What is a cataract?
A cataract is a clouding of the lens in the eye that affects vision. Most cataracts are related to aging. Cataracts usually start as a slight cloudiness that progressively grows more opaque. As a cataract becomes more dense, the retina receives less light. The light that does reach the retina becomes increasingly blurred and distorted, causing gradual impairment of vision. If you are experiencing any of the symptoms of cataracts, it is important for you to schedule an appointment with one of our physicians for a thorough eye examination.
If left untreated, cataracts can cause blurred vision and can interfere with your ability to function in daily activities. At Apple Hill Eye Center, our physicians have the technology and training in microsurgical techniques that permit cataracts to be removed safely and in an outpatient setting. An artificial lens will be implanted during cataract surgery to help restore vision. The recovery from cataract surgery is quick and virtually pain free.
What Causes Cataracts?
Cataracts may be caused by:
- Aging. The development of cataracts is a normal part of aging, and is a result of natural changes in the lens that coincide with other changes in the body.
- Trauma. Sometimes cataracts can result from an injury to the eye.
- Childhood. Some infants are born with congenital cataracts, and occasionally, cataracts can develop in children.
- Other Causes. Cataracts can also develop due to the use of certain drugs or medications, exposure to harmful chemicals, excessive sunlight and some diseases. It is recommended that you wear glasses with a UV coating when outdoors to block the UV light from the sun.
Cataract Symptoms
Most individuals with cataracts have one or more of the following symptoms:
- A gradual deterioration in vision
- Objects may appear yellow, hazy, blurred or distorted
- Reduced vision at night or in low light conditions
- Reduced in bright or sunshine due to glare
- Seeing haloes around bright lights at night
Effect of Cataracts
Since cataracts can cause a blurring or distortion of vision as well as decreased vision in low light conditions, they can have a dramatic impact upon one’s lifestyle. Some limitations due to cataracts include the following:
Normal vision
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The same scene as viewed by a person with cataract
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- Inability to read or watch television
- Inability to drive / loss of driver's license
- Lack of desire to go out at night
- Loss of independence
- Increased chances of injury due to impaired eyesight
Diagnosing a Cataract
Anyone who suspects that they have a cataract should have a thorough eye examination. Your eye doctor can determine if the changes in your vision are due to the cataract, other conditions or diseases affecting your eye, or simply a focusing problem than can be corrected with a change in your eyeglass prescription. To consider the net improvement that can be expected from cataract surgery, our physicians will conduct a thorough eye examination to determine if a cataract is present and assess the other structures of the eye.
Cataract Surgery
Over the years, cataract surgery has improved greatly due to significant advances in techniques and technology. Apple Hill Eye Center’s Dr. Steven Olkowski is one of York’s leading cataract surgeons. The surgery is a relatively quick and painless outpatient surgery, requiring just a few hours at an ambulatory/outpatient surgical center. Post-surgery recovery time has been dramatically reduced. Many people enjoy improved vision with minimal dependence upon corrective eyewear as a result of modern cataract surgery
Cataract surgery is a delicate operation performed using a high-powered microscope that allows the surgeon to view the parts of the eye clearly. Dr. Olkowski has advanced training in cataract surgery. The steps of the microsurgery are as follows.
1. Tiny incision
The surgeon makes a tiny incision on the side of the cornea - the front part of the eye.
2. Small opening
The surgeon makes a small opening in the front of the capsule that holds the natural lens.
3. Ultrasound
The surgeon inserts a small ultrasound device (phacoemulsification tip) that is used to remove the cataract. By use of the ultrasound, the probe breaks up the cataract, allowing it to be gently vacuumed from the eye.
4. Lens implant
Using soft material that can be folded, a foldable artificial lens implant can be inserted inside the eye through the original surgical incision.
5. Lens unfolds
The lens unfolds to fill the capsule just like the natural lens of the eye had done prior to surgery.
What about Foldable Artificial Lens Implants?
Because cataract surgery removes the cloudy, natural lens of the eye, another means is needed to bring light into proper focus upon the back of the eye (the retina). In the past, vision was corrected using thick cataract glasses or contact lenses. Now, tiny artificial lenses (intraocular lenses) can be placed inside the eye to clear vision following surgery. Through careful examination prior to surgery, your doctor may be able to select a lens power to correct nearsightedness or farsightedness, reducing your dependence upon corrective eyewear after surgery.
What is the Necessary Anesthesia?
Cataract surgery is a pain-free experience due to advances in anesthesia. Patients are awake during surgery and are able to resume normal activities shortly afterwards. There are two types of anesthesia used during surgery—eyedrops or regional.
Eyedrop anesthesia uses no needles or injections. An anesthetic in the form of eyedrops is applied to completely numb the surface of the eye. Patients may sense pressure, but will feel no pain. This anesthesia allows patients to enjoy functional vision almost immediately after surgery.
Regional anesthesia is administered through an injection given gently near the eye, blocking all feeling in the eye region. The injection is usually given while the patient is momentarily under the effect of a sedating medication. Regional anesthesia gradually wears off over the course of the day. As the anesthesia wears off, the function of the eye is restored.
Each form of anesthesia has its advantages. The doctors at Apple Hill Eye Center will consider your individual needs and select the form of anesthesia that is best for you.
What are the Benefits of Cataract Surgery?
Benefits: improved color vision
Cataract surgery offers a dramatic restoration of clear vision. It is one of a few medical procedures that can literally turn back the hands of time and allow many patients to achieve vision comparable to the eyesight they enjoyed in their youth. Specific benefits include the following.
Improved color vision
Once the cataract is removed, colors will be much more vivid and vibrant.
Improved clarity of vision
Visual acuity is usually improved. Activities such as reading and watching television can be enjoyed thanks to sharper, clearer vision.
Increased independence
After surgery, many patients’ eyesight is improved to the point that they can regain their driver’s licenses.
Improved quality of life
When vision is improved, patients begin enjoying their work, hobbies, family and friends again.
Reduced dependence on corrective eyewear
The foldable artificial lens implant may be able to compensate for pre-existing focusing problems such as nearsightedness or farsightedness. Glasses may be needed for reading or driving. If glasses are required to be worn at all times, the lenses are usually much thinner and lighter.
What are the Risks of Cataract Surgery?
No surgery is without risks, but cataract surgery is highly successful due to technological and surgical advances. Few complications are associated with cataract surgery. These potential risks and complications are discussed with the patient prior to surgery.
What are Secondary Cataracts?
Following cataract surgery, many patients experience clouding of the capsule which holds the replacement lens. This is called a secondary cataract, and results in the same symptoms of reduced vision as caused by the original cataract. A secondary cataract can occur months or even years after the original surgery, and if it occurs in one eye, it is likely to occur in the other.
Secondary cataracts can be easily treated with a laser procedure called a YAG laser capsulotomy. This brief, painless outpatient procedure is performed without anesthesia or a surgical incision. The laser makes a small opening in the clouded capsule behind the artificial lens, allowing light to reach the retina without distortion. The result is improved vision.
A patient’s activities are not limited following YAG laser treatment. In most cases, improvement of vision is noticed within minutes to a few hours after the procedure. It is normal to see fragments of the lens capsule floating as shadows across the field of vision after the procedure. With time, these fragments or “floaters” usually become less noticeable as the eye absorbs them.
Early treatment of symptomatic secondary cataracts with the YAG laser is recommended. The procedure is highly effective when performed at the time the capsule first turns cloudy and begins to affect your vision.
What can be expected after Surgery?
Patients return home after surgery, and are usually examined the following day, the following week and then again after a month to monitor healing. Eye drops are used to accelerate the healing process and prevent infection, and patients are instructed to avoid any activity that could harm the eye while recovering from surgery. It’s normal to feel mild itching and irritation for a few days after surgery. You may have some discharge on the eyelids of the operated eye. Do not press or rub the operated eye. You may wear an eye patch or protective shield the day of surgery. Dr. Olkowski will prescribe eyedrops and medication to prevent infection and control eye pressure. After a few days, all discomfort should disappear.
Patients may resume driving as soon as they feel safe and comfortable behind the wheel. Do not drive if light sensitive or if vision is blurry.
If all goes well, you'll heal fast and your vision will start to improve within a few days. The patient’s prescription may no longer be correct for the operated eye. A final eyeglass prescription will be given in approximately four weeks.
The specifics of surgery may be different for each individual, so be sure to consult Dr. Olkowski at Apple Hill Eye Center.
