Huang Ophthalmology Center Inc.

The most commonly seen cataract is the nuclear cataract which is caused by the aging process and changes.  Other risk factors for the development of cataracts include people who are diabetic, have excessive exposure to the sun or some types of radiation, eye injury and prolonged intake of steroids or cortisone medication for medical conditions such as lupus or severe arthritis.  In some cases babies are born with cataracts or can develop during their childhood. 

 In the early stages, you may have very minimal impaired vision, so only your ophthalmologist can tell.  Your first symptom can be slight hazy vision only in bright light however at some point you might start noticing other changes as listed below.

Common signs and symptoms

• Cloudy or blurry distance vision, however in some cases reading vision may temporarily be improved  (Print may be difficult to read or appears faded lacking contrast, frequent prescription changes in your eye glasses or contact lens, edges of stairs or curbs are difficult to detect)
• Poor night vision.  (Streaks or ray of light coming from headlights and stop lights at night,
• Double vision or several images in one eye. (This symptom may clear as the cataract gets larger.)
• Difficulty telling the difference between colors.  For example, blue may appear as a shade of green, white as gray or beige, and yellow as white. Normal 0
• Glare.  Sunlight, headlights, lamps all may appear too bright.  

As to date, there is no medication that can slow down the growth of or clear the clouded lens.  In the early stages of the cataracts, most people can get by with improving their vision with new glasses, contacts, anti-glare sunglasses, or magnifying glass, however as the cataracts gets worse over time, surgery is the only effective treatment.  If left untreated, the cataract will become so clouded that it would be very difficult to see any details.  In a cataract surgery, the physician would remove the clouded damaged lens and replace it with a clear plastic intraocular lens (IOL).  In the past, before the development of the IOL implants, physicians would wait until the cataract is advanced and dense, however today with advanced surgical techniques and equipments, physicians tend to suggest cataract surgery at an earlier stage in development. 

The is currently no proven method to prevent cataracts that develop as a result of getting older, however you can wear sunglasses or wear hats with a brim to block ultraviolet sunlight to delay the chances of getting cataracts.  Some researchers also identified antioxidants such as vitamins C and E to be linked to reducing and slowing the progression of developing cataracts.

Once you’ve decided to have cataract surgery, your doctor will discuss with you to decide which intraocular lens (IOL) is best suited for your visual needs.  It is an important part of the decision process as it determines the vision you will live with for the rest of your life.

IOL is an artificial lens that is implanted in the eye during cataract surgery to replace the eye’s clouded crystalline lens.  There are two basic types of IOLs, each designed to correct vision at a specific visual range.  The Monofocal IOL is an intraocular lens that provides patients with only one focal point.  Typically these lenses only correct distance vision, which results in the need to use reading glasses for reading after the surgery.  Multifocal IOL provides patients with multiple focal points and corrects vision at most ranges: near, far and everywhere in between.  Although you cannot expect to have the full range of crisp vision at both near and distance that you had when you were young, for the most part, you will be able to see with the freedom from glasses.

Apart from the types of lenses to use, another factor to consider is cost.  The Monofocal IOL’s are generally fully covered by your insurance or Medicare, while Multifocal IOL’s require an additional fee.  Since it is considered a luxury and not a medical necessity, most insurance plans will not cover for the extra costs incurred when choosing Multifocal IOL lenses.

 Cataract surgery is an outpatient procedure that typically takes only 20 to 30 minutes. Below is a brief overview of the process:

• You’ll first receive a number of medicated eye drops, to prevent infection and inflammation, and to ensure you feel no pain during the surgery. It is not necessary for you to be put to sleep for the procedure.  You will likely receive a mild sedative, to make sure you stay relaxed and comfortable throughout.
• After making a tiny incision in your cornea, your surgeon will use a probe the size of a pen tip to break apart and remove the old lens. The most common technique for removing cataracts is a process called phacoemulsification also known as “phaco.” 
• Once the old lens has been removed, the surgeon will insert the replacement IOL into your eye. Typically, the IOL is rolled up into the tip of an injector tool, so that it can be inserted through the same tiny incision. Once injected, the IOL unfolds perfectly into place.
• Because of the small surgical incision, you probably will not require stitches and  your eye should heal itself naturally. For protection, you will have a protective patch placed over your eye for recovery.

And that’s it! All you’ll have to do after surgery is rest up, and get ready to enjoy the benefits of improved vision.