Cataracts

Cataracts: A common and reversible cause of vision loss.

Definition

Cataracts – the gradual clouding of the eye’s natural lens – are a normal part of the aging process, and are the leading cause of reversible vision loss in adults.

If you’re over age 65, there’s an almost 50 percent chance that you’re developing cataracts; if you’ve reached the age of 75, there’s a 70 percent chance that this clouding is significant enough to have a noticeable effect on your vision.

Development

The lens in each eye acts much like the lens of a camera, focusing the light that enters the eye so it forms a sharp image on the retina (the light sensitive membrane lining the back of the eye that sends signals to the optic nerve>.

As a cataract develops, the clear lens can darken and become cloudy, just as a piece of clear plastic does when exposed to the elements. When this happens, light passing through the lens is scattered and no longer forms a sharp image on the retina.

Symptoms

The symptoms of cataracts vary among patients and can include:

• Painless blurring of vision
• Increased sensitivity to light
• Appearance of halos around bright sources of light like street lights or the headlights of oncoming cars
• Reduced night vision
• Need for bright light when reading
• Darkening or yellowing of colors
• Double vision in one eye or both eyes

Many people experiencing the vision-related problems of cataracts feel that their eyeglasses need more frequent cleaning or that they need a stronger eyeglass prescription.

Risk factors

Aging is the primary risk factor in the development of cataracts, but other risk factors can speed the process.

These include:

• Diabetes
• Prolonged use of corticosteroids
• Smoking
• Previous eye injury
• Eye inflammation
• Previous eye surgery
• Excessive exposure to sunlight/UVB rays

Treatment

The only effective treatment for cataracts is a quick, virtually painless surgery that removes the clouded lens and replaces it with a clear synthetic intraocular lens (IOL) implant.

In decades past, the risks of surgery often caused ophthalmologists to advise their patients to delay cataract surgery as long as possible.

Today, advances in surgical techniques and instruments have made cataract surgery one of the safest, most predictable surgeries performed in the world, with benefits that far outweigh the risks.

This means a cataract can be safely and successfully treated at any stage. Surgery is now recommended when cataracts begin to affect quality of life or interfere with everyday activities. More than 2.7 million Americans now choose to have vision-restoring cataract surgery every year.

Procedure

Dr. Behler has performed cataract surgeries for his patients since the mid 1980s. He uses the most advanced surgical technique that requires no needles, stitches, or wearing of an eye patch.

He first applies eye-drop anesthesia to the eye, then places a micro-incision on the clear corneal tissue. Placing the incision on the clear cornea, where there are no blood vessels, means that patients who are on blood thinners do not have to interrupt their medication regimen to reap the benefits of cataract surgery.

This incision serves as a portal for introducing a delicate probe that uses highly advanced torsional ultrasound technology to emulsify the natural lens. Gentle suction removes the lens material, creating a place for the IOL. The IOL is introduced through the same small incision, which begins to heal immediately without the need for stitches to secure it.

The entire procedure is accomplished within a matter of minutes, recovery is rapid, and patients can resume their normal activities the day after surgery.

If both eyes need to be treated (cataracts usually develop in both eyes), surgeries are usually scheduled a week apart.

Results

Following cataract surgery, patients notice an immediate improvement in their vision: colors are more vibrant, visual acuity is sharper, night vision is improved, and the halos around light sources disappear.

Depending upon the type of IOL used to replace the natural lens, patients may also find that they no longer need eyeglasses in most situations.

Medicare covers the cost of placing single-prescription IOLs during cataract surgery, so a patient may select a prescription that delivers either crisp distance or near vision, and use eyeglasses for other purposes. Monovision correction is also covered: a patient can choose to have one eye corrected for distance vision and the other corrected for near or reading vision.

Premium IOLs for a little extra

Exciting new developments in the design of IOLs mean patients have more choices in achieving clear vision at a range of distances following cataract surgery, freeing them from the need for eyeglasses in most all situations.

More and more patients today are finding it worthwhile to pay the difference between Medicare’s coverage for traditional IOLs and the cost of premium IOLs. Examples are the accommodating Crystalens® that works with the muscles inside the eye to restore focusing ability, and multifocal lenses like ReSTOR®, and TECNIS® that provide good distance and near vision.

To determine which of these premium lenses is best suited for a particular patient’s visual needs, Dr. Behler spends time learning about each patient’s lifestyle demands. Every patient’s need is unique, and Dr. Behler has worked with all the available implants long enough to understand their unique properties. He spends whatever time is necessary to select the best implant, or combination of implants, that is right for each patient.