What is a Cataract?
A normal lens is clear and lets light pass to the back of the eye. A cataract is a clouding of the lens of the eye. Because of this cloudiness, vision becomes hazy.
Cataract is a normal part of aging. About half of Americans ages 65 to 74 have cataract. About 70 percent of those age 75 and over have this condition. Most people with cataract have a cataract in both eyes. However, one eye may be worse than the other because each cataract develops at a different rate. Some people with cataract don’t even know it. Their cataract may be small, or the changes in their vision may not bother them very much. Other people who have cataract cannot see well enough to do the things they need or want to do.
What Are the Symptoms of Cataract?
The signs of a cataract include: – Cloudy, fuzzy, foggy, or filmy vision. – Changes in the way you see colors. – Problems driving at night because oncoming headlights seem too bright. – Problems with glare from lamps or the sun. – Frequent changes in your eyeglass prescription. – Double vision.
These symptoms also can be signs of other eye problems.
How is Cataract Diagnosed?
A regular eye exam is all that is needed to find a cataract. Your eye doctor will ask you to read a letter chart to see how sharp your sight is. You probably will get eye drops to enlarge your pupils (the round black centers of your eyes). This helps the doctor to see the inside of your eyes. The doctor will use a bright light to see whether your lenses are clear and to check for other problems in the back of your eyes.
How is Cataract Treated?
A change in your glasses, stronger bifocals, or the use of magnifying lenses may help improve your vision and be treatment enough. The way to surgically treat a cataract is to remove all or part of the lens and replace it with an artificial lens. Just because you have a cataract does not mean it must be removed immediately. Cataract surgery can almost always be delayed until you are unhappy with the way you see.
Your eye doctor will tell you whether you are one of a small number of people who must have surgery. For example, your doctor may need to see or treat an eye problem that is behind the cataract. Or surgery may be required because a cataract is so large it could cause blindness.
How Do I Decide Whether To Have Surgery?
Most people have plenty of time to decide about cataract surgery. Your doctor cannot make your decision for you, but talking with your doctor can help you decide.
Tell your doctor how your cataract affects your vision and your life. Do you see well enough to do your work? Do you see well enough to do the things you need to do at home? Because of your cataract, are you less independent than you would like to be?
What Should I Know About Surgery?
The UW Health eye doctors believe in helping you understand your options before choosing the best kind of cataract removal and lens replacement for you. He or she will also explain how to prepare for surgery and how to take care of yourself after it is over.
Modern day cataract surgery, in most cases, does not require a stay overnight in a hospital. UW eye surgeons utilize the outpatient surgery centers at the University of Wisconsin, Meriter Hospital, and Madison Surgery Center (MSC). In this setting, you visit the outpatient center, have your cataract removed, and leave when the doctor says you are fit to leave–most often the same day. However, you will need a friend or family member to take you home.
Although there is usually prompt improvement of vision, it takes a few months for an eye to heal after cataract surgery. Your eye doctor should check your progress and make sure you have the care you need until your eye recovers fully. Pre and postoperative care is performed in cooperation with your family eye doctor and offers you added convenience.
There are three types of surgery to remove lenses that have a cataract:
- Phacoemulsification (pronounced FAY-co-ee-mul-sih-fih-CAY-shun). In this type of extracapsular surgery, the surgeon softens the lens with sound waves and removes it through a needle. The back half of the lens capsule is left behind.
- Extracapsular surgery. The eye surgeon removes the lens, leaving behind the back half of the capsule (the outer covering of the lens).
- Intracapsular surgery. The surgeon removes the entire lens, including the capsule. This method is rarely used.
A person who has cataract surgery usually gets an artificial lens at the same time. A clear plastic disc, called an intraocular lens, is placed in the lens capsule inside the eye. Other choices are contact lenses and cataract glasses. Your doctor will help you to decide which choice is best for you.
Can a Cataract Return
A cataract cannot return because all or part of the lens has been removed. However, in about a third of all people who have extracapsular surgery or phacoemulsification, the lens capsule becomes cloudy. This cloudiness of the lens capsule, if it occurs, usually develops months or years after surgery. It causes the same vision problems as a cataract does.
The treatment for this condition is a procedure called YAG capsulotomy. The doctor uses an invisible laser (light) beam to make a tiny hole in the capsule to let light pass. This surgery is painless and does not require a hospital stay.
Most people see better after YAG capsulotomy, but, as with cataract surgery, complications can occur. Your doctor will discuss the risks with you. YAG capsulotomies should not be performed as a preventative measure.
Is Cataract Surgery Right for Me?
Most people who have a cataract recover from surgery with no problems and improved vision. In fact, serious complications are not common with modern cataract surgery. This type of surgery has a success rate of 95 percent in patients with otherwise healthy eyes. But no surgery is risk free. Although serious complications are not common, when they occur they could result in loss of vision. If you have a cataract in both eyes, experts say it is best to wait until your first eye heals before having surgery on the second eye. If the eye that has a cataract is your only working eye, you and your doctor should weigh very carefully the benefits and risks of cataract surgery.
You will be able to make the right decision for yourself if you know the facts. Ask your doctor to explain anything you do not understand. There is no such thing as a “dumb” question when it comes to your health.
The information in this booklet was based on The Clinical Practice Guideline on Cataract in Adults: Management of Functional Impairment. The guideline was developed by an expert panel sponsored by the Agency for Health Care Policy and Research.