What are Cataracts and How Do They Develop?

More than half of all Americans have had a cataract by the age of 80.  Mostly related to age, a cataract is the clouding of the eye's lens, the clear part that helps focus light to the retina.  Cataracts can sometimes develop as a result of an eye injury, after exposure to radiation, or in children as a birth defect.  For the most part, however, cataracts develop in old age from protein clumping or gradual discoloration.

The risk of developing a cataract can be heightened by certain medical conditions (like diabetes), smoking, use of alcohol, exposure to ultraviolet rays, and, of course, age.  Cataracts can occur in either one or both eyes, but do not spread from one eye to the other.  Surgery to remove a cataract is not necessary until vision becomes impaired unless the cataract interferes with the treatment of other eye problems.

How It's Done              

During cataract surgery the cloudy or discolored eye lens is removed, and replaced with an artificial lens.  Surgery can be done through the use of one of two different procedures:

• Phacoemulsification (phaco) - After a small incision is made on the side of the cornea, a probe is inserted into the eye and vibrates, breaking the cataract in to tiny particles.  These particles are then removed via suction.  This type of removal requires smaller incisions than traditional cataract surgery and can be completed in less than 15 minutes.
• Extracapsular - This procedure requires a longer incision on the side of the cornea, and the lens is removed in one piece.  This type of removal is less common than phaco, and is usually used in patients with more advanced cataracts.  Visual recovery is slower and discomfort is usually greater than with phaco.

After the cataract is removed, an artificial lens called an IOL (intraocular lens) is inserted into the eye.  

Technology              

The newest advancement in cataract surgery is the use of the phaco technique, which allows smaller incisions and a shorter recovery time.  With advancements in laser and probe surgery, cataract patients can usually have their other eye problems corrected after the cataract has been removed.

Recovery/Post Op Expectations

Directly after surgery, protective eyewear is required and you will need a friend or family member to drive you home.  Irritation and discomfort is normal, but should disappear within a few days.  Eye drops are often prescribed to remedy these problems.  Everyday activities can be returned to within a few days, although heavy lifting and other strenuous activities should be avoided.

Vision returns to normal within eight weeks in most cases, as the surgically repaired eye takes time to focus with the other.  Vision is usually blurry for the first several days and light often appears brighter through the new, clear lens.  In some instances an after-cataract or secondary cataract can develop, and is treated in an outpatient procedure with the use of a laser.

Complications             

In rare cases, patients can suffer infection, bleeding, loss of vision, double vision, change in eye pressure, or inflammation, which usually can be successfully treated if medical attention is sought immediately.  Additionally, cataract surgery slightly increases the risk of retinal detachment.  Retinal detachment does not cause pain, but can be identified by a sudden increase in flashes or floating specs in the field of vision.   

Am I A Candidate             

Cataract surgery is usually not necessary until a cataract develops to the point that it impairs vision.

Cost  

Costs of cataract surgery vary based on severity, type of removal procedure, and lens replacement.  On average, however, phaco surgery with an IOL replacement is about $1,128 and extracapsular removal with an IOL is around $906.             

Cataract surgery is covered by most healthcare providers.