Cataracts: What Patients Should Know

It’s common knowledge that surgeries of all types are performed on a routine basis. Despite this fact, you’ll probably be a bit surprised at just how often Americans go under the knife. In the year 2010 alone, the Centers for Disease Control and Prevention (CDC) reported that over 51 million inpatient surgeries occurred in the United States (an “inpatient” refers to a person who spends at least one night in a hospital for medical treatment). While many of these surgeries are geared towards mending the heart, intestine and knees, the eyes also undergo a large number of surgical operations. One such procedure is eye cataract surgery, an operation that ranks as one of the most frequently- performed surgeries in the United States.

Why Cataracts are Problematic

The human eye contains a number of various parts, each of which plays a role in helping us see clearly. Among these parts is the lens; positioned right behind the iris at the front of the eye, the lens is tasked with properly focusing light onto the retina. Upon reaching the retina, this light is converted into nerve signals and sent to the brain, where it is again transformed into a clear visual image.

Cataracts occur when the lens becomes cloudy, interfering with the eyes’ ability to transmit visual information to the brain. Instead of the sharp and well-defined vision most people enjoy, the outside world to those with cataracts appears very blurry and unfocused. Additionally, cataract patients must also contend with the symptoms listed below:

• A reduced ability to properly view colors, which appear faded
• Sensitivity to glare from headlights or lamps. Sunlight might also be problematic.
• Difficulty seeing at night
• Double vision in one eye; an afflicted eye might also start seeing multiple images of one object

In many cases, cataracts force patients to repeatedly get new prescription eyeglasses or contact lenses. It bears noting that the aforementioned symptoms might not indicate cataracts, but another type of eye-related problem instead.

Treatment Options

A cataract diagnosis doesn’t necessarily mean the patient must undergo surgery. Other possible treatment methods include anti-glare sunglasses and certain types of prescription eye glasses. Cataract patients also have the option of purchasing a number of products with magnifying glasses. Included in this category are handheld magnifying glasses, headset magnifiers and coil stand magnifiers. Coil stand magnifiers are magnifying glasses positioned on one or more legs; they are small enough to be placed upon books, newspapers or other written material. Finally, cataracts can also be addressed with special magnifying lenses, which can be attached to both eye glasses and sunglasses.

Cataract Surgery

Doctors usually turn to surgery only when other measures have failed and when cataracts begin to greatly interfere with the patient’s daily life. Patients should thoroughly discuss this option with health care professionals before deciding on surgery. Fortunately, the decision on whether to get this procedure does not have to be made quickly. For most people, delaying eye cataract surgery will not have long-term repercussions for the eye’s health, nor will it make it more difficult for doctors to operate on the eye.

During eye cataract surgery, the surgeon attempts to remove the patient’s natural lens and replace it with an artificial one. There are two specific methods that can be used for surgically removing damaged lenses:

 

Phacoemulsification – In this procedure, the surgeon removes the lens using a small probe. This device, known as a phaco probe, uses sound waves to break apart the eye’s lens into a number of small pieces. In order to do this, the surgeon must make two surgical cuts where the cornea meets the sclera (the cornea is a transparent, dome-shaped section at the front of the eye, whereas the sclera is simply the white area of the eye’s surface). Another incision must be made at the surface of the lens, a section known as the capsule. After the procedure is finished, the eye can usually heal itself from the surgery without the aid of stitches.

 

Extracapsular surgery – If the patient’s lens is strong enough to resist a phaco’s sound waves, the surgeon might be forced to perform an extracapsular surgery. Extracapsular surgery might also be necessary if the cataract has heavily damaged the eye’s vision. This procedure involves a medium-sized incision at the side of the cornea. This allows the surgeon to extract the central section of the lens, which is removed intact from the patient’s eye. The remaining portion of the lens is extracted via suction.

 

The artificial lens used to replace the eye’s natural lens is called an intraocular lens, or an IOL for short. Made from plastic, this clear-colored lens quickly becomes a fully-functioning part of the eye, noticeably improving the patient’s vision.

IOLs cannot be given to every patient with cataracts. The presence of other eye-related diseases or complications during surgery can prevent an IOL from being used. In these cases, the patient may instead be advised to wear soft contact lenses or high-magnification glasses.

Preparing for and Recovering From Surgery

Prior to cataract surgery, the doctor must determine the appropriate size of the patient’s IOL. This might involve measuring the overall size and shape of the eye, along with the curve of its cornea. The doctor may also prohibit the patient from eating or drinking anything in the twelve hours preceding the surgery.

Though the eye is a very sensitive part of the human body, many patients opt to remain awake during the operation. Thanks to anesthesia, eye cataract surgery is nearly pain-free. Before the incisions are made, the patient is usually given either a topical anesthetic (in the form of eye drops) or a local anesthetic (local anesthetics target only a specific area of the body).

Following the procedure, the patient might have to wear a patch for a short period of time. The eye will have to be protected with either eyeglasses or an eye shield. People often experience mild discomfort, itching sensations and sensitivity to light and touch while the eye heals. Doctors often prescribe eye drops to recovering patients, which are used to both guard against infection and assist the healing process. The eye should be fully recovered after about eight weeks.

The track record of eye cataract surgery speaks for itself; according to the National Institutes of Health, roughly 90 percent of people who undergo this procedure enjoy improved vision afterwards (link: http://www.nei.nih.gov/health/cataract/cataract_facts.asp#4d). This fact helps explains why cataract surgery is so common; the high success rate of this operation has allowed millions of adults to enjoy decent vision well into their later years.