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A cataract is the clouding of the natural lens inside of the eye, making it difficult to read, drive and perform many daily functions. Cataracts are a normal part of the aging process and develop slowly. Early in life, the lens is transparent and lets light pass through; with time, the lens becomes cloudy and it is harder for light to pass through. This makes vision similar to trying to see through a frosted window. As the cataract matures, the cloudiness increases, resulting in significant loss of sight and even blindness.
In most cases, the answer is age. Most cataracts form slowly and they never cause any pain. Some things that speed the development of a cataract include the long-term use of corticosteroids, alcoholism, diabetes mellitus, eye injury, smoking, and long-term exposure to ultra-violet (UV) light.
Many people have cataracts without knowing it. This is because in the early stages the cataract doesn’t interfere with vision. As the lens gets thicker, it has more power within the eye that can actually improve reading vision, which is sometimes called “second sight.” With time, the lens becomes cloudier and may cause a gradual blurring of vision. This is often noticed as difficulty reading road signs or reading the scroll on the bottom of the TV screen. Night driving can also be affected and halos around lights are often seen. Sensitivity to bright lights and decreased vision in bright light are common complaints of people with cataracts. The ability to distinguish or perceive colors may also be impaired.
For early-stage cataracts, changing the patient’s glasses prescription may improve vision for a while. There are no medications or eye drops that will help. When the cataracts are interfering with daily activities, cataract surgery should be considered. Cataract surgery is necessary to remove the cloudy lens. Usually, cataract surgery is done in our state-of-the-art Surgery Center, located right here at our office complex, as an outpatient procedure. Our surgeons make a tiny incision and the clouded lens is removed through “phacoemulsification,” a process that uses ultrasound power to liquefy the lens so it can be withdrawn from its sac. The old lens is replaced by an artificial lens called an intraocular lens (IOL). Until recently, all IOLs were fixed for one distance, which meant that most patients needed glasses after cataract surgery. Today, there are many different lens options available, and the cataract surgeon will help you decide which lens is best for you depending on your individual needs and lifestyle.
Astigmatism is an irregularly shaped cornea, resulting in a vision error that occurs when light rays entering the eye scatter instead of providing a single focal point. We use the latest state-of-the-art technology to diagnose all levels of astigmatism. One test is called a corneal topography in which a special camera is used to photograph the corneal pattern. A detailed map is produced to show the cone’s size, shape, and steepness. Another test called a Pentacam is used to scan the front segment of your eye as well as a precise analysis of the central cornea. These tests are fast and painless and will be performed before your cataract surgery.
Using the results from the corneal topography and Pentacam, a procedure called astigmatic keratotomy is performed at the same time as cataract surgery to reduce astigmatism. The physician uses the information from the corneal scans to see exactly where to make a carefully planned surgical incision in the eye. The 1/10th-inch incision uses a self-sealing technique so no stitches are needed. After the astigmatic keratotomy procedure, the cornea’s shape is more rounded like a basketball instead of irregular like a football, which further reduces your dependence on glasses for distance after surgery. Reading glasses will still be needed for fine print.
One advanced lens we use at Prairie Eye Center can correct a certain amount of astigmatism. It is called the AcrySof toric lens. The traditional IOL will clear the vision from a cataract but cannot correct astigmatism. To treat astigmatism without the toric IOL, corrective eyewear or additional surgery (see the section above on AK) is needed to reduce blurring and distortion. The unique design of the AcrySof toric lens makes it possible to reduce or eliminate corneal astigmatism and significantly improve uncorrected distance vision. Patients will still need reading glasses to correct near vision (reading vision).
Prairie Eye Center and our surgeons are recognized internationally as leaders in cataract surgery and lens replacement and specialists in advanced technology lens procedures. At the time of cataract surgery, you can choose to have your natural lens replaced with either a traditional single focus intraocular lens (IOL), a multifocal intraocular lens, or a toric lens, which is referred to as an advanced technology lens.
Some advanced technology lenses have built-in trifocals that provide all distances of vision without dependence on glasses or contact lenses, allowing clear vision at near, intermediate, and distance viewing. Most advanced technology lens patients experience visual freedom after their procedure, allowing them to see both far and near without glasses. This lens allows the greatest degree of independence from glasses.