CATARACT Therapy

Treatment Make sure that eyeglasses or contact lenses are the most accurate prescription possible Improve the lighting in your home with more or brighter lamps When outside during the day, wear sunglasses to reduce glare Limit night driving

Think about how the cataract affects your daily life Can you see to do your job and drive safely Do you have problems reading or watching television? Is it difficult to cook, shop, climb stairs or take medications? How active are you? Does lack of vision affect your level of independence? Are you afraid you'll trip or fall or bump into something?

Sometimes a cataract should be removed even if it doesn't cause major problems with vision If it is preventing the treatment of another eye problem, such as age-related macular degeneration, diabetic retinopathy or retinal detachment

If you have cataracts in both eyes and decide to have surgery, your eye doctor typically removes the cataract in one eye at a time This allows time for the first eye to heal before the second eye surgery

Cataract surgery is the most common operation performed on patients over 65 years of age More than 95% of patients have improved vision after surgery Benefits include improvement in uncorrected and best-corrected visual acuity, improved binocularity, depth perception, and increased peripheral vision to enhance patients' ability to drive, read, work, and manage their own medications

Advances in surgical technique and more sophisticated technology have helped make surgery a safe and effective treatment for cataracts Prior to surgery, your eye doctor measures the size and shape of your eye to determine the proper lens implant power This measurement is made with a painless ultrasound test

Cataract surgery is typically an outpatient procedure that takes less than an hour Most people are awake and need only local anesthesia On rare occasions some people may need general anesthesia if they have difficulty laying flat or have claustrophobia

Two things happen during cataract surgery — the clouded lens is removed, and a clear artificial lens is implanted

Phacoemulsification During phacoemulsification, phaco for short, the surgeon makes a small incision, where the cornea meets the conjunctiva

The surgeon then uses the probe, which vibrates with ultrasound waves, to break up (emulsify) the cataract and suction out the fragments

Once the cataract is removed, a clear artificial lens is implanted to replace the original clouded lens This lens implant is made of plastic, acrylic or silicone and becomes a permanent part of the eye

Some IOLs are rigid plastic and implanted through an incision that requires several stitches (sutures) to close However, many IOLs are flexible, allowing a smaller incision that requires no stitches

Patients usually go home the same day Patients are seen in the office the next day, the following week, and then again after a month so that he or she can check the healing progress It's normal to feel mild discomfort for a couple of days after surgery You may wear an eye patch or protective shield the day of surgery Your doctor may prescribe medications to prevent infection and control eye pressure

Post-op Course Patients are usually examined 1 day, 1 week and then one month after the surgery date

Complications of Surgery Vitreous Loss- 3.1% Vitreous Hemorrhage-0.3% Uveitis-1.8% Increased Eye Pressure- 1.2% Retinal Detachment- 0.7% Endophthalmitis- 0.13%

Post Operative Period Contact your doctor immediately if you experience any of the following signs or symptoms after cataract surgery: Vision loss Pain that persists despite the use of over-the- counter pain medications A definite increase in eye redness Light flashes or multiple spots (floaters) in front of the eye Nausea, vomiting or excessive coughing

Posterior Subcapsular Opacity This condition occurs when the back of the lens capsule eventually becomes cloudy and blurs vision PCO can develop months or years after cataract surgery Occurs approx. 20% percent of the time

Treatment for PCO is simple and quick Laser capsulotomy is a quick, painless outpatient procedure that usually takes less than five minutes Capsulotomy means "cutting into the capsule" and YAG is an abbreviation of yttrium-aluminum-garnet, the type of laser used for the procedure

YAG Laser Capsulotomy A technique in which a laser beam is used to make a small opening in the clouded capsule to let light pass through

Post YAG Afterward, patients typically stay in the doctor's office for about an hour to make sure the eye pressure is not elevated In some people, particularly those who have glaucoma or are extremely nearsighted, YAG laser surgery can raise eye pressure Other complications are rare but can include swelling of the macula and a detached retina

Most cataracts occur with age and can't be avoided altogether Regular eye exams remain the key to early detection You can take steps to help slow or prevent the development of cataracts

Do not smoke Smoking produces free radicals, increasing your risk of cataracts. Eat a balanced diet Include plenty of fruits and vegetables. Ultraviolet light protection since UV light may contribute to the development of cataracts Diabetes Control

New Frontiers Researchers are continuing to explore new ways to prevent and treat cataracts, such as developing medications that would reduce or eliminate the need for surgery Until then, cataract surgery is the method to restore vision