Cataracts

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What is a cataract?

A cataract is a loss of transparency, or clouding, of the eye lens. The eye lens plays a vital role in focusing images on the retina. A cloudy lens interferes with light passing through to the retina, the light-sensing layer of cells at the back of the eye. Compare a cataract to looking at the world through a foggy or blurry window. Light rays do not focus clearly if the lens loses its clarity, as it does when a cataract develops. Glasses or contact lenses cannot sharpen vision if a cataract is present.

What causes a cataract?

The most common cause of a cataract is aging. As you get older, chemical changes in your lens make it less transparent. The loss of transparency may be so mild that vision is hardly affected or so severe that no shapes or movements are seen, only light and dark. You have a cataract when the lens gets cloudy enough to obstruct vision to any significant degree.

Other causes of cataracts include trauma, medications like steroids, systemic diseases such as diabetes, and prolonged exposure to ultraviolet light. Occasionally, babies are born with a cataract. Glasses or contact lenses cannot sharpen your vision if a cataract is present.

Reducing the amount of ultraviolet light exposure by wearing a wide-brim hat and sunglasses may reduce your risk for developing a cataract, but once set, there is no cure except to have the cataract surgically removed. Outpatient surgical procedures remove the cataract either through a small incision (phacoemulsification) or a large incision (extracapsular extraction). The time to have the surgical procedure is when your vision is bad enough to interfere with your lifestyle.

What are the symptoms?

Cataract formation is a slow, progressive, and painless decrease in vision. Ironically as the lens gets harder, farsighted (hyperopic) people experience improved distance vision and are less dependent on glasses. However, nearsighted (myopic) people become more nearsighted, causing distance vision to worsen.

  • Blurring of vision
  • Glare, particularly at night
  • Frequent glasses prescription changes
  • Reduction in color intensity
  • Yellowing of images
  • Double vision in rare cases

How is a cataract diagnosed?

A cataract is detected during our comprehensive eye exams. Your eyes will be dilated, so the pupils are wide open, enabling our medical team to look for signs of a cataract with a slit lamp, along with checking your retina and optic nerve. We will also do a refraction to test your visual acuity.

What are the treatments?

The treatment for a cataract is to remove the lens and implant an Intraocular Lens (IOL). An IOL is a tiny, lightweight, clear plastic disk placed in the eye during cataract surgery. Intraocular lenses have many advantages. The IOL remains in the eye after surgery, unlike contact lenses, which must be removed, cleaned, and reinserted. An IOL replaces the focusing power of the eye's natural lens. The rapid evolution of IOL designs, materials, and implant techniques has made them a safe and practical way to restore normal vision after cataract surgery.

One and a half million people have a cataract procedure every year, and 95% achieve success. As with any surgery, complications may occur during or after, and some are severe enough to limit vision. In most cases, vision, as well as the quality of life, improves.

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