By Dr. Sarah Eccles-Brown, Elmquist Eye Group
One in six Americans
older than age 40 will develop cataracts. By the time we turn 70,
over one-half of Americans will have them.
Cataracts are the
leading cause of vision loss for people older than 55, but they don’t
have to be. Unlike many eye diseases, vision loss due to cataracts
can be restored. Cataract surgery is one of the most commonly
performed procedures in the United States with a 95 percent success
rate. However, the existence of cataracts does not necessarily mean
that surgery is needed immediately, so it is important to understand
your options before proceeding. A second opinion can help determine
if and when surgery is right for you.
The eye is like a
camera, and it uses a lens to focus. As we age, some of the protein
and water that let light pass through may clump together and start to
cloud the lens. You might notice your vision becoming blurry,
increased sensitivity to light with glare, needing brighter light to
read, poor night vision, or a fading or yellowing of colors.
Types of cataract include:
percent of cataracts are age-related, usually after age 40
are present at birth, usually caused by infection or inflammation
during pregnancy; possibly inherited
damage from a hard blow, cut, puncture, intense heat or chemical
burn may cause cataracts
medicines including steroids, eye diseases, eye infections, or
systemic diseases such as diabetes cause these cataracts
can develop after exposure to some types of radiation
factors for cataract in addition to age include certain diseases,
such as diabetes, smoking and alcohol use, and prolonged
exposure to ultraviolet sunlight.
and a hat with a brim to block ultraviolet sunlight may help to delay
cataract development. If you smoke, stop.
Researchers also believe good nutrition including green leafy
vegetables, fruit, and other foods with antioxidants can help
reduce the risk of age-related cataracts.
The National Eye
Institute recommends everyone over the age of 60 have a dilated exam
once a year. If you are African American, the recommendation starts
at age 40 because of a higher risk of
developing glaucoma. If you have diabetes, you should have an annual
dilated exam every year, no matter how old you are.
Cataract is detected
through a comprehensive eye exam that includes:
- Visual acuity test with an eye chart to test
how well you see at various distances.
- Dilated eye exam. Drops are placed in your
eyes to widen, or dilate, the pupils. Your eye care professional
uses a special magnifying lens to examine your retina and optic
nerve for signs of damage and other eye problems. After the exam,
your close-up vision may remain blurred for several hours.
- Tonometry. An instrument measures the pressure
inside the eye. Numbing drops may be applied to your eye for this
You may be unaware
you are developing vision loss, because at first, the cloudiness may
affect only a small part of the lens. In time, the cataract may grow
larger. If not treated, cataracts can result in complete loss of
“age-related” is a little misleading. You don’t have to be a
senior citizen to get this type of cataract. In fact, people can have
an age-related cataract in their 40s and 50s. But during middle age,
most cataracts are small and do not affect vision.
It is after age 60
that most cataracts cause problems with a person’s vision. A cataract
needs to be removed only when vision loss interferes with your
everyday activities, such as driving, reading, or watching TV. You
and your eye care professional can make this decision together. Once
you understand the benefits and risks of surgery, you can make an
informed decision about whether cataract surgery is right for you.
In the early stages
of cataracts, patients often find that their vision is not affected
significantly, and any minor variations can be managed with
eyeglasses or other lifestyle changes such as utilizing brighter
lighting, magnifying lenses and anti-glare sunglasses. As cataracts
increase over time, weakened eyesight may begin to interfere with
your daily activities, such as driving at night, or hobbies you enjoy
like reading, cooking or detailed crafts. If your vision is no longer
helped by eyeglasses, it may be time to consider surgery.
It can be difficult
to determine if cataract surgery is truly necessary, so don’t
hesitate to get a second opinion before moving forward. A second
opinion from an independent party can enable you to make a
well-informed decision about your eye care. When getting a second
opinion, inform the doctor of your medical history and what tests
have already been completed, the surgery methods you are considering,
and what questions you have.
involves removing of the eye’s natural lens which has become cloudy
and formed a cataract and replacing it with an artificial lens
implant. If you have cataracts in both eyes that require surgery, the
surgery will be performed on each eye at separate times, usually a
few weeks apart. Additional minimally invasive glaucoma procedures
can also be performed in tandem with cataract surgery, such as the
iStent Inject and Kahook dual blade to lower eye pressure and obtain
better glaucoma control.
Without a lens
implant to replace your natural lens, you would have to wear thick
coke-bottle glasses after cataract removal. However, thanks to the
rapid pace of technology in ophthalmology, there are now many
different types of lens implants available to place in the eye once
the cataract is removed. Precise measurements will be taken of your
eye to determine which types of lens implants would help you see your
best. With multifocal lens implants or blended monovision, it is now
possible to be minimally dependent on glasses, only needing them for
very fine print or dim lighting. Astigmatism, which occurs when the
clear, dome-shaped cornea is shaped like a football rather than a
round soccer ball, previously could only be corrected with glasses.
Now, a toric lens implant or small incisions on the cornea, called
limbal relaxing incisions, can be completed during cataract surgery
to fix this condition.
If you choose to move forward with cataract surgery, it’s important to ensure the procedure is performed by an experienced, successful surgeon. Schedule an appointment to meet your surgeon, ask questions and confirm you are comfortable with them performing your surgery. Important inquiries for a potential surgeon include how many procedures have been completed, the number of successful outcomes, complication rates, what kind of lens implant is recommended and what to expect for postoperative care and recovery. Ask for a referral from your friends, relatives, or your regular eye doctor. Online registries from medical associations like the American Academy of Ophthalmology are also helpful resources for determining potential surgeons.
About the Author:
Eccles-Brown, a board-certified ophthalmologist at Elmquist Eye
Group, is the practice’s lead surgeon responsible for premium
cataract surgery, eyelid surgery, LASIK, in-office procedures and
iStent Inject, a minimally invasive procedure for the treatment of
glaucoma. For more information, visit www.Elmquist.com,
call 239-936-2020 or stop by an Optical Boutique location in Fort
Myers or Cape Coral.