What is a Cataract? Symptoms, Treatment, & Surgery Risks

What is a Cataract? Symptoms, Treatment, & Surgery Risks

What is a Cataract?

Your eye is amazing! The eye is designed to take in the images from the world around you, focus the light and provide a clear picture that is sent by electrical signals to the brain. The eye has a lens just like a camera that helps to focus the light and make a clear picture inside the eye. At birth, your natural lens is perfectly clear, just like glass.

As you age, the lens proteins start to break down and the lens becomes cloudy. This cloudy lens is known as a cataract. Many people have the misconception that a cataract is a film or cloudiness that develops in front of the eye. This is incorrect. A cataract is simply a cloudy lens. Cataract surgery is, therefore, a lens replacement surgery.

In this picture see how the new clear plastic lens has replaced the cloudy cataract lens, restoring clear vision.

Cataract Symptoms

As cataracts develop, several visual symptoms may occur. Many of these symptoms are not noticed with early cataracts because they are mild and the visual changes occur gradually. Common cataract symptoms include:

  • Blurry vision at distance and up close
  • Halos or starbursts around lights mainly noticed at night
  • Glare from oncoming headlights or bright sunlight is extremely bothersome
  • Low light situations make seeing more difficult, such as a dim restaurant
  • Small print is difficult to read
  • Frequent changes are required in your glasses prescription

When to Remove a Cataract?

Simple Steps to Better Vision

Many patients ask “When is the right time to remove a cataract?” The answer is very simple. The time for you to consider cataract surgery is when you feel dissatisfied with your vision. Here are some common scenarios that may lead you to consider cataract surgery:

  • I feel unsafe driving because I cannot see the street signs until I am very close to them.
  • I have stopped driving at night because I can’t see well when other cars are coming towards me.
  • I love reading but have been reading less because it has become difficult to see the small print.
  • Everything just seems hazy and foggy. It looks like my glasses are smudged, but taking them off and cleaning them constantly does nothing.
  • I am having a difficult time seeing the scores on the TV when I watch a basketball or football game.

A common misconception is that cataract surgery should not be done until the cataract is “ripe”. In reality, a cataract should be removed when it is causing visual symptoms. People are unique and there is a wide range of visual needs. Some people with visually demanding professions such as engineers and architects may notice even minor changes to their vision and be unhappy. Dr. DeBry will be able to help you determine when to remove a cataract.

What is the Treatment for a Cataract?

There is no cataract treatment such as drops or medications that can fully reverse the cloudiness in the lens that develops with age. Therefore, once the lens starts to turn cloudy and symptoms develop, the primary cataract treatment is surgery.

  • With cataract surgery a very small incision (only 3 mm or 1/8 of an inch) is made in the side of the cornea (the front window of the eye). A small ultrasound instrument is placed in the eye.
  • The instrument then breaks up the cataract into very small fragments using ultrasound energy and vacuums it out of the eye. A new, clear artificial lens is then placed inside the eye to restore sharp clear vision.

Many patients feel like they have turned back the clock a decade with their new cataract treatment.

What are the Risks Associated with Cataract Surgery?

Cataract surgery is an extremely safe and effective procedure, but there are rare cataract surgery risks associated with the surgery. These complications are unusual, but some of them are potentially sight-threatening. Some patients do not like to hear about scary problems related to a medical procedure. If this is you then skip this section. We believe that it is important for you to understand all the possible risks associated with a procedure. As with any surgical procedure, there is a risk of infection with cataract surgery. A severe infection inside the eye, known as endophthalmitis, may occur. In the United States, only 1 out of every 500 surgeries develops an infection. This can often be treated without any permanent vision loss. Antibiotic eye drops are used before and after the surgery to reduce the possibility of infection.

Several problems could result in the need for additional surgery in the weeks or months following cataract surgery. This situation occurs in less than 1-in-100 patients. Problems requiring an additional surgery include retinal detachment; cataract fragments retained in the eye, poor position of the artificial lens implant, and blurred vision due to incorrect lens power.

  • The retina is the layer of tissue inside the eye that allows you to see. As a result of the surgery, the retina may detach, similar to wallpaper peeling off a wall. Should this occur, a retina specialist will need to perform another procedure to reattach the retina.
  • At times, pieces of the cataract break off and are not able to be removed completely from the eye. In some cases, a small piece will not create problems. With bigger fragments, a second procedure is required to remove them.
  • The new lens implanted after the cataract is removed is held in position by a very thin membrane. Any weakness or tear in this membrane may cause the lens to shift and no longer be in the perfect position. If the shift is large enough to affect the vision, a second procedure may be necessary to reposition the lens implant.
  • The power of your lens implant is determined using complex math equations and detailed measurements of your eye. Small errors in these measurements may result in an overestimation or underestimation of the power of the lens implant. In rare cases, a second operation may be required to remove the old lens and replace it with a better one.

Swelling develops when tissue injury occurs. You may have seen a friend or relative with a sprained ankle and noticed the bruising and swelling that developed. Swelling can also occur as a result of a cataract procedure. It occurs most commonly in the cornea, but can also be seen in the retina. When present, swelling can cause the vision to be blurry. The treatment for retinal swelling is anti-inflammatory eye drops. Your consent form contains a detailed list of possible side effects and complications from cataract surgery. Please read it carefully and ask Dr. DeBry or your surgery counselor any questions you may have about risks from the surgery.

Peter DeBry
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