Cataracts

Cataracts obscure the eye’s natural lens and limit your ability to see details. The lens, a light-sensitive membrane in your eye, works like the lens in a camera. Just as a foggy camera lens makes everything dim, a cataract makes it hard for you to see clearly.

Cataracts can develop from normal aging, from an eye injury, from previous eye surgery or if you have taken certain medications. Cataracts may cause blurred vision, dulled vision, sensitivity to light and glare, and/or ghost images. If the cataract changes vision so much that it interferes with your daily life, the cataract may need to be removed. Surgery is the only way to remove a cataract. The alternative to surgery is to not have the cataract removed. If you do not have the surgery, your vision probably will not improve and may continue to get worse.

You are more likely to develop cataracts if you have any of these risk factors:

• Too much sunlight exposure
• Smoking
• Cortisone use
• Diabetes
• High blood pressure
• Excessive alcohol consumption

Common Cataract Symptoms

• Clouded, blurred or dim vision
• Impaired night vision or glare
• Sensitivity to light and glare
• Need brighter light for reading and other activities
• Seeing "halos" around lights
• Frequent changes in eyeglass or contact lens prescriptions
• Fading or yellowing of colors
• Double vision in a single eye

What are the different types of cataracts?  

• Age-related cataract: Most cataracts are related to aging.
• Congenital cataract: Some babies are born with cataracts or develop them in childhood, often in both eyes. These cataracts may not affect vision. If they do, they may need to be removed.
• Secondary cataract: Cataracts are more likely to develop in people who have certain other health problems, such as diabetes. Also, cataracts are sometimes linked to corticosteroid use.
• Traumatic cataract: Cataracts can develop soon after an eye injury, or years later.

During a comprehensive eye exam, our ophthalmologists quickly and accurately determine your diagnosis. If needed, this is confirmed using one or more of the following tests or procedures:

Visual Acuity Tests - These tests help determine if your vision is impaired.

Slit Lamp Exams - By giving your doctor a magnified three dimensional (3-D) view of your eye, this diagnostic tool makes it easier to find tiny abnormalities.

Retinal Exams - While examining your retina, your doctor checks your lens for signs of cloudiness.

Cataract Extraction Surgery - Surgical removal of a clouded lens is considered the best, most successful treatment for this condition. Bascom Palmer doctors participated in the development of the femtosecond cataract laser which can be used just before surgery to soften the cataract and reduce astigmatism.  The surgery is performed through a small opening at the front of the eye. The surgeon gently breaks up and vacuums out the clouded cataractous lens with high frequency ultrasound. This lens is then replaced with a new artificial lens, called intraocular lens (IOL).  If you have significant astigmatism, your surgeon may correct it with a Toric IOL or another procedure such as LASIK or a limbal relaxing incision (LRI) to reshape your cornea. Your doctor will guide you in choosing the intraocular lens that is right for you, depending on your condition and preferences.

Monofocal Fixed Focus Intraocular Lenses - Whether surgery is done to remove cataracts or to correct refractive error, the lens that was removed is replaced with an IOL that is positioned in the same place as the natural lens. The power of the lens is selected to create a focus at distance, intermediate distance or at near for reading. Various replacement lenses are available. The standard IOL is a monofocal lens that corrects distance vision. With this lens, you see well from a distance, but need glasses to read. Alternatively a person may chose to focus the eye at an intermediate distance or at a reading distance. Some people may chose to have one eye focused at distance and the other focused at near for reading. This is called “monovision.”

Accommodating Intraocular Lenses -  Alternatives to standard monofocal lenses, these accommodating lenses provide distance and some near vision. Presently, the only “accommodating” intraocular lens available in the US is the Crystalens. It generally gives good distance vision and usable intermediate distance vision for a computer screen. Most people can also read large type without glasses but some need reading glasses to read small type.

Toric IOLs - These fixed focus single-vision lenses help people with astigmatism see better for distance or for near vision than they would with a non-Toric single vision IOL. Although Toric lenses improve visual sharpness at a distance or near without glasses, they do not provide both near and distance vision simultaneously.

Multifocal IOLs - The ReZoom and ReSTOR lenses provide distance and intermediate and/or reading vision. The optical results are not always perfect and some patients are bothered by subnormal distance and/or reading vision. Other common side effects include halos around lights at night and reduced vision in bright or dim light.