Cataracts

A cataract is a cloudiness that develops in the lens of the eye. The lens, about the size of an aspirin, is the transparent fine focusing part of the eye located behind the pupil. It is comprised of a strong, transparent outer covering or capsule filled with a clear gel material. When the gel becomes cloudy, the incoming light rays are distorted or blocked before reaching the retina at the back of the eye. As the cataract develops, vision is increasingly reduced. Your eye doctor will usually discover developing cataracts in the course of routine eye exams. If you have cataracts that are causing visual difficulties, your doctor will usually recommend surgery, the only known cure for cataracts.

Causes of cataract development

Cataracts are most commonly caused by age. In fact, everyone who lives long enough will develop cataracts. Age-related cataracts are brought about by chemical changes within the lens of the eye. These changes result in the lens hardening and becoming cloudy.

Cataracts can also be caused by severe injuries to the eye, reactions to certain drugs, exposure to harmful chemicals or radiation, and some eye diseases and physical conditions such as diabetes. Smoking and exposure to high amounts of sunlight have been shown to increase the onset of cataract formation. Babies can also be born with congenital cataracts.

Symptoms

Cataracts vary in the way they develop, but generally, people experience one or more of these common symptoms:

  • Haziness, blurring, distortion and yellowed vision.
  • Need for more light to read or see clearly.
  • Night glare, halos or colored rings around lights, or glare in sunlight
  • Gradual loss of color vision.
  • Dark spots or shadows that move with the eye.
  • Becoming more nearsighted and not needing reading glasses.
  • Double vision.
  • Being able to see better without glasses.
  • In advanced stages, a white or yellow pupil.

Treatment

Unfortunately, there is no way to prevent or reverse the development of cataracts without surgery.  Although there is evidence that anti-oxidants such as vitamin A, C and E may delay their development, there is no known way to prevent cataracts or to make the cloudy lens clear again.

If there are no other serious problems with the eye, an experienced cataract surgeon can restore vision in 99% of patients. In fact, cataract surgery is one of the most successful surgeries being performed.  Cataract surgery involves two main parts: First, the cloudy lens must be removed and secondly, the focusing power must be replaced.

Removing the cloudy lens

The surgeon first makes tiny incisions in the cornea.  A delicate clear capsule is opened, and the hard cataract is broken up.  These steps can be done by femtosecond laser or manually by your surgeon.  The lens fragments are then removed from the eye using a process called phacoemulsification, in which a ultrasound probe vibrates at 40,000 times per second and suctions the material out of the eye.   The rest of the capsule is left intact to provide a sac for holding the new artificial lens.

Replacing the focusing power

In removing the lens of the eye, its focusing ability is also removed during cataract surgery. To replace it, a tiny artificial lens implant can be inserted into the original lens capsule. This lens implant is held securely in place by gentle, flexible loops. Artificial lens implants are available in all ranges of power so patients can often achieve better vision than they have ever experienced.  Many people find that they can see without their glasses.  Although clear vision can be restored very quickly, glasses still may be needed for some activities such as driving or reading.

We live in an age where we can tailor the intraocular lens (IOL) selection to your lifestyle.  Your surgeon will discuss various options for lens replacements.  At Achieve Eye and Laser, we offer the latest in aspheric monofocal lenses, toric astigmatism lenses, multifocal lenses, and accommodating lenses.  It is important to note that different lenses are appropriate for different kinds of eyes, and your doctor will discuss options that are a good fit for your eye.  You will hear about your choices and will make your lens selection at your pre-operative appointment.IOLchartLarge

At the most basic level, your choices will hinge on whether or not you have astigmatism (when your cornea is round, but rather, “football” shaped). If you have astigmatism, you can elect to correct this astigmatism with a toric intraocular lens, or go with the aspheric monofocal IOL, which does not correct astigmatism. Your doctor will explain the benefits and drawbacks of each. Visit here for a vision simulator with your lens options.

If you do not have astigmatism, your options are the aspherical monofocal lens, or a multifocal or accomodating IOL. Visit here for a vision simulator with your IOL options.

Risks

As with any surgery, there are risks involved with cataract surgery, though serious problems are very rare.  Problems that do occur can generally be resolved so vision is not permanently lost.   Your surgeon will carefully examine your eyes prior to surgery and inform you of any risk factors specific to your individual eyes.  All of our surgeons live in Kitsap County and are readily available should you have any problems.

Your Surgery Experience

Our surgeons use the Pacific Surgery Center and Surgery Center of Silverdale.  Both are conveniently located, but please verify that you can easily find your surgery center on the day of surgery.

You will find out your arrival time a few days before your surgery.  Schedulers from the surgery center will call you.  We do not know your time until two days before your surgery.  Please call the surgery center if you not hear from them by the day before surgery.

When you arrive at the surgery center, you are treated as a special guest. Patient counselors verify your insurance and answer billing questions.

Nurses then review your medical history and answer any questions you may have. The kind staff and home-like atmosphere provide a soothing touch of assurance. You feel calm and relaxed, and unlike most other surgery, cataract treatment at Achieve Eye and Laser Specialists will not disrupt your lifestyle.

Before entering the surgical suite, you will change into a light gown.  Your eye is gently numbed so that you can stay alert through the procedure without discomfort.  Numbing is done without any needles.  An anesthesia doctor makes sure you are safe and comfortable.

The experience of surgery is painless.  You will see a colorful light show and feel water in your eye.   Most cases are completed in 10-15 minutes.

Within a few minutes the operation is completed. Oftentimes, no patch is used. As you leave the operating room, nurses gently tend to the smallest details of your comfort. Once you receive after-surgery instructions, you are free to go home or return to your hotel.

The next morning you come back to Achieve Eye and Laser Specialists office for a quick check up.

The magic of the experience at Achieve Eye and Laser Specialists is more than skillful surgery. There is an atmosphere of care and compassion from the Doctors and Staff.

You can feel confident that each of our surgeons have performed thousands of cataract surgeries and are very comfortable performing standard as well as complex cases.

After-surgery care

You will likely see better in the first few days, and the vision continues to clear over the following weeks.  Some note a small amount of irritation, others feel normal from the first day out.

Your surgeon will follow you until you are stable.  In some cases, patients may return to their regular eye doctor for after-surgery care.  It is comforting to know that you always have access to your surgeon at Achieve Eye and Laser Center if you have a question or concern after your surgery.

You will take prescribed eye drops for about 3-4 weeks after surgery, and have a few days restrictions on bending, lifting, and swimming.  There are no travel or flying restrictions, as long as you can make your post operative appointments.

After-surgery clouding

In about a third of cataract surgery cases, the clear capsule that holds the new plastic lens becomes cloudy or frosted over. Again, vision is reduced.  This is NOT the cataract returning.  This opacity is easily treated with laser at our office.  No incisions or cuts are involved; a beam of laser light is used to make a small opening in the back of the cloudy capsule to restore clear vision.  It is painless and easy.

For more information

The American Society of Cataract and Refractive Surgeons web site contains a wealth of information about cataracts and their treatment.

The EyeSmart website has more information and videos about cataracts and cataract surgery.

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