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\n\tCataracts at a Glance:<\/strong><\/p>\n What is a cataract?<\/strong><\/p>\n A cataract is a clouding of the lens in the eye that affects vision. Most cataracts are related to aging. Cataracts are very common in older people. By age 80, more than half of all Americans either have a cataract or have had cataract surgery. A cataract can occur in either or both eyes. It cannot spread from one eye to the other.<\/p>\n\t\t\tWhat is the lens?<\/a>\n\t\t\t\t\t\t\tExpand<\/i><\/a>\n\t\t The lens is a clear part of the eye that helps to focus light, or an image, on the retina. The retina is the light-sensitive tissue at the back of the eye. In a normal eye, light passes through the transparent lens to the retina. Once it reaches the retina, light is changed into nerve signals that are sent to the brain. The lens must be clear for the retina to receive a sharp image. If the lens is cloudy from a cataract, the image you see will be blurred.<\/p>\n\t\t\tAre there different types of cataracts?<\/a>\n\t\t\t\t\t\t\tExpand<\/i><\/a>\n\t\t Yes. Although most cataracts are related to aging, there are other types of cataract:<\/p>\n Secondary cataract.<\/strong> Cataracts can form after surgery for other eye problems, such as glaucoma. Cataracts also can develop in people who have other health problems, such as diabetes. Cataracts are sometimes linked to steroid use.<\/p>\n Traumatic cataract.<\/strong> Cataracts can develop after an eye injury, sometimes years later.<\/p>\n Congenital cataract.<\/strong> Some babies are born with cataracts or develop them in childhood, often in both eyes. These cataracts may be so small that they do not affect vision. If they do, the lenses may need to be removed.<\/p>\n Radiation cataract.<\/strong> Cataracts can develop after exposure to some types of radiation.<\/p>\n\t\t\tWhat causes cataracts?<\/a>\n\t\t\t\t\t\t\tExpand<\/i><\/a>\n\t\t The lens lies behind the iris and the pupil. It works much like a camera lens. It focuses light onto the retina at the back of the eye, where an image is recorded. The lens also adjusts the eye’s focus, letting us see things clearly both up close and far away. The lens is made of mostly water and protein. The protein is arranged in a precise way that keeps the lens clear and lets light pass through it.<\/p>\n But as we age, some of the protein may clump together and start to cloud a small area of the lens. This is a cataract. Over time, the cataract may grow larger and cloud more of the lens, making it harder to see.<\/p>\n Researchers suspect that there are several causes of cataract, such as smoking and diabetes. Or, it may be that the protein in the lens just changes from the wear and tear it takes over the years.<\/p>\n\t\t\tHow can cataracts affect my vision?<\/a>\n\t\t\t\t\t\t\tExpand<\/i><\/a>\n\t\t Age-related cataracts can affect your vision in two ways:<\/p>\n Clumps of protein reduce the sharpness of the image reaching the retina.\u2028The lens consists mostly of water and protein. When the protein clumps up, it clouds the lens and reduces the light that reaches the retina. The clouding may become severe enough to cause blurred vision. Most age-related cataracts develop from protein clumpings. \u2028When a cataract is small, the cloudiness affects only a small part of the lens. You may not notice any changes in your vision. Cataracts tend to “grow” slowly, so vision gets worse gradually. Over time, the cloudy area in the lens may get larger, and the cataract may increase in size. Seeing may become more difficult. Your vision may get duller or blurrier.<\/p>\n The clear lens slowly changes to a yellowish\/brownish color, adding a brownish tint to vision. \u2028As the clear lens slowly colors with age, your vision gradually may acquire a brownish shade. At first, the amount of tinting may be small and may not cause a vision problem. Over time, increased tinting may make it more difficult to read and perform other routine activities. This gradual change in the amount of tinting does not affect the sharpness of the image transmitted to the retina. \u2028If you have advanced lens discoloration, you may not be able to identify blues and purples. You may be wearing what you believe to be a pair of black socks, only to find out from friends that you are wearing purple socks.<\/p>\n What can I do if I already have lost some vision from a cataract?<\/strong><\/p>\n If you have lost some sight from cataract or cataract surgery, ask your eye care professional about low vision services and devices that may help you make the most of your remaining vision. Ask for a referral to a specialist in low vision. Many community organizations and agencies offer information about low vision counseling, training, and other special services for people with visual impairments. A nearby school of medicine or optometry may provide low vision services.<\/p>\n\t\t\tWho is at risk for cataract?<\/a>\n\t\t\t\t\t\t\tExpand<\/i><\/a>\n\t\t The term “age-related” is a little misleading. You don’t have to be a senior citizen to get this type of cataract. In fact, people can have an age-related cataract in their 40s and 50s. But during middle age, most cataracts are small and do not affect vision. It is after age 60 that most cataracts steal vision. The risk of cataract increases as you get older. Other risk factors for cataract include:<\/p>\n Wearing sunglasses and a hat with a brim to block ultraviolet sunlight may help to delay cataract. If you smoke, stop. Researchers also believe good nutrition can help reduce the risk of age-related cataract. They recommend eating green leafy vegetables, fruit, and other foods with antioxidants.<\/p>\n If you are age 60 or older, you should have a comprehensive dilated eye exam at least once every two years. In addition to cataract, your eye care professional can check for signs of age-related macular degeneration, glaucoma, and other vision disorders. Early treatment for many eye diseases may save your sight.<\/p>\n What are the symptoms of a cataract?<\/strong><\/p>\n The most common symptoms of a cataract are:<\/p>\n Cataract is detected through a comprehensive eye exam that includes:<\/p>\n Your eye care professional also may do other tests to learn more about the structure and health of your eye.<\/p>\n How is a cataract treated?<\/strong><\/p>\n The symptoms of early cataract may be improved with new eyeglasses, brighter lighting, anti-glare sunglasses, or magnifying lenses. If these measures do not help, surgery is the only effective treatment. Surgery involves removing the cloudy lens and replacing it with an artificial lens.<\/p>\n A cataract needs to be removed only when vision loss interferes with your everyday activities, such as driving, reading, or watching TV. You and your eye care professional can make this decision together. Once you understand the benefits and risks of surgery, you can make an informed decision about whether cataract surgery is right for you. In most cases, delaying cataract surgery will not cause long-term damage to your eye or make the surgery more difficult. You do not have to rush into surgery.<\/p>\n Sometimes a cataract should be removed even if it does not cause problems with your vision. For example, a cataract should be removed if it prevents examination or treatment of another eye problem, such as age-related macular degeneration or diabetic retinopathy. If your eye care professional finds a cataract, you may not need cataract surgery for several years. In fact, you might never need cataract surgery. By having your vision tested regularly, you and your eye care professional can discuss if and when you might need treatment.<\/p>\n If you choose surgery, your eye care professional may refer you to a specialist to remove the cataract.<\/p>\n If you have cataracts in both eyes that require surgery, the surgery will be performed on each eye at separate times, usually four to eight weeks apart.<\/p>\n Many people who need cataract surgery also have other eye conditions, such as age-related macular degeneration or glaucoma. If you have other eye conditions in addition to cataract, talk with your doctor. Learn about the risks, benefits, alternatives, and expected results of cataract surgery.<\/p>\n\t\t\tAbout Cataract Surgery<\/a>\n\t\t\t\t\t\t\tExpand<\/i><\/a>\n\t\t Cataract Surgery is one of the most successful and safest procedures performed in the world. In fact, more than 3 million are performed each year in the United States. It is a quick outpatient procedure that we perform in one of our several state-of-the-art surgical suites. Patients often resume their normal daily activities the next day.<\/p>\n Based on your vision and examination, your doctor may recommend removing the cataract and replacing it with a clear lens implant. The procedure is painless and precise.<\/p>\n Your surgeon will remove the cataract through a tiny incision so small that it will seal without even needing a stitch. Once the cataract has been removed, your doctor will place a new, clear lens in the eye to restore sharper vision.<\/p>\n What are the different types of cataract surgery?<\/strong><\/p>\n There are two types of cataract surgery. Your doctor can explain the differences and help determine which is better for you:<\/p>\n After the natural lens has been removed, it often is replaced by an artificial lens, called an intraocular lens (IOL). An IOL is a clear, plastic lens that requires no care and becomes a permanent part of your eye. Light is focused clearly by the IOL onto the retina, improving your vision. You will not feel or see the new lens.<\/p>\n Some people cannot have an IOL. They may have another eye disease or have problems during surgery. For these patients, a soft contact lens, or glasses that provide high magnification, may be suggested.<\/p>\n No-Stitch Cataract Surgery offers a patient impressive benefits – safety, less time in surgery, relief from the usual discomfort and stress, less risk of complications and improved likelihood of success for an operation already known for its high success rate.<\/p>\n With this procedure, the eye is anesthetized by eye drops instead of by injection. This approach not only eliminates the uncomfortable sensation associated with injection, but also eliminates complications that can be induced by injection.<\/p>\n These complications are rare, but can be serious, such as permanent loss of vision, bleeding or hemorrhage behind the eye and the temporary cessation of breathing or heartbeat. Omitting injection is more convenient for the patient who may be on anti-coagulation medication and spares the patient the unpleasant experience of emerging from surgery with a “shiner”.<\/p>\n The incision used is so small that no sutures are required. Other techniques for extracapsular cataract extraction, with lens implantation, require a comparatively larger incision. Then stabilizing sutures are generally used under the muscles of the eye to hold it still for surgery.<\/p>\n Patients undergoing No-Stitch Cataract Surgery receive only half the normal amount of tranquilizer prior to surgery because they must cooperate with the surgeon to assure success. The patient is awake but feels no pain when the ophthalmologist makes a tiny incision into the white part of the eye usually covered by the upper lid. Use of the eye drop therapy is possible only because of the small incision.<\/p>\n The cataract is removed, using ultrasound and suction, through the very small incision. This incision is crafted in such a way that it becomes self-sealing, thereby requiring no sutures for closure. Then an intraocular lens is implanted behind the iris in the back of the eye. After the lens is implanted, the eye is repressurized with a special solution to make sure the wound is closed and leak proof.<\/p>\n The patient’s usual medications need not be altered prior to surgery. They can be taken with a swallow of water just before the operation. Anti-coagulants are not stopped.<\/p>\n Diabetics are asked to not take their diabetic medication by mouth or insulin injection the day of surgery. The insulin-dependent diabetic receives a modified dose after surgery, prior to the first meal. The patient may then return to their usual routine the next day.<\/p>\nNo-Stitch Cataract Surgery is not appropriate for the younger or anxious patient because the procedure does require good cooperation. It is not recommended for the individual who is unable to cooperate, or the patient whose surgery is likely to be complicated.<\/li>\n<\/ul>\n\t\t\tAbout Hi-Tech Lenses<\/a>\n\t\t\t\t\t\t\tExpand<\/i><\/a>\n\t\t If you are interested in decreasing your dependence on distance and\/or reading glasses, ask your doctor about our Hi-Tech Lens options. These lenses have advanced optics that focus in ways that standard implantable lenses cannot. The result can often be excellent vision without the need for spectacles. If you are a good candidate, your doctor will discuss this option with you.<\/p>\n A Multifocal or Pseudo-Accommodating Lens<\/strong> can provide excellent, clear vision after cataract surgery at a variety of distances – often eliminating the need for distance or reading glasses. These lenses address the issue of presbyopia or “the need for reading glasses” by utilizing advanced optical properties that can focus light for distances near and far.<\/p>\n A Toric Lens<\/strong> corrects astigmatism and can help patients who have worn glasses their whole life see much clearer in the distance – often without the aid of glasses. Your cataract surgeon will personally review these options with you, so that you can make the best decision for your eyes.<\/p>\n Cataract Multifocal Implants<\/strong> can often provide excellent vision after Cataract Surgery at both distance and near. Depending on your specific vision requirements, there are several types of presbyopia correcting multifocal lens implants.<\/p>\n\t\t\tIs cataract surgery effective?<\/a>\n\t\t\t\t\t\t\tExpand<\/i><\/a>\n\t\t Cataract removal is one of the most common operations performed in the United States. It also is one of the safest and most effective types of surgery. In about 90 percent of cases, people who have cataract surgery have better vision afterward.<\/p>\n What happens before surgery?<\/strong><\/p>\n A week or two before surgery, your doctor will do some tests. These tests may include measuring the curve of the cornea and the size and shape of your eye. This information helps your doctor choose the right type of IOL.<\/p>\n You may be asked not to eat or drink anything 12 hours before your surgery.<\/p>\n What happens during surgery?<\/strong><\/p>\n At the hospital or eye clinic, drops will be put into your eye to dilate the pupil. The area around your eye will be washed and cleansed.<\/p>\n The operation usually lasts less than one hour and is almost painless. Many people choose to stay awake during surgery. Others may need to be put to sleep for a short time.<\/p>\n If you are awake, you will have an anesthetic to numb the nerves in and around your eye.<\/p>\n After the operation, a patch may be placed over your eye. You will rest for a while. Your medical team will watch for any problems, such as bleeding. Most people who have cataract surgery can go home the same day. You will need someone to drive you home.<\/p>\n What happens after surgery?<\/strong><\/p>\n Itching and mild discomfort are normal after cataract surgery. Some fluid discharge is also common. Your eye may be sensitive to light and touch. If you have discomfort, your doctor can suggest treatment. After one or two days, moderate discomfort should disappear.<\/p>\n For a few days after surgery, your doctor may ask you to use eyedrops to help healing and decrease the risk of infection. Ask your doctor about how to use your eyedrops, how often to use them, and what effects they can have. You will need to wear an eye shield or eyeglasses to help protect your eye. Avoid rubbing or pressing on your eye.<\/p>\n When you are home, try not to bend from the waist to pick up objects on the floor. Do not lift any heavy objects. You can walk, climb stairs, and do light household chores.<\/p>\n In most cases, healing will be complete within eight weeks. Your doctor will schedule exams to check on your progress.<\/p>\n Can problems develop after surgery?<\/strong><\/p>\n Problems after surgery are rare, but they can occur. These problems can include infection, bleeding, inflammation (pain, redness, swelling), loss of vision, double vision, and high or low eye pressure. With prompt medical attention, these problems can usually be treated successfully.<\/p>\n Sometimes the eye tissue that encloses the IOL becomes cloudy and may blur your vision. This condition is called an after-cataract. An after-cataract can develop months or years after cataract surgery.<\/p>\n An after-cataract is treated with a laser. Your doctor uses a laser to make a tiny hole in the eye tissue behind the lens to let light pass through. This outpatient procedure is called a YAG laser capsulotomy. It is painless and rarely results in increased eye pressure or other eye problems. As a precaution, your doctor may give you eyedrops to lower your eye pressure before or after the procedure.<\/p>\n When will my vision be normal again?<\/strong><\/p>\n You can return quickly to many everyday activities, but your vision may be blurry. The healing eye needs time to adjust so that it can focus properly with the other eye, especially if the other eye has a cataract. Ask your doctor when you can resume driving.<\/p>\n If you received an IOL, you may notice that colors are very bright. The IOL is clear, unlike your natural lens that may have had a yellowish\/brownish tint. Within a few months after receiving an IOL, you will become used to improved color vision. Also, when your eye heals, you may need new glasses or contact lenses.<\/p>\n\t\t\tWhat are the risks of cataract surgery?<\/a>\n\t\t\t\t\t\t\tExpand<\/i><\/a>\n\t\t As with any surgery, cataract surgery poses risks, such as infection and bleeding. Before cataract surgery, your doctor may ask you to temporarily stop taking certain medications that increase the risk of bleeding during surgery. After surgery, you must keep your eye clean, wash your hands before touching your eye, and use the prescribed medications to help minimize the risk of infection. Serious infection can result in loss of vision.<\/p>\n Cataract surgery slightly increases your risk of retinal detachment. Other eye disorders, such as high myopia (nearsightedness), can further increase your risk of retinal detachment after cataract surgery. One sign of a retinal detachment is a sudden increase in flashes or floaters. Floaters are little “cobwebs” or specks that seem to float about in your field of vision. If you notice a sudden increase in floaters or flashes, see an eye care professional immediately. A retinal detachment is a medical emergency. If necessary, go to an emergency service or hospital. Your eye must be examined by an eye surgeon as soon as possible. A retinal detachment causes no pain. Early treatment for retinal detachment often can prevent permanent loss of vision. The sooner you get treatment, the more likely you will regain good vision. Even if you are treated promptly, some vision may be lost.<\/p>\n Talk to your eye care professional about these risks. Make sure cataract surgery is right for you.<\/p>\n What is Presbyopia<\/strong><\/p>\n Presbyopia is one of the first changes that results from the crystalline lens losing its flexibility. Presbyopia begins at around age 40 and progresses until about age 65. Until approximately the age of 40, the crystalline lens is both “crystal clear” and quite soft and flexible. This flexibility permits the crystalline lens to change its shape and alter its curvature so that it can help focus your vision at various distances-from far, to near, to arm’s length, to far or near again. This flexibility gives you the ability to see things at all distances.<\/p>\n Around the time we enter our 40’s, the crystalline lens begins to stiffen. The stiffening of the crystalline lens makes it progressively more difficult to change focus and thus to see clearly at all distances. Usually this reduces our ability to see objects clearly at arms-length or close objects or reading material. When this loss of flexibility occurs, it is called Presbyopia or “old eyes”. Presbyopia is a normal and expected consequence of growing older and it affects everyone. As the crystalline lens loses its ability to flex and change shape, it is no longer able to bend light rays. This results in a gradual and progressive loss of your ability to focus on near objects.<\/p>\n Patients who experience the start of Presbyopia will most often observe, that their “arms are too short” requiring them to see up close by moving near objects and reading material farther away in order to bring them into focus and see them clearly.<\/p>\n It is important to note that Presbyopia affects everyone including those who have cataracts. When Presbyopia begins people, who have never worn eyeglasses find that they need reading glasses or bifocals in order to read and see up close. People who already wear glasses may need bifocals or trifocals in order to see comfortably up close.<\/p>\n There have been many advances in cataract surgery and lens implant surgery techniques. Today, patients can elect to have presbyopia correcting multifocal lens implants so that lens replacement surgery can often help patients achieve clear distance vision as well restore their normal range of vision without being dependent on eyeglasses, bifocals or reading glasses.<\/p>\n\t\t\tLens Options<\/a>\n\t\t\t\t\t\t\tExpand<\/i><\/a>\n\t\t Basic Monofocal Lens Implants<\/strong><\/p>\n A Monofocal Lens Implant is the most basic type of Lens Implant used to correct vision after Cataract Surgery. For approximately the first thirty years of Lens Implant Surgery, all Lens Implants were of a type called a Monofocal Lens Implant. A Monofocal Lens Implant can provide very good vision after Cataract Surgery-but only at one set distance-usually for seeing things at a distance such as for driving or going to the movies. A Monofocal Lens Implant does not correct intermediate or arm’s length vision for doing things like playing cards and seeing the golf ball on the tee, or even seeing computer screens clearly. Nor do Monofocal Lens Implants correct near vision for doing things up close like seeing medicine bottles, reading or keeping your golf score, as these tasks require the correction of Presbyopia. Thus, patients electing to have Monofocal Lens Implants will be dependent on glasses either some or most of the time in about 70% of cases.<\/p>\n Aspheric Lens Implants<\/strong><\/p>\n An Aspheric Lens Implant is a type of Lens Implant that is specifically designed to reduce the visual disturbances caused by the optical aberrations found in ordinary Lens Implants. This reduces the tendency to see “glare” that you might experience with basic Lens Implants and thus can offer improved sharpness and contrast, helping patients in certain lighting conditions. Aspheric Lens Implants only correct distance or far vision, such as that required for driving. Aspheric Lens Implants do not usually correct intermediate or “arm’s length” vision, such as that required for viewing computer screens, and do not correct near vision as required for reading. Patients who wish to have the best quality of distance vision may wish to consider an Aspheric Lens Implant, but need to remember that it will still be necessary to wear reading glasses or bifocals to correct their intermediate and near vision. Aspheric Lens Implants usually cost slightly more than a basic lens implant and it is possible that your insurance will not completely cover the cost of the Aspheric Lens Implant. If you are particularly demanding and want the best possible distance vision after your Cataract Surgery, you will be able to discuss this option with your Cataract Surgeon and Lens Counselors during your Cataract Consultation. Your Cataract Surgeon will be able to explain all of the possible benefits and the Lens Counselor will be able to explain any additional costs and arrange payment if necessary.<\/p>\n Toric Lens Implants<\/strong><\/p>\n Toric Lens Implants are a type of Lens Implant that can correct astigmatism. Astigmatism is an optical aberration that is caused by the cornea being shaped more like a football, than a sphere like a basketball. For Cataract patients who have astigmatism, and who do not wish to wear eyeglasses to see clearly at a distance, choosing a Toric Lens Implant can help them be independent of glasses for tasks such as driving, that require clear distance vision. Toric Lens Implants do not correct Presbyopia, and thus even with Toric Lens Implants to correct astigmatism after Cataract Surgery, most patients still require reading glasses or bifocals to be able to comfortably perform near vision tasks such as reading and intermediate vision tasks such as computer work.<\/p>\n Near Vision Presbyopia Correcting Multifocal Lens Implants<\/strong><\/p>\n Near Vision Presbyopia Correcting Lens Implants can often provide excellent vision after Cataract Surgery at both distance and near. Depending on your specific vision requirements, there are several types of presbyopia correcting multifocal lens implants the Eye Consultants of Pennsylvania Cataract Surgeons might suggest, including the ReSTOR\u00ae Lens Implant, the Crystalens\u00ae Lens Implant or the ReZoomTM Lens Implant. Each of these lens implants or Intraocular Lenses (IOL) works in a different way to help you achieve your vision correction goals of being able to see at a variety of distances after cataract surgery- with less dependence on eyeglasses or reading glasses. Presbyopia correcting multifocal lens implants can correct both your distance vision and your presbyopia after cataract surgery. For the vast majority of patients, having a multifocal lens implant means that you will be able to see at distance and up close without being completely dependent on eyeglasses.<\/p>\n So, patients choosing to have a presbyopia correcting multifocal lens implant will likely find that they can drive, watch television, play golf and keep score, read a menu, play cards or do crafts-without the need for glasses. Patients choosing multifocal lens implants typically experience a greater overall freedom from glasses allowing them to participate in most everyday activities without dependence on, or the hassle and expense of glasses.<\/p>\n You can see the optical zones of these lenses in concentric circles and this is the optical physics that permit the multi-focusing power of these lenses.<\/p>\n\t\t\tCosts<\/a>\n\t\t\t\t\t\t\tExpand<\/i><\/a>\n\t\t Medicare and most insurance cover the cost of the cataract surgery, the surgical facility fee for cataract surgery, the surgical fee for cataract surgery, but not the cost of the presbyopia correcting multifocal lens and its implantation. In most cases, Medicare or your insurance provider asks Eye Consultants to bill you for the additional cost of the necessary testing, the multifocal lens itself and its implantation. Our staff will be pleased to review any costs as well arrange easy affordable monthly payments to fit your budget, should you decide that the multifocal lens is the best choice.<\/p>\n Check with your insurance provider for the details of your insurance coverage.<\/p>\n Cataract Videos<\/p>\n\t\n
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