Cataract Center of Excellence

Cataract FAQs

Cataract Quick Reference Guide

What is a Cataract?
Signs and Symptoms?
What does a Cataract look like?
What Happens?
What are the Symptoms?

 

What causes a Cataract?
Screening and diagnosis
Treatment
Cataract surgery
Lens implants


What is a cataract?
Normally the lens of your eye is clear. A cataract is a clouding of the lens. It is like looking through a foggy window. Cataracts can make it difficult to read, drive a car — especially at night — or see detail. Cataracts often affect distance vision and cause glare. They generally don't cause surface irritation or pain.

Clouding of the lens is a normal part of getting older. Most Americans older than 60 have some degree of clouding of the lens. After age 75, as many as 70 percent of Americans have cataracts that are significant enough to impair their vision.

In the early stages, stronger lighting and eyeglasses can help you deal with the vision problems. But at some point, if impaired vision jeopardizes your normal lifestyle, you might need surgery. Fortunately, cataract removal is one of the safest, most effective and most common surgical procedures.

Signs and Symptoms?
A cataract usually develops slowly and causes no pain. At first, the cloudiness may affect only a small part of the lens and you may be unaware of any vision loss. Over time, however, as the cataract grows larger, it clouds more of your lens. When significantly less light reaches your retina, your vision becomes impaired.

What does a cataract look like?
Advanced cataracts are often visible to the naked eye. They frequently look like a yellow or white cloud behind the iris (the colored part of the eye).

What happens?
Normal vision (left) becomes blurred as a cataract forms (right)


What are the symptoms?
Symptoms of a cataract include:

  • Clouded, blurred or dim vision
  • Increasing difficulty with vision at night
  • Sensitivity to light and glare
  • Halos around lights
  • The need for brighter light for reading and other activities
  • Frequent changes in eyeglass or contact lens prescription
  • Fading or yellowing of colors
  • Double vision in a single eye
    If you have a cataract, light from the sun, lamps or oncoming headlights may seem too bright. Glare and halos around lights can make driving uncomfortable and dangerous. You may experience eyestrain or find yourself blinking more often to clear your vision.

Cataracts don’t typically cause any change in the appearance of your eye. Pain, redness, itching, irritation, aching in your eye or a discharge from your eye aren’t signs or symptoms of a cataract, but may be signs and symptoms of other eye disorders.

What causes a cataract?

  • Age
  • Trauma
  • Medications
  • Diabetes
  • Prior Eye Surgery
  • Ultra Violet Light
  • Smoking
  • Radiation
  • Steroids

How do Cataracts reduce vision?
When your eyes work properly, light passes through the cornea and the pupil to the lens. The lens focuses this light, producing clear, sharp images on the retina — the light-sensitive membrane on the back inside wall of your eyeball that functions like the film of a camera. As a cataract develops, the lens becomes clouded, which scatters the light and prevents a sharply defined image from reaching your retina. As a result, your vision becomes blurred.

The lens consists of three layers. The outer layer (capsule) is a thin, clear membrane. It surrounds a soft, clear material (cortex). The hard center of the lens is the nucleus. If you think of the lens as a piece of fruit, the capsule is the skin, the cortex is the fleshy fruit and the nucleus is the pit. A cataract can form in any part of the lens.

Cataracts occur in three main types:
Nuclear. A nuclear cataract occurs in the center of the lens. In its early stages, as the lens changes the way it focuses light, you may become more nearsighted or even experience a temporary improvement in your reading vision. Some people actually stop needing their glasses. Unfortunately, this so-called second sight disappears as the lens gradually turns more densely yellow and further clouds your vision. As the cataract progresses, the lens may even turn brown. Seeing in dim light and driving at night may be especially troublesome. Advanced discoloration can lead to difficulty distinguishing between shades of blue and purple.

Cortical. A cortical cataract begins as whitish, wedge-shaped opacities or streaks on the outer edge of the lens cortex. As it slowly progresses, the streaks extend to the center and interfere with light passing through the center of the lens. Both your distance and near vision can be impaired. Focusing problems and distortion are common. You may also have problems with glare and loss of contrast.

Subcapsular. A subcapsular cataract starts as a small, opaque area just under the capsule of the lens. It usually forms near the back of the lens, right in the path of light on its way to the retina. This type of cataract may occur in both eyes but tends to be more advanced in one eye than the other. A subcapsular cataract often interferes with your reading vision, reduces your vision in bright light and causes glare or halos around lights at night.

Screening and diagnosis
The only way to know for sure if you have a cataract is to have an eye examination that includes several tests:

Visual acuity test. Acuity refers to the sharpness of your vision or how clearly you see an object. In this test, your eye doctor checks to see how well you read letters from across the room. Your eyes are tested one at a time, while the other eye is covered. Using the chart with progressively smaller letters from top to bottom, your eye doctor determines if you have 20/20 vision or less acute vision.

Slit-lamp examination. A slit lamp allows your eye doctor to see the structures at the front of your eye under magnification. The microscope is called a slit lamp because it uses an intense line of light — a slit — to illuminate your cornea, iris, lens and the space between your iris and cornea. The slit allows your doctor to view these structures in small sections, which makes it easier to detect any small abnormalities.

Retinal examination. In this procedure, your eye doctor puts dilating drops in your eyes to open your pupils wide and provide a window to the back of your eyes. Using a slit lamp or a special device called an ophthalmoscope, he or she can examine your lens for signs of a cataract and, if needed, determine how dense the clouding is. Your eye doctor will also check for glaucoma and, if you have blurred vision or discomfort, check for other problems involving the retina and the optic nerve.

Treatment
The only effective treatment for a cataract is surgery to remove the clouded lens, which usually includes replacing the lens with a clear lens implant.

Cataracts can’t be cured with medications, dietary supplements, exercise or optical devices. In the early stages of a cataract when symptoms are mild, a good understanding of the condition and a willingness to adjust your lifestyle can help. Some self-care approaches, such as using a magnifying glass to read or improving the lighting in your home, may help you deal with the effects of having a cataract.

Cataract Surgery
Thanks to medical and surgical advancements in recent years, cataract surgery has become one of the most gentle medical procedures performed today. Most patients are now able to enjoy their best possible vision with minimal recovery time.

This is possible thanks to a tiny, micro-incision, commonly called the “self-sealing” incision. It is called “self-sealing” because the eye’s natural internal pressure holds the incision tightly closed allowing the eye to heal without stitches. The self-sealing is made at the edge of the “clear cornea,” and is less than 2.5 mm in length. The clear cornea is the transparent covering of the front of the eye.

The cataract is situated inside the lens capsule, which is like an elastic bag that holds the lens in place. To remove the cataract, the front portion of the lens capsule is carefully opened. The cataract is gently broken apart using ultrasonic vibrations and vacuumed out of the lens capsule. This technique is called phacoemulsification. The lens capsule is left undisturbed so a tiny lens implant can be inserted in place of the original lens.

Many types of lenses are used; most are made of either Acrylic or Silicone.

Intraocular Lens Implant
Intraocular lenses, commonly called IOLs, may be one of the most important ophthalmic developments in the past 30 years. These tiny prescription lenses are placed inside the eye during cataract surgery, replacing the eye’s natural lens (called a cataract when it becomes clouded). Prior to the development of IOLs, cataract patients were forced to wear thick “coke bottle” glasses or contact lenses after the surgery. They were essentially blind without their glasses.

Today, patients receiving IOLs often enjoy the best vision of their lives. Thanks to sophisticated formulas used to calculate the corrective prescription power of the lens, the IOL not only replaces the need for thick glasses, it can also correct the eye’s existing refractive error. (need for glasses)

There are two basic types of IOLs: foldable and hard. Foldable lenses are made of silicone or acrylic and can be rolled up and placed inside a tiny tube. The tube is inserted through a very small incision less than 2.5 mm in length. Once inside the eye, the IOL gently unfolds. Hard plastic lenses are appropriate in certain circumstances determined by the surgeon. Since they cannot be folded, they are placed through a slightly larger incision.

Selecting the best implant…
Great Advances in Artificial Lens technology now enables patients to choose the vision that best fits their lifestyle. Advanced technology lenses now routinely implanted include Crystalens, Restor and Rezoom. These advanced implants allow patients to see near, far and everything in between– often without dependence on glasses. Your Surgeon can help you pick the lens that best fits your lifestyle.


 
 


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