Cataracts

A cataract is a clouding of the natural lens, the part of the eye responsible for focusing light and producing clear, sharp images. The lens is contained in a sealed bag or capsule. As old cells die they become trapped within the capsule. Over time, the cells accumulate causing the lens to cloud, making images look blurred or fuzzy. For most people, cataracts are a natural result of aging.

In fact, they are the leading cause of visual loss among adults 55 and older. Eye injuries, certain medications, and diseases such as diabetes and alcoholism have also been known to cause cataracts.

Signs of Cataracts

Symptoms depend on the cataract's location in the lens and the amount of clouding. Cataracts are painless and often progress slowly, so many years may pass before a patient experiences symptoms. If only one eye develops a cataract, the patient may never experience symptoms, as long as sight in the other eye remains stable.

Common symptoms of cataracts include:

• Blurry vision
• Colors appear faded
• Frequent changes in prescription eyeglasses or contacts
• Poor night vision
• Seeing a halo around lights
• Sensitivity to bright sunlight or headlight glare at night

Cataract Treatment

In early cataracts, vision can usually be improved by changing the eyeglass prescription, using a magnifying lens for close work, or using stronger lighting. If the cataract interferes with vision to the point where daily activities such as driving, working, or reading become difficult, the cataract may need to be surgically removed.

Surgery

Cataract removal is one of the most commonly performed, safe, and effective surgical procedures in the United States. Approximately 90% of patients who undergo cataract removal experience improved vision afterward. Two procedures can be used to remove a cataract: phacoemulsification and extracapsular surgery.

Phacoemulsification (phaco) is the most commonly used procedure. A small incision is made on the side of the cornea and a tiny probe is inserted into the eye. This probe emits an ultrasound wave that softens and breaks up the cataract. The debris is then removed by suction.

Extracapsular surgery requires a longer incision in the cornea. The hard center of the lens is removed in one piece and the rest of the lens is suctioned out. The natural lens is then replaced with an intraocular lens (IOL), a clear, artificial lens that becomes a permanent part of the eye. The IOL is made of silicone, a plastic called PMMA, or acrylic. Light is then able to pass to the retina, improving vision. The artificial lens does not require additional care and the eye looks and feels normal.

Patients who are unable to have an IOL inserted because of eye disease or other complications can use soft contact lenses or glasses with powerful magnification.