DR. CHRISTOPHER BORGMAN
Cataracts are probably the most common reversible/treatable ocular disease and afflict millions of people in the U.S. and throughout the world.
Cataracts are technically defined as a clouding of the natural crystalline lens inside the eye. There can be many causes of cataracts; however, by far, the most common cause is age-related clouding of the lens typically after many years of excessive sunlight exposure, mainly from UVA/UVB light.
Wearing a good pair of 100 percent UVA/UVB blocking sunglasses is important as this can delay cataract formation in many people. Fortunately, 100 percent UVA/UVB blocking eyewear/sunglasses are sold almost everywhere nowadays and can be very inexpensive. In reality, most individuals over the age of 50 probably have at least the earliest stages of cataract formation, although the cataracts may not be quite advanced enough to be affecting vision.
Cataracts tend to develop very slowly over time, so some individuals don’t even know how bad their eyesight has become until they have a comprehensive eye exam with their eye doctor. Typical symptoms of cataracts include: difficulty seeing objects at distance as well as near, smoky/hazy view of objects, difficulty watching television or reading street signs while driving and/or increasing glare from oncoming car headlights at night.
Historically, visual acuity of 20/40 or worse was the cutoff point for surgical consideration as this was the point where the benefits of surgery outweighed the risks. However, with the continued refinement and improvement in surgical techniques available today there has been a movement to perform surgery earlier in people whose vision does not allow them to perform their daily activities at a level patients deem acceptable.
Cataracts are rarely, if ever, considered a true ocular emergency, which means they usually can be watched over a period of time until vision is affected enough to warrant treatment, even though vision will usually only get worse the longer a person waits. An updated spectacle prescription may be all that is needed in some cases. However, when surgery is indicated, surgical treatment of cataracts is a rather straightforward outpatient procedure.
The process of removing the lens (called phacoemulsification) usually takes only 10-20 minutes per eye and uses high frequency ultrasound to break up the cataract into small pieces, then a vacuum removes the small pieces.
A new, clear, plastic lens is then inserted into the location the natural lens once rested. There are many lens implant options now available for a very wide variety of patients. There are inherent risks to any surgery, even cataract surgery; however, today’s standard cataract removal process is very efficient and refined, and for the vast majority of patients the process results in clearer vision.
Peri-operative care includes a series of appointments with the surgeon along with eye drop regimens designed to prevent infection and accelerate the recovery process. Most patients typically have stable vision and are off of their eye drops by four weeks after surgery. The best way to see if you are suffering from cataracts is to get regular eye exams with an eye care professional.
Borgman is a clinical instructor at The Eye Center at the Southern College of Optometry, www.tec.sco.edu.