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Cataracts

What are Cataracts?

Cataracts may occur at any age, but they are an extremely common and a natural part of aging.  Cataracts occur when the lens in your eye becomes cloudy. The normally clear proteins inside the lens begin to build up and become cloudy over time. The result is blurry, foggy or fuzzy vision.

Symptoms of Cataracts can include:

  • Cloudy, foggy, blurry or dim vision
  • Increasing difficulty with night vision
  • Sensitivity to light and glare.
  • Need for brighter light for reading and other activities.
  • Seeing "halos" around lights, especially at night
  • Seeing “starbursts” around lights, especially at night
  • Frequent changes in eyeglass or contact lens prescription.
  • Fading or yellowing of colors.

    • What causes Cataracts?

    Aging is the most common cause. Around the age of 40 the normally clear proteins of the lens begin to go through changes that, with time, will eventually become cloudy. People over age 60 usually start to have some clouding of their lenses. Other reasons you may develop cataracts include:

  • Having certain medical conditions, such as diabetes.
  • Smoking.
  • Having had an eye injury, an eye surgery, or radiation treatments on your upper body.
  • Having spent a lot of time in the sun, especially without sunglasses or UV protection.
  • Using certain medications such as corticosteroids (i.e., Prednisone)

    • 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.

    What are my
    Treatment Options?

    Cataracts can be removed only with surgery.

    Cataracts may not need to be removed if their symptoms are not bothering you much. You might just need a new glasses prescription to help you see better. However, if changing your glasses does not help or the cataract symptoms are interfering with your daily activities, cataract surgery is often necessary.

    Cataract Surgery

    Cataract surgery is an operation performed to remove the cloudy proteins from your lens. The lens then must be replaced with a new, clear artificial lens called an intraocular lens (IOL). Every patient who has cataract surgery will get a new IOL implanted. This is the standard of care. The good news is that cataract surgery is an opportunity to improve your vision, correct your astigmatism, enhance your focus and decrease the dependency on glasses should you choose.

    • Painless
    • No stitches
    • No patch
    • Takes about ten minutes
    • Will not "see the surgery"
    • Limited Restrictions
    • Back to work in a day or two
    • Cataract will never come back
    • Decrease dependency on glasses/contacts

    Laser Assisted Cataract Surgery

    With the addition of the LenSx laser, we are able to bring increased precision, accuracy and safety to the cataract procedure. The laser can perform many of the critical steps of the surgery without the need for a scalpel. This bladeless form of cataract suergery can also aid in correcting astigmatism and placement and centration of premium IOL's. The Laser works by docking safely and comportably to the eye like a contact lens. The computer then scans and gives real time images of the structures of the eye, including the lens, cataract and cornea. Once the surgical plan is confirmed, the actual painless laser treatment takes 20-30 seconds. The entire process is less than 2 minutes start to finish.
    The LenSx laser softens the cataract, treats astigmatism if necessary and allows for a totally blade-free cataract surgery, but the softened cataract will still need manually removed from the eye. Studies have shown that pretreatment of the cataracts with the LenSx laser and subsequent removal takes over 50% less time and over 40% less energy. This may result in a healthier eye with less swelling and faster vision recovery over standard phacoemulsification.
    Generally, laser asssisted cataract suergery is preferred, however, talk to Dr. Pine about whether or not LenSx is right for you.

    • Takes Less than 2 minutes
    • Painless
    • Accurate and Precise
    • Safe
    • Faster Rehab
    • Can treat some Astigmatism

    Intraocular Lens Choices

    Choosing an intraocular lens for your cataract surgery is an important, once-in-a-lifetime decision. Your new lens will change the way you see the world around you, so you will want to choose the lens that’s right for you. There is nothing more in this world that you will use every day more than your eyesight. Because of this, many people feel that paying extra for an advanced-technology lens, such as the PanOptix lens, is a wise investment.

    After a thorough eye exam and the necessary testing has been performed, Dr. Pine will discuss with you the different choices you may have when it comes to selecting the correct IOL for you. Not all lenses are good options for every patient. Many factors, such as health of the eye, astigmatism and your personal visual needs will play a role in your decision. The single most important question you can answer for Dr. Pine is “What would you like out of your vision after cataract surgery?’

    An Overview of the Cataract Surgery and Process

    Initial Visit

    Dr. Pine will perform a comprehensive, dilated eye exam at the initial visit. Several things will take place during this visit that are important to the overall cataract surgery process:

  • Many different measurements and tests of your eyes will be performed that help determine the general health of your eyes and what choices you may have to improve your vision.
  • Dr. Pine wants to know what it is about your vision that is frustrating as well as what you ideally would like out of your vision after surgery.
  • Only with a detailed exam and open, honest communication between you and Dr. Pine can your choices and expectations for your outcome be determined.
  • Once the decision for surgery has been made, Dr. Pine will take the time to explain and answer any questions you may have about the exam findings, surgery process and IOL choices you may have.
  • The necessary eyedrops will be sent electronically to the pharmacy of your choice.
  • At the conclusion of the visit, our friendly and knowledgeable staff will schedule your surgery and all ancillary visits necessary. You will receive an envelop with the dates and times listed plainly on the outside and containing other useful information inside.

    • Preparing for Surgery

  • Get your eyedrops from your pharmacy.
  • Ensure you have a ride to and from the surgery center for the days of surgery.
  • Decide how much time you may want to take off work if necessary.
  • Follow the instructions on the envelop provided to you.
  • Wear comfortable clothing and do not eat or drink anything after midnight the evening before your surgery.
  • Arrive on time the day of surgery.

    • Day of Surgery

  • Surgery is performed at the free-standing ambulatory Surgery Center at Sarah Bush Lincoln Hospital.
  • Wear comfortable clothing.
  • Nurses will greet you and take you to the preoperative area.
  • An IV will be placed and drops in your operative eye will be starting in preparation for surgery.
  • Dr. Pine will come in to see you, place a mark over your eye and answer any last-minute questions you may have prior to surgery.
  • Medicine will be placed in the eye to numb it prior to surgery. There will be no pain.
  • Anesthesia will give you medicine in your IV that will relax you prior to entering the operating room.
  • Your eye will be prepped and draped appropriately for the surgery.
  • A lid speculum will gently hold your eye open so that you cannot blink.
  • You will not be able to see the surgery or the instruments being used. You will only see bright lights.
  • The surgery itself usually takes 10 minutes or less.
  • You can help Dr. Pine by staying relaxed and simply staring at the light.
  • Your choice of IOL will be placed based on the testing/discussion with Dr. Pine from the initial visit.
  • Once complete, a clear protective shield will be placed over the operative eye.
  • You will be taken to a recovery room and allowed to go home typically 30-45 minutes after the procedure.
  • The nursing staff will go over your discharge instructions, including instructions on starting the eye drops you picked up from the pharmacy.

    • Post-Operative

  • You will be seen by either Dr. Pine or the referring Optometrist the day after surgery.
  • This visit is important not only to check the vision, but also the eye pressure.
  • You will be given further instructions and color-coded charts which detail how often to use the eyedrops. Please follow the eyedrop instructions carefully. Appropriate eyedrop use is important to the outcome of your surgery.
  • You may use over-the-counter artificial tears anytime.
  • Continue any other eyedrops you may have been prescribed (i.e.glaucoma drops)
  • It may take up to 72 hours for the dilation from surgery to wear off.
  • It is normal to have mild scratchiness, watering or irritation as the eye is healing. Using artificial tear eyedrops 4-6 times a day can help these symptoms.
  • If a new glasses prescription is necessary, this will be performed approximately one month after surgery which allows time for the eye to heal and vision to stabilize.