A cataract occurs when the normally clear lens in your eye becomes cloudy, often impairing vision. Clouded vision may make it more difficult for you to read, drive a car or see as clearly as you once did.
For most people, cataracts (which develop slowly over time) are a natural result of aging. About half of Americans between the ages of 65 and 75 have cataracts to some degree.
The key to living with cataracts is knowing when it’s time not to live with them anymore. Usually, this happens when your normal lifestyle — reading the morning paper, driving to the grocery store or seeing the expression on the face of a child or grandchild — is jeopardized by impaired vision. Fortunately, advanced surgical methods make cataract surgery one of the most successful surgical procedures performed today.
Signs and Symptoms
Signs and symptoms of cataracts may include:
- Blurry or dim vision
- Poor night vision
- Halos around lights
- Sensitivity to light and glare
- Need for brighter light for reading and other activities
- Frequent changes in eyeglass prescription
Surgery is the most effective treatment for cataracts. More than 95 percent of the people who have cataract removal end up with better vision.
Using microsurgery and local anesthesia, an eye surgeon (ophthalmologist) removes the cataract, leaving much of your eye’s natural lens capsule in place. The capsule helps support the clear artificial lens that the surgeon inserts to replace the cloudy lens. The procedure is usually done on an outpatient basis and takes less than 1 hour. If both eyes are affected, surgery is usually performed on one eye at a time, allowing the first eye to heal before surgery is done on the second one.
The two most common surgical methods are:
Phacoemulsification (FAY-co-ee-mul-sih-fih-CAY-shun). This method, often called “phaco,” is the most common cataract surgery in the United States. An eye surgeon uses a special instrument to break up the cataract with ultrasound waves and then vacuums out the emulsified pieces. Phacoemulsification requires only a small eye incision — about 1/8 inch (3 millimeters).
Extracapsular. Through an incision about 3/8-inch (10 millimeters) long, an eye surgeon opens your lens capsule and removes the harder, central portion of the lens in one piece. The surgeon then vacuums out the softer parts of the lens. Your surgeon may suggest this method if your cataracts advance beyond the point where phacoemulsification may be effective.
Once the cataract is out, an eye surgeon inserts an artificial lens implant that has been corrected to meet your eye’s specific needs. The surgeon folds the flexible implant lens to insert it, and once in place the lens opens to about 1/4 inch (6 millimeters). In most cases of cataract surgery, no sutures are necessary.
Initially, your eye may have mild inflammation and irritation and may feel a little scratchy for a couple of days. You may need to wear an eye patch for the first 24 hours. Return visits to the doctor usually are set up for the day after and then several times during the next 4 to 6 weeks.
Improvement in vision usually begins within 1 or 2 days of surgery. Because your eye takes time to heal from the surgery, the greatest improvement in vision won’t occur until about 4 weeks after surgery. Most people still need to wear glasses after cataract removal.
Although cataract surgery is generally successful, complications such as bleeding, swelling, inflammation, infection or retinal detachment can occur. Contact your doctor immediately if you experience any of the following after cataract surgery:
- Loss of vision
- Pain that persists despite the use of over-the-counter pain medication
- Significant increase in eye redness
- Light flashes or multiple new spots before your eye
- Nausea, vomiting or excessive coughing
Occasionally, cataract surgery will not be helpful because of the presence of other diseases of the eye, such as glaucoma or macular degeneration.