What are Cataracts?
Cataracts cloud the natural lens of the eye. This happens when the proteins that make up the lens clump together and opacify. Cataracts are most common in people over the age of 60. Cataracts form over a period of many years, and doctors are able to correct this condition during a routine surgery. By undergoing cataract surgery, you can restore your vision and enhance your quality of life. The treatment that is right for you will depend on your degree of vision loss. If significant, then cataract surgery will be necessary.
How do Cataracts Form?
The eye’s lens consists of protein and water and normally is completely transparent. Cataracts form when the protein molecules begin to clump together. This causes tiny opacities in the eye’s lens. When this happens, some of the incoming light gets blocked from reaching the retina, resulting in blurry vision, glare from sunlight during the day and glare from headlights driving at night. This clumping often occurs over time and is painless.
What Are The Symptoms of Cataracts?
Vision impairment can produce a number of side effects. As cataracts slowly worsen over time, the symptoms may not be obvious at first. In fact, you may adapt to them as your vision degrades. Because of this, you may seek treatment much later than you should. Early detection can allow us to explore your treatment options and help delay the onset of the condition. If you experience any vision impairment, it is important that you seek diagnosis. Common symptoms of cataracts include:
- Blurred or cloudy vision
- Muted colors
- Lack of definition
- Glare or the appearance of halos around light sources
- Inhibited night vision
- Double vision
- A marked degradation in your visual prescription over time (for eyeglass users)
How can Cataracts be Prevented?
As we age, the possibility of developing cataracts increases. Currently, there is no evidence that cataracts can be prevented, however, there are ways that may be helpful to mitigate your chances of developing a cataract. Wearing sunglasses or wide-brim hats while outside, for example, can help reduce exposure to UV rays, and prevent the breakdown of proteins which causes cataracts. Smoking or a poor diet can also contribute to the formation of a cataract. By quitting smoking and eating a healthy, balanced diet rich in vegetables and fruits, it may be possible to slow cataract development. Regular eye appointments can help provide early detection if a cataract is forming. If a cataract is present but detected early, it may be possible to improve vision through non-surgical use of corrective lenses or simply by using brighter lights while indoors.
The presence of cataracts in one or both eyes can dramatically affect vision, having a profound effect on quality of life. Driving with cataracts can be very dangerous as you maybe unable to distinguish certain colors and handle the glare of light.
How are Cataracts Diagnosed?
A cataract exam may require a combination of tests to gauge not only if you have cataracts, but the severity of the cataracts. Doctors may use further testing beyond this to determine what type of cataract you have.
Am I at Risk for Cataracts?
Most people develop cataracts simply as a result of aging, with the majority of cases occurring in people over the age of 55. Other risk factors include eye injury or disease, a family history of cataracts, smoking or use of certain medications.
When Should Cataracts be Removed?
A cataract may not need to be removed right away if your lifestyle isn’t significantly affected. In some cases, simply changing your eyeglass prescription may help to improve your vision. Contrary to popular belief, a cataract does not have to be “ripe” to be removed. However, once you are diagnosed with a cataract, we need to monitor your vision regularly for any changes. When a cataract causes bothersome vision problems that interfere with your daily activities, cataract surgery may be necessary.
How are Cataracts Removed?
When detected early, vision can improve with corrective lenses. If these measures do not help, doctors can recommend surgical removal of the cataract. If left untreated, the cataract may continue to grow. The doctors at SightMD perform advanced cataract surgery. Because of advanced technology, our cataract procedure takes about 10 to 20 minutes. Patients return to the comfort of their home the very same day! The two most common types of surgery are:
- Small-incision cataract surgery (Phacoemulsification) – Small-incision cataract surgery is the most common type of cataract removal. The eye surgeon makes a very small opening on the eye, next to the outer corner. A tiny probe gives off ultrasound waves to dissolve the core, hard part of the cloudy lens. The rest of the cataract material is then removed by another probe, which provides suction through the same opening.
- Extracapsular surgery – During extracapsular surgery, a larger opening is made on the top part of the eye to remove the hard center of the lens. The rest of the cataract material is then taken out by suction, through the large opening. This type of larger incision cataract surgery is rarely done today.
The removed lens is replaced by an intraocular lens (IOL), which is inserted through the previous opening at the end of the surgery. An IOL is a clear, artificial lens that does not need care. It becomes part of the eye. With an IOL, a person usually has better eyesight because light will be able to pass to the retina. The person does not see or feel the new lens.
What to Expect after Cataract Surgery
Within a few hours of the surgery, you will likely notice that colors are brighter, due to the removal of the clouded lens. However, your vision may be blurry during the first couple of days, and your eye may be slightly light-sensitive. Dryness, occasional itching, burning and/or red eyes are also common Most of these effects will end within a few days.
Your ophthalmologist will prescribe eye drops or medications to prevent or control inflammation, infection or high pressure of the eye. An eye shield is also recommended at bedtime to protect the operated eye.
You will also be scheduled for three or four follow-up appointments with your ophthalmologist to monitor your recovery progress. A month after the surgery, you will need an eye exam so you can be prescribed new eyeglasses if necessary.
How Long is Recovery from Cataract Surgery?
Most patients usually go back to work with light duty two or three days after surgery. However, full recovery from cataract surgery usually takes one to two months. This includes the time needed for the eye to adjust to the replacement lens and the restoration of your vision to its highest potential.
How Much Does Cataract Surgery Cost?
Without private insurance or Medicare, you can expect an out-of-pocket expense anywhere from $3,000 to $7,000 per eye. In most cases, insurance covers cataract surgery. Medicare and most insurance companies deem cataract surgery medically necessary. This allows for most cases to cover the procedure. There are deductibles and copays in some plans. Patients are always relieved to find out that our cataract surgeons, the anesthesiologist, and the eye surgery center are all covered.
What Factors Affect the Cost of Cataract Surgery?
The cost of cataract surgery can vary on such factors as:
- Setting: Having cataract surgery in an ambulatory surgical center tends to cost less than outpatient surgery in the hospital.
- Type of surgery: Two traditional techniques are phacoemulsification (“phaco”) and extracapsular cataract extraction surgery (ECCE). Phaco uses a small incision, while ECCE uses a larger incision. For these procedures, uninsured people can expect to pay $3,000 to $5,000. Laser-assisted cataract surgeries, with more advanced technology, can average $4,000 to $6,000.
- Type of lens: You and your doctor can choose the type of IOL that suits you best. The monofocal lens improves vision at one distance only and is less expensive than the multifocal lens that helps you see both near and far.
- Surgeon experience: The technology used for phaco may require the surgeon to have more extensive medical training. As a result, this technique can be more costly than other types of cataract surgery.
- Post-surgical complications: Sometimes, the artificial lens can also become cloudy weeks or years after the surgery. Addressing the problem may call for a laser surgery known as posterior capsulotomy, which costs about $600 to $800.
Cataract Common FAQs
How long should I wait before I get cataract surgery?
Many people live with cataracts that do not impair their vision. We do not recommend surgery for these individuals. Generally, if your vision loss becomes significant enough to interfere with your daily activities, then we do recommend surgery.
Can cataracts return after surgery?
No, once removed a cataract cannot redevelop. However, a secondary cataract may develop around the IOL. Treatment for secondary cataracts consists of a simple, painless laser procedure. This procedure clears the fogged area around the lens.
Are there treatment options for cataract without surgery?
Yes, if caught early before the cataracts have significantly impaired your vision. Your eye doctor may be able to change your lens prescription to mitigate the development of cataracts. Beyond that, there is nothing that can treat a cataract without surgically removing it.
What are the risks of cataract surgery?
Even with the many advances that have been made in the field of cataract surgery, including the advent of laser cataract treatment, it’s important to note that all surgical procedures carry some degree of risk. With that in mind, our experienced cataract surgeons have made cataract surgery a large focus of our practice. We have successfully performed this procedure on many individuals, and our surgeons skills and expertise, combined with utilization of state-of-the-art technology, allow our surgeons to minimize risks associated with this procedure.
Some of the potential complications of cataract surgery include:
- Posterior Capsule Opacity – a condition that can impair vision after cataract surgery
- Malpositioned/Dislocated Intraocular Lens
- Minor Eye Inflammation
- Retinal Detachment
- Corneal Or Retinal Swelling
- Ocular Hypertension – increased pressure inside the eye
- Bleeding or Infection inside the eye leading to significant vision loss or blindness (very rare)
- Ptosis – drooping eyelid