What are Cataracts?



Cataracts develop in the sensitive lens of your eye as opaque clumps of tissue. Since the lens focuses light into crisp images, just like a camera lens, this causes a particular loss of vision. Symptoms include dimness, selective blurriness, night blindness, double vision, yellowish or grey colors, or blocked regions of view. Cataracts form in old age, or can accompany other diseases such as diabetes. When diagnosed early, they are surgically removed with a high rate of success.

Light enters our eye through the pupil, travels through the lens, and lands on our retina in a focused, clear, colored picture. The lens is susceptible to accumulating lumpy strands of protein as we age. This collection interferes with exact focus and color in an image. Although cataracts are not a cloud, growth, or infection, they can still be compared to smearing oil on a camera lens. Looking through the camera, you would see blurred, obstructed, or shaded sections in your field of view because the grime has scattered the light.

Although the risk for cataracts is extremely high in those individuals aged above 50, they are not the first stage in total blindness in both eyes. Cataracts seriously compromise common activities, like reading, driving at night, watching television, or even walking in unfamiliar territory, but they do not always get progressively worse until you cannot see at all. Accurate diagnosis by an ophthalmologist can separate your vision problems from diseases of the retina, optic nerve, cornea, or brain that might be caused by unrelated eye conditions like macular degeneration or glaucoma. Consult your physician at the first sign of vision loss.

Since 70% of people older than 75 have at least one cataract, early diagnosis is the most important part of the healing process. Mild cases can be temporarily treated with a different eyeglass prescription, or simple lifestyle changes such as only driving during the day or using a brighter light to read. A permanent solution is cataract surgery under local anesthetic. While you should discuss the risks of surgery with your health care provider, this common procedure has a 95% success rate. Make sure to visit your eye doctor every 1-3 years, once you get above the age of 50, to catch problems sooner rather than later.

Am I A Candidate?

Eye-care professionals may mention during a routine eye exam that you have early cataract development even if you are not yet experiencing visual symptoms. Although your doctor will be able to tell when you first begin to develop cataracts, you will generally be the first person to notice changes in your vision that may require cataract surgery. Clouding of the lens may start to be seen at any age, but it is uncommon before the age of 40. However, a large majority of people will not begin to have symptoms from their cataracts until many years after they begin to develop. Cataracts can be safely observed without treatment until you notice changes in your vision.

Surgery is recommended for most individuals who have vision loss and are symptomatic from a cataract. If you have significant eye disease unrelated to cataracts that limits your vision, your ophthalmologist may not recommend surgery. Sometimes after trauma to the eye or previous eye surgery, a cataract may make it difficult for your eye-care professional to see the retina at the back of the eye; in these cases, it may still be appropriate to remove the cataract so that further retinal or optic nerve evaluation and treatment can occur. The mode of surgery can be tailored to individuals based on coexisting medical problems. Cataract surgery is generally performed with minimal sedation and generally takes less than 30 minutes. Therefore the surgery does not put significant strain on the heart or the lungs.

Clear Lens Exchange

Clear Lens Exchange is performed as any other cataract procedure; the only difference is the decreased use or absence of phacoemulsification power and the almost exclusive use of aspiration. Ideally, this procedure is performed using a clear cornea approach, making a 3-mm or smaller corneal incision, creating a regular capsulorrhexis, performing aspiration within the bag, and placing an IOL of choice in the bag.