As we get older, chemical changes occur causing the lens to become cloudy, forming what we call cataracts. A cataract is a painless, gradual clouding of the normally transparent crystalline lens inside the eye. Contrary to popular belief, they are not caused by eyestrain or wearing improper glasses. However, when they develop, light transmission through the eye becomes increasingly scattered, causing vision clarity to decrease.
If you have recently been diagnosed with cataracts, you’re in good company. They are one of the most common and treatable causes of vision loss in the world. Poor vision from cataracts affects 60 percent of all people over 60. In fact, over one million Americans have cataracts removed every year.
Virtually all of our cataract patients regain their vision.
That’s right. At Bennett & Bloom Eye Centers, we use the most advanced, and safe, testing and surgical techniques available, so you do not have to live with the vision loss associated with cataracts.
We will strive to help you achieve the best attainable vision with as little dependency on corrective lenses following surgery as possible. Our success rate with vision improvement in cataract surgery patients exceeds 99%. Many of our patients report vision improvement as fast as one day after surgery. Some even report having better vision than they can ever remember.
What is a cataract?
A cataract is a painless, gradual clouding of the natural crystalline lens inside the eye, located directly behind the colored iris. Our natural lens is normally transparent. Its job is to focus light on the retina at the back of the eye to help make a sharp picture of what we see. As we get older, chemical changes occur causing the lens to become cloudy, forming what we call cataracts. Cataracts are not something growing in the eye or a film over the eye. In its most advanced stages, the cataract might cause the normally black pupil to appear white or dark brown, but vision may be significantly affected long before then. Vision is blurred or dimmed because light rays can’t focus onto the retina.
Cataracts usually begin slowly, and it may take years before you notice any problems. Everyone will develop cataracts if they live long enough since they are not preventable in an otherwise healthy eye. It is common to have cataracts in both eyes at the same time, although one is often more advanced than the other. They are not caused by eyestrain nor from wearing improper glasses. But when they do develop, light transmission through the eye becomes increasingly scattered, and clarity of vision decreases.
Normal vision
Cataract vision
The main symptom of cataracts is a decrease in vision. Just how, and under what conditions vision decreases varies depending on the type of cataract. Some people have difficulty reading, while others have more trouble seeing in brightly lit conditions, such as being outside on a sunny day. Many people notice that colors are not as vivid, while most find night driving especially bothersome. Lights often seem to have a smoke-like appearance.
Is there more than one kind of cataract?
Although all cataracts occur in the natural lens of the eye, the cloudiness may develop in different parts of the lens. Furthermore, a number of conditions may cause cataracts. The most common kind of cataract occurs as a natural part of the normal aging process, sometimes as early as age 40, is called an age-related cataract.
Injuries to the eye, from a sharp blow, for example, can damage the clear lens and cause another type of clouding called a traumatic cataract. Other conditions, including certain infections, drugs or diabetes, can cause a secondary cataract. In rare instances, cataracts are present at birth or shortly thereafter. These congenital cataracts can result from infections transmitted during pregnancy.
Medical science knows of no way to prevent cataracts, and of no way other than surgery to remove them. Your cataract should be removed only when you feel it is causing problems. But since other eye conditions may cause similar symptoms, we at Bennett & Bloom Eye Centers take great care to examine your eyes thoroughly. If other eye conditions are found in addition to a cataract, we use sophisticated equipment to determine just how much of the vision loss is due to the cataract and to what extent vision would be restored if the cataract were removed. We use the safest and most modern equipment and microsurgical techniques to treat your cataract, but consider surgery only if your vision could be improved. Once you decide to have your cataract removed, we can work out when and where to schedule your surgery, usually on an outpatient basis, based on your convenience, desires, and your medical coverage. Our insurance department is skilled and experienced at determining where you can receive the best care at the least expense to you. We will also work with your regular eye doctor to help coordinate your care before and after surgery.
What happens during my cataract surgery?
Most of our cataract surgeries are performed using our No Needles…No Stitch…No Patch technique. That means only eye drops are needed to numb your eye. You’ll be comfortable, relaxed, and alert throughout the procedure. The operation usually takes only about 10 minutes, but the total time spent in the hospital or outpatient center is considerably longer, allowing time for preparation before surgery and time for dressing and instructions following surgery.
There are 2 excellent surgical options for removing cataracts, traditional small-incision surgery, and femtosecond laser-assisted cataract surgery.
Small-incision surgery.
By using the latest techniques and most modern, high-tech equipment, we can perform the entire surgery through the smallest possible incision, providing greater safety, faster recovery and minimal post-operative restrictions. The small incision, often less than one-eighth of an inch, is made in the sclera (the white part of the eye) or cornea (the clear front layer of the eye). This incision is specially constructed to seal without stitches when the operation is completed. Next, we open the lens capsule (capsulotomy), a clear membrane like a cellophane wrapper which surrounds the cataract-clouded lens.
Once the lens capsule is opened, the entire cataract inside is removed. We use a special ultrasonic surgical instrument called a Phacoemulsifier to do this. This instrument vibrates more than 40,000 times each second, separating the cataract so, with gentle suction, it can be easily removed from the eye through the small incision.
Femtosecond Laser Assisted Cataract Surgery (FLACS).
Use of the CATALYS® Precision Laser System may improve the precision, accuracy, and reproducibility for the corneal incision and capsulotomy, management of astigmatism, and cataract fragmentation. To decide if laser cataract surgery is the best choice for you, ask your cataract surgeon or counselor for more information about this exciting technology during your preoperative exam and consultation.
After removing the cataract, a tiny, precision-made lens called an intraocular lens implant is inserted into the eye in the same position where the cataract had been. With the surgery completed, the incision normally closes without the need for any stitches. No eye patch is required.
Do I need to have an implant?
Once the cloudy, natural lens has been removed, we need to restore the eye’s focusing power. Years ago, thick eyeglasses were used. Today, we insert intraocular lens implants into the eyes of nearly all our patients. These synthetic lenses, made of high-grade plastic or silicone material, are permanent and non-toxic. Since we use specially shaped or foldable implants, we can insert them through the small incision.
The lens implants have other advantages, too. Because they stay in the eye, you will have a more natural appearance. They also can improve your depth perception as well as aid your side vision. Although you may need corrective eyeglasses after your surgery for activities such as reading, a strong prescription is generally not required.
Click here to learn about the types of intraocular lens implants available at Bennett & Bloom Eye Centers serving the greater Louisville area and more.
What happens after surgery?
You will likely be ready to go home shortly after the procedure. Even though you may not need an eye patch, you will not be able to drive immediately, so most of our patients have a friend or relative drive them.
There is usually little discomfort after surgery although some patients use nonprescription pain relievers like Tylenol or Advil. Some scratchy feelings, light sensitivity, and tearing is normal.
You may bend over, sleep on any side, shower and resume most other normal activities immediately. Only a few restrictions are needed for just one week following our small incision cataract surgeries. Our staff will give you specific, written instructions about your post-operative routine.
Will I need eye drops after surgery?
Traditionally post-operative cataract patients must put in several eyedrops for many weeks following their surgery. These drops are expensive and inconvenient. Bennett & Bloom Eye Centers was the first in the greater Louisville region to offer “No Drop” cataract surgery. At the end of the cataract procedure, a few drops of anti-inflammatory medicine and antibiotic (TriMoxi) are injected around the intraocular lens implant. Patients typically notice some transient floaters from the medicine for a few weeks. Dropless surgery is now used for the vast majority of our patients, although some may not be candidates if they are allergic to the injected medications, have a history of severe glaucoma or elevated eye pressures with steroids.
Can cataracts grow back?
Once removed, cataracts cannot return. In some cases, however, cloudiness (posterior capsule fibrosis) may occur in the lens capsule months or even years after the initial cataract surgery. To correct this, we use the beam of an ophthalmic laser to open the capsule. This procedure, using a high-tech YAG laser, is normally safe and painless and takes just a few minutes to complete.