered if you have a higher level of astigmatism. It helps to make your vision without glasses even better. If you do not have much astigmatism, this lens is unnecessary. There will be additional costs for this type of lens implant.
  • Multifocal Cataract Implant – this is the only implant option that allows for both far and near vision and can give the most freedom from glasses. However, this lens may not be ideal for everyone and may cause additional nighttime glare after surgery. There will be additional costs for this type of lens implant.


What happens during surgery? At the outpatient surgical center or eye clinic, drops will be put into your eye to dilate the pupil. The area around your eye will be washed and cleansed. The operation usually lasts less than 15 and is almost painless. The cataract is removed by making a small opening on the front of the eye, dissolving the cloudy lens, and inserting an artificial lens implant in its place. After the operation, a patch may be placed over your eye. You will rest for a while. Your medical team will watch for any side effects, such as bleeding. You will need someone to drive you home. 


What happens after surgery? Itching and mild discomfort are normal after cataract surgery. Some fluid discharge is also common. Your eye may be sensitive to light and touch. If you have discomfort, treatment can be modified to help. After one or two days, moderate discomfort should disappear. For a few weeks after surgery, you may be asked to use eyedrops to help healing and decrease the risk of infection. You will need to wear an eye shield or eyeglasses to help protect your eye. Avoid rubbing or pressing on your eye. When you are home, try not to bend from the waist to pick up objects on the floor. Do not lift any heavy objects. You can walk, climb stairs, and do light household chores. In most cases, healing will be complete within eight weeks. 

Your doctor will schedule exams to check on your progress. The day after surgery, the surgeon will ensure that the eye is healing properly. Subsequent follow up visits at one week and one month are done in our office or by the surgeon if more convenient.