What is a Cataract?
A cataract is the clouding of the natural lens inside of the eye, making it difficult to read, drive and perform many daily functions. Cataracts are a normal part of the aging process and develop slowly. Early in life, the lens in transparent and lets light pass through; with time the lens becomes cloudy and makes it harder for the light to pass through. This makes vision similar to trying to see through a frosted window. As the cataract matures the cloudiness increases resulting in significant loss of sight and even blindness.
What Causes Cataracts?
In most cases, the answer is age. Most cataracts form slowly and they never cause any pain. Some things that speed the development of a cataract include: Long-term use of corticosteroids, alcoholism, Diabetes Mellitus, eye injury, smoking, and long-time exposure to ultra-violet (UV) light.
How Will I Know If I Have a Cataract?
Many people have cataracts without knowing. This is because in the early stages the cataract doesn’t interfere with vision. As the lens gets thicker, it has more power within the eye which can actually improve reading vision, sometimes called “second sight." With time, the lens becomes cloudier and may cause a gradual blurring of vision. This is often noticed as difficulty reading road signs or reading the scroll on the bottom of the TV screen. Night driving can also be affected and halos around lights are often seen. Sensitivity to bright lights and decreased vision in bright light are common complaints of cataracts. The ability to distinguish or perceive colors may also be impaired.
For the early stage cataracts, changing the glasses prescription may improve vision for a while. There are no medications or eye-drops that will help. When the cataracts interfer with daily activities, cataract surgery should be considered. Cataract surgery is necessary to remove the cloudy lens. Cataract surgery is typically performed at St. John's Surgery Suites - Montvale as an outpatient procedure. Our surgeons make a tiny incision and the clouded lens is removed through “phacoemulsification”, a process that uses ultrasound power to liquefy the lens so it can be withdrawn from its sac. The old lens is replaced by an artificial lens called an intraocular lens (IOL). Until recently all IOL’s were fixed for one distance; therefore requiring most patients to need glasses after cataract surgery. Today, there are many different lens options available. Your surgeon will help you decide which lens is best for you.
Astigmatism is an irregularly shaped cornea, resulting in a vision error that occurs when light rays entering the eye scatter instead of providing a single focal point. One test to diagnose astigmatism is called a corneal topography where a special camera is used to photograph the corneal pattern. A detailed map is produced to show the cone’s size, shape and steepness. Another test, called a Pentacam is used to scan the front segment of your eye as well as a precise analysis of the central cornea. These tests are fast and painless and will be performed prior to your cataract surgery.
Treating Astigmatism Using AK
Using the results from the corneal topography and Pentacam, a procedure called Astigmatic Keratotomy is performed at the same time as cataract surgery to reduce astigmatism. The surgeon uses the information form the corneal scans to see exactly where to make a carefully planned surgical incision in the eye. The incision is made with the 1/10th-inch incision, a self-sealing technique so no stitches are needed. After the Astigmatic Keratotomy procedure, the cornea’s shape is more rounded like a basketball instead of irregular like a football, further reducing your dependence on glasses for distance after surgery. Reading glasses will still be needed for fine print.
One advanced lens used at the Surgery Suites - Montvale can correct a certain amount of astigmatism. It is called the Acrysof Toric lens. The traditional intraocular lens (IOL) will clear the vision from a cataract, but cannot correct astigmatism. To treat astigmatism without the Toric IOL, corrective eyewear or additional surgery (see section above regarding AK) is needed to reduce the blurring and distortion. The unique design of the Acrysof Toric lens makes it possible to reduce or eliminate corneal astigmatism and significantly improve uncorrected distance vision. Patients will still need reading glasses to correct near vision (reading vision).
The surgeons at the Surgery Suites - Montvale are recognized internationally as leaders in cataract surgery and lens replacement, specializing in the advanced technology lens procedure. At the time of cataract surgery, you can choose to have your natural lens replaced with either a traditional single focus intraocular lens (IOL), a multifocal intraocular lens, or a Toric lens, referred to as advanced technology lenses.
Some advanced technology lenses have built-in trifocals that provide all distances of vision without dependence on glasses or contact lenses, allowing clear vision at near, intermediate and distance. Most advanced technology lens patients experience visual freedom after their procedure, allowing them to see both far and near without glasses. This lens allows the greatest degree of independence from glasses.