Inside our eyes, we have a natural lens. The lens bends (refracts) light rays that come into the eye to help us see. The lens should be clear, like the top lens in the illustration.
Vision problems with cataracts
If you have a cataract, your lens has become cloudy, like the bottom lens in the illustration. It is like looking through a foggy or dusty car windshield. Things look blurry, hazy or less colourful with a cataract.
What Are the Symptoms of Cataracts?
Most age-related cataracts develop gradually. As a result, you may not notice signs or changes in your vision right away when cataracts first develop.
Cataract symptom progression
Here are some vision changes you may notice if you have a cataract:
- Having blurry vision
- Seeing double (when you see two images instead of one)
- Being extra sensitive to light
- Having trouble seeing well at night, or needing more light when you read
- Seeing bright colors as faded or yellow instead
Cataract as part of aging
Though there are other risk factors for cataracts, aging is the most common cause. This is due to normal eye changes that happen after around age 40. That is when normal proteins in the lens start to break down. This is what causes the lens to get cloudy. People over age 60 usually start to have some clouding of their lenses. However, vision problems may not happen until years later.
Most age-related cataracts develop gradually. Other cataracts can develop more quickly, such as those in younger people or those in people with diabetes. Doctors cannot predict how quickly a person’s cataract will develop.
Who Is at Risk for Cataracts?
Besides aging, other cataract risk factors include: having parents, brothers, sisters, or other family members who have cataracts having certain medical problems, such as diabetes having had an eye injury, eye surgery, or radiation treatments on your upper body having spent a lot of time in the sun, especially without sunglasses that protect your eyes from damaging ultraviolet (UV) rays If you have any of these risk factors for cataract, you should schedule an appointment with your ophthalmologist.
Cataract Surgery
Cataract surgery is an operation to remove your eye’s lens when it is cloudy. The purpose of your lens is to bend (refract) light rays that come into the eye to help you see. Your own lens should be clear, but with a cataract it is cloudy. Having a cataract can be like looking through a foggy or dusty car windshield. Things may look blurry, hazy or less colorful. The only way to remove a cataract is with surgery. Your ophthalmologist will recommend removing a cataract when it keeps you from doing things you want or need to do. During cataract surgery, your cloudy natural lens is removed and replaced with a clear artificial lens. That lens is called an intraocular lens (IOL). Your ophthalmologist will talk with you about IOLs and how they work.
What to expect with cataract surgery
Before surgery:
Your ophthalmologist will measure your eye to set the proper focusing power for your IOL. Also, you will be asked about any medicines you take. You might be asked not to take some of these medicines before surgery.
You may be prescribed eyedrop medicines to start before surgery. These medicines help prevent infection and reduce swelling during and after surgery.
The day of surgery:
Your ophthalmologist may ask you not to eat any solid food at least 6 hours before your surgery.
Here is what will happen: Your eye will be numbed with eye drops or with an injection around the eye. You may also be given a medicine to help you relax. You will be awake during surgery. You may see light and movement during the procedure, but you will not see what the doctor is doing to your eye. Your surgeon will enter into the eye through tiny incisions (cuts, created by laser or a blade) near the edge of your cornea (the clear covering on the front of your eye). The surgeon uses these incisions to reach the lens in your eye. Using very small instruments, he or she will break up the lens with the cataract and remove it. Then your new lens is inserted into place. Usually your surgeon will not need to stitch the incisions closed. These “self sealing” incisions eventually will close by themselves over time. A shield will be placed over your eye to protect it while you heal from surgery. You will rest in a recovery area for about 15–30 minutes. Then you will be ready to go home.
Cataract Surgery Recovery
- Days or weeks after surgery:
- You will have to use eye drops after surgery. Be sure to follow your doctor’s directions for using these drops.
- Avoid getting soap or water directly in the eye.
- Do not rub or press on your eye. Your ophthalmologist may ask you to wear eyeglasses or a shield to protect your eye.
- You will need to wear a protective eye shield when you sleep.
- Your ophthalmologist will talk with you about how active you can be soon after surgery. He or she will tell you
- when you can safely exercise, drive or do other activities again.
- Your vision could become cloudy or blurry weeks, months or years after cataract surgery. This is not unusual. If
- you notice cloudy vision again, you might need to have a laser procedure. Called a posterior capsulotomy, this procedure helps restore clear vision.
What are the risks of cataract surgery?
- Like any surgery, cataract surgery carries risks of problems or complications. Here are some of those risks:
- Eye infection.
- Bleeding in the eye.
- Ongoing swelling of the front of the eye or inside of the eye.
- Swelling of the retina (the nerve layer at the back of your eye).
- Detached retina (when the retina lifts up from the back of the eye).
- Damage to other parts of your eye.
- Pain that does not get better with over-the-counter medicine.
- Vision loss.
- The IOL implant may become dislocated, moving out of position.
- Your ophthalmologist will talk with you about the risks and benefits of cataract surgery.
IOL Implants: Lens Replacement After Cataracts
An intraocular lens (or IOL) is a tiny, artificial lens for the eye. It replaces the eye’s natural lens that is removed during cataract surgery.
The lens bends (refracts) light rays that enter the eye, helping you to see. Your lens should be clear. But if you have a cataract, your lens has become cloudy. Things look blurry, hazy or less colorful with a cataract. Cataract surgery removes this cloudy lens and replaces it with a clear IOL to improve your vision.
IOLs come in different focusing powers, just like prescription eyeglasses or contact lenses. Your ophthalmologist will measure the length of your eye and the curve of your cornea. These measurements are used to set your IOLs focusing power.
What are IOLs made of?
Most IOLs are made of silicone or acrylic. They are also coated with a special material to help protect your eyes from the sun’s harmful ultraviolet (UV) rays.
Monofocal IOLs
The most common type of lens used with cataract surgery is called a monofocal IOL. It has one focusing distance. It is set to focus for up close, medium range or distance vision. Most people have them set for clear distance vision. Then they wear eyeglasses for reading or close work.
Some IOLs have different focusing powers within the same lens. These are called multifocal and accommodative lenses. These IOLs reduce your dependence on glasses by giving you clear vision for more than one set distance.
Multifocal IOLs
These IOLs provide both distance and near focus at the same time. The lens has different zones set at different powers. It is designed so that your brain learns to select the right focus automatically.
Toric IOLs
For people with astigmatism, there is an IOL called a toric lens. Astigmatism is a refractive error caused by an uneven curve in your cornea or lens. The toric lens is designed to correct that refractive error.
As you plan for your cataract surgery, talk to your ophthalmologist about your vision needs and expectations. He or she will explain IOL options for you in more detail.