If your vision has become cloudy or things you see are not as bright as they used to be, a cataract may have developed in one or both of your eyes. A cataract is a clouding of the eye’s naturally clear lens. Your eye becomes like a window that is frosted or yellowed. The amount and pattern of cloudiness within the lens can vary. If the cloudiness is not near the center of the lens, you may not be aware that a cataract is present. Cataracts are a common cause of vision loss, especially as we age, but they are treatable.
What are the Symptoms of Cataracts?
The only way to know if you have cataracts for certain is when your ophthalmologist does a dilated eye exam. Get a baseline exam at age 40, when early signs of disease and changes in vision may start to occur. Your doctor will let you know how often you should return for follow-up exams. At any point, if you have symptoms or risks for eye disease, see your doctor. Because your risk for cataracts and other eye diseases increases as you get older, starting at age 65 you should see your doctor every year. A complete eye examination will rule out any other condition that may be causing blurred vision or eye problems.
Most age-related cataracts develop gradually. As a result, you may not immediately notice changes in your vision when cataracts first develop.
In time, you may have symptoms such as:
- Painless clouded, blurry or dim vision
- Increasing difficulty seeing at night or in low light
- Sensitivity to light and glare, seeing halos around lights
- Colors seem faded or yellowed
- The need for brighter light for reading and other activities
- Frequent changes in eyeglass or contact lens prescription
- Double vision within one eye
Cataracts occur as part of the aging process, so everyone is at risk eventually. By age 75, about 70 percent of people will have cataracts. The eye’s lens slowly becomes less flexible, less transparent and thicker. Then areas of the lens become cloudy. Usually, cataracts develop in both eyes at about the same time.
These factors increase the risk of developing cataracts:
- Advanced age
- Family history
- Previous eye injury or inflammation
- Prolonged steroid use (especially combined use of oral and inhaled steroids)
- Extensive exposure to sunlight
What Can I Do to Protect my Vision?
Wearing sunglasses and a hat with a brim to block ultraviolet sunlight may help to delay cataract. If you smoke, stop. Researchers also believe good nutrition can help reduce the risk of age-related cataract. They recommend eating green leafy vegetables, fruit, and other foods with antioxidants. If you are age 60 or older, you should have a comprehensive dilated eye exam at least once every two years. In addition to cataract, your eye care professional can check for signs of age-related macular degeneration, glaucoma, and other vision disorders. Early treatment for many eye diseases may save your sight.
If your vision is only slightly blurry, a change in your eyeglass prescription may help for a while. However, if you are still not able to see well enough to do the things you like or need to do after the change in eyeglass prescription, cataract surgery may be considered. Cataract surgery is performed as an outpatient procedure and does not require an overnight stay. There are usually few restrictions, and you will be able to resume your normal activities almost immediately.
What To Expect
Before surgery, the length of your eye will be measured in what is called an A-scan, and the curve of your cornea will be measured in a technique called keratometry. These measurements help your doctor select the proper lens implant for your eye.
After the cloudy lens has been removed, the surgeon will replace it with an intraocular lens (IOL) implant made of silicone or acrylic. This new lens allows light to pass through and focus on the retina. The IOL becomes a permanent part of your eye. In most cases, the IOL is inserted behind the iris, the colored part of your eye, and is called a posterior chamber lens. Sometimes, the IOL must be placed in front of the iris. This is called an anterior chamber lens. When the IOL is in place, the surgeon closes the incision. Stitches may or may not be used.
Most people who wear bifocals or reading glasses for near vision may still need to wear glasses after cataract surgery for reading, and, in some cases, even for distance. If you choose to have a multifocal or accommodative IOL, your dependence on glasses may be minimized or, in some cases, eliminated completely.
Post Cataract Haze
Once a cataract is removed, it does not grow back. However, a clear membrane is left behind the IOL at the time of surgery. Over time, this membrane will haze, causing decreased vision and increased glare. This may occur as soon as a few weeks after surgery, but it is usually one to two years after surgery before the haze becomes significant. When the haze is significant, a laser procedure can be performed (YAG capsulotomy) to clear it. This is a one-time procedure which is painless, safe and generally performed in our office, although it may be scheduled in an outpatient center based on patient need and physician preference.