Our natural lenses are comprised of proteins that break down and clump together as we age. These protein clusters — what we know as cataracts — eventually cause an individual’s vision to become blurry.
The pace at which cataracts develop varies based on the individual, however, for most people cataracts will develop somewhat slowly over a matter of years, as a result of aging. However, some people experience a more rapid cataract development, usually as a result of diabetes or underlying eye conditions.
Cataracts develop so slowly that many patients aren’t even aware they have them until their symptoms become too obvious to ignore. These symptoms may include cloudy vision, “halos” appearing around bright lights, sensitivity to bright lights and glare, and difficulty seeing at night or performing daily tasks. Some patients may also notice that they must frequently visit their eye doctor for a new glasses or contact lens prescription.
There are three primary types of cataracts: nuclear sclerotic, cortical and posterior subcapsular.
Nuclear Sclerotic Cataracts: The most common type of cataracts. These age-related cataracts are caused by the hardening and yellowing of the lens over time. Nuclear Sclerotic Cataract may take years to develop and affect vision, but as the cataract progresses, it will affect the eye’s ability to focus. For some people, this type of cataract may produce the symptom of “second sight” which temporarily improves close-up vision. However, this symptom is not permanent, and as the cataract progresses, vision will continue to decline.
Cortical Cataracts: This type of cataract develops as cloudy areas in the lens cortex, causing vision problems such as blurring, glare, and depth perception due to the way that light scatters while entering the eye. People with diabetes are at a higher risk for developing cortical cataracts.
Posterior Subcapsular Cataracts: These cataracts begin as a small cloudy area on the back surface of the lens, causing vision problems with reading, “halos”, and glare around lights. Subcapsular cataracts can have a rapid development and symptoms might become noticeable within months. People who have diabetes, extreme nearsightedness, or who use steroids are at the highest risk of developing this type of cataract.
Surgery is currently the only option for treating cataracts. That said, due to the slowness with which cataracts develop, many patients choose to forego immediate surgical intervention in favor of a stronger glasses or contact lens prescription. Cataract surgery is typically performed when stronger prescriptions are no longer enough to allow patients to perform everyday tasks like reading or driving a car.
Patients with age-related macular degeneration or diabetic retinopathy may opt to receive cataract surgery sooner rather than later, as the procedure will enable them to receive additional treatment for their more serious conditions.
There is not yet a proven way to prevent cataracts. Doctors do not yet know much about why cataracts develop, however, it has been hypothesized that there are certain risk factors that could be involved. It is suggested that you try to avoid risk factors such as, smoking, long-term exposure to sunlight, and excessive alcohol consumption. There are also mixed ideas on the involvement of an antioxidant-rich diet in preventing or slowing cataracts, but this has yet to be proven.
The best thing you can do is to have regular eye examinations to help detect cataracts at the earliest stages.
When cataracts start to affect a person’s vision enough that they cannot see what they need to see in order to perform daily activities such as driving or reading, it is time to consider cataract surgery. This timing can be very different for individual patients, based on what is important to them and how badly they feel they are affected.
Cataract surgery is an outpatient procedure that begins with an eye surgeon numbing the nerves in and around your eye with a local anesthetic. Once the anesthetic has taken effect, the surgeon will make a small incision and remove your cataract-clouded lens. The natural lens is then replaced with an intraocular lens (IOL) made of plastic, silicone, or acrylic, and the incision is closed. The entire procedure takes approximately 15 minutes to complete. During the recovery process, the IOL fuses with the eye and becomes an integral part of the eye’s structure.
Cataract surgery is one of the safest vision correction procedures available, and more than three million cataract surgeries are performed each year in the U.S. alone. Like all surgeries, cataract surgery presents a minor risk of bleeding and infection. Retinal detachment — a rarer but more serious complication — is also possible. Your eye care specialist will review these risks with you during your consultation and recommend any precautions you should take to help ensure a smooth procedure.
Yes, patients are typically awake during cataract surgery. However, you will be given local anesthetics to numb the eye completely, and in some cases, you may be offered a sedative to help you relax which could make you groggy during the procedure.
Cataract surgery requires a local anesthetic, which means you will not be allowed to drive yourself home after the procedure, so be sure to arrange a ride with a friend or family member. You should wait for your eye doctor’s approval before you start driving again.
It typically takes approximately four weeks to recover from cataract surgery. During this time, you may experience blurry vision as your eye adjusts to the replacement lens. This is completely normal and will fade quickly. Your doctor will also ask you to wear an eye patch in the days immediately following your surgery to prevent you from unintentionally rubbing your eye as it recovers.
It’s best to avoid lifting heavy objects or bending from the waist during the recovery process. Patients are also not allowed to drive until approved to do so by their doctor. (All patients are required to get a ride home from their surgery.) If you experience severe pain or feel that you aren’t recovering according to schedule, contact your Swagel Wootton Eye Institute specialist immediately.
Every type of replacement lens will eliminate cataracts and improve your vision. However, depending on the lens you choose, you may still need to wear glasses after surgery. It’s important to talk through your IOL options with your doctor to determine which is best for your unique vision goals.
Cataract surgery removes the lens of the eye, where cataracts grow, therefore, it is impossible for cataracts to grow back. However, there is a such thing as “secondary cataracts”. This occurs when leftover epithelial cells accumulate in the posterior lens capsule, creating a scar like tissue that affects your vision, similar to the symptoms of cataracts. Secondary Cataracts are treated with a YAG laser capsulotomy, a simple outpatient procedure that can be completed within minutes.
There is no standard price for cataract surgery. The cost of the procedure will vary depending on the type of replacement lens you choose, the surgical techniques utilized during your procedure, and the timing of your operation.
Patients with private health insurance or Medicare can typically have all or part of their procedure covered, but it’s important to contact your insurer to identify whether your cataract surgery will be covered. At Swagel Wootton Eye Institute, we’ll work with you to develop an affordable financing plan that meets your unique budgetary needs.