Cataracts

WHAT ARE CATATRACTS?

A cataract is a clouding of the normally clear lens of your eye. Looking through a cloudy lens is like trying to see through a frosty or fogged-up window. Clouding of the lens is a normal part of aging. About half of Americans older than 65 have some degree of clouding of the lens. After age 75, as many as 70 percent of Americans have cataracts that are significant enough to impair their vision. Cataracts can also be caused by diabetes, certain medications- such as steroids or trauma.

(An example of the vision of a person with cataracts.)

Most cataracts develop slowly. But as clouding progresses, cataracts eventually interfere with your vision. In the early stages, stronger lighting and eyeglasses can help you deal with any vision problems you may have. But at some point, if impaired vision interferes with your daily activities, you might need surgery. Fortunately, cataract removal is one of the safest, most effective and most common surgical procedures.

Many people think of cataracts as diseases. Often times, the general population thinks that when they have a growth removed from the outside of the eye, they in fact had cataract surgery. For your information, cataracts do not occur on the exterior of the eye. Cataracts occur internally. One of the normal anatomical structures of the eye is called the crystalline lens. The crystalline lens participates in our ability to see clearly. If the crystalline is clear, we are able to see clearly. If the crystalline lens is opaque for whatever reason, we will not be able to see as clearly as desired.

(Normal lens.)

(Lens with cataract.)

With age, diabetes, intraocular inflammation, intraocular surgery or anti-inflammatories (aka, steroids), the natural, clear crystalline lens can become opaque and cloudy. The specific description of an opaque and cloudy lens is cataract. It is imperative to know that cataracts do not occur in everyone at the same rate. In addition, cataracts do not affect everyone the same way. And, cataracts do not need to be removed for everyone.

SYMPTOMS

Symptoms of a cataract include; clouded, blurred or dim vision, increasing difficulty with vision at night, sensitivity to light and glare, halos around lights, the need for brighter light for reading and other activities, frequent changes in eyeglass or contact lens prescription, fading or yellowing of colors or double vision in a single eye. If you have a cataract, light from the sun, lamps or oncoming headlights may seem too bright. Glare and halos around lights can make driving uncomfortable and dangerous. You may experience eyestrain or find yourself blinking more often to clear your vision.

WHEN TO SEE US

There are times when cataracts need to removed emergently. Additionally, if cataracts are contributing to a person developing glaucoma, or if the cataract is causing specific types of glaucoma, it may behoove the patient to have the cataract removed. Most importantly, if you’re experiencing difficulty with your vision, pay a visit to your eye doctor, and allow to fully evaluate your eye to determine if cataract removal is the best option at the time. The only treatment for a cataract is surgery to remove the clouded lens, which usually includes replacing the lens with a clear lens implant.

CATARACT DIAGNOSIS

Your Visual Acuity will be assessed using the Snellen Eye Chart (pictured below) which measures how well each eye can see. A detailed history of the quality of your vision will be obtained, including if you are bothered by glare or if you have been experiencing problems seeing in dim light.

A refraction will be performed to determine your best level of vision and if your vision can be improved by changing your glasses in lieu of surgery. Drops are put in your eye that help to widen (dilate) the pupils. Then, using a special magnifying lens, your eye doctor will look at your natural lens, which over time becomes yellowed and cloudy – a cataract. Your overall eye health will be assessed as well and a diagnosis will be made. Once it has been determined that you are a good candidate for Cataract Surgery, your questions will be answered and your surgery may be scheduled.

CATARACT TREATMENT OPTIONS

More than 1.4 million people in the U.S. have cataract surgery each year. More than 95% of cataract surgeries are performed with no complications and improved vision.

You and your ophthalmologist should decide together when cataract surgery is appropriate for you. Thanks to innovative medical advances, cataract surgery is one of the safest and most successful procedures performed today. Cataract surgery is a common outpatient procedure performed using a topical anesthetic, causing little discomfort. The goal of the operation is to remove the cataract and insert a synthetic lens to replace the natural lens. Traditionally, the surgeon performed these tasks by making a tiny incision in the eye and then using an instrument about the size of a pen tip.

CATARACT SURGERY

A small incision is made close to the edge of the cornea. A tiny, high-frequency ultrasound instrument is inserted that breaks up center of the lens. Broken-up cloudy lens material is removed through the incision.

An Intraocular lens (IOL) implant is inserted into your eye to replace the cloudy lens. The IOL is customized for your eye; restores focusing power. The IOL usually placed behind the iris (posterior chamber lens), but sometimes placed in front of iris (anterior chamber lens).

Most cataract surgical procedures are performed without complications and result in immediate improvement in vision. You will apply eye drops for several weeks following surgery to reduce the possibility of infection and/or inflammation in the eye. You may need an eyeglass prescription to obtain your clearest vision following surgery.

In a number of cases, the natural capsule supporting IOL can become cloudy after cataract surgery. A Posterior Capsulotomy, (laser surgery done in the office) can be performed to opencloudy capsule and restore clear vision. This procedure is normally done in a surgery center but we are able to perform this procedure directly in our office.

CATARACT SURGERY

Now patients also have the option of choosing a bladeless, computer-controlled laser to perform several of the most critical steps of cataract surgery. The LenSx femtosecond laser is an advanced precision technology that operates with computer control, helping surgeons to customize the procedure to your eye. It is a technologically advanced option for cataract patients as well as those with increased astigmatism, as the LenSx corrects moderate astigmatism. Please watch below for an informational video about the LenSx.

LENS IMPLANTS FOR ASTIGMATISM

THE ACRYSOF® TORIC IOL

Astigmatism is an optical condition that can blur vision at both distance and near. Until recently, patients with significant amounts of astigmatism were forced to still depend on glasses or contacts after cataract surgery or refractive lens exchange surgery to improve their vision.

The AcrySof® Toric Intraocular Lens has advanced technology that can eliminate the cataracts that cloud your vision and correct the astigmatism that distorts your vision all at the same time. In a recent FDA study 97% of patients were able to eliminate the need for glasses to see in the distance and achieved 20/25 or better. Patients enjoy activities like sports, driving, or watching T.V. and movies without the need for contacts or glasses.

MULTIFOCAL LENS IMPLANTS

PanOptix Trifocal Lens implant is for “far away, intermediate and near vision”. The PanOptix Lens gives you a full range of vision and reduces your need to wear glasses. See effortlessly without blurry zones.

VIVITY LENS IMPLANT

The AcrySof® IQ Vivity™ Extended Vision Lens allows you to see clearly at the crucial far and intermediate distances while still providing functional near vision.

RESTOR MULTIFOCAL™

The Restor Multifocal Intraocular Lens corrects vision for near, intermediate and far distances. The lens willcorrect vision far away, up close and all distances in between. In most cases, this lens eliminates the need for glasses after cataract surgery. The multi focal implants are in many ways similar to bifocal and multifocal contacts. Because multifocal lenses are implanted inside the eye, they don’t require any care and routine replacement like contact lenses do.

TRADITIONAL LENS IMPLANTS

Traditional intraocular lenses have a spherical optical design, meaning the front surface is uniformly curved from the center of the lens to its periphery. A spherical intraocular lens can induce minor optical imperfections which can affect quality of vision, particularly in low-light conditions such as driving at night.
Premium lenses, on the other hand, match more closely the shape and optical quality of the eye’s natural lens, and thereby can provide sharper vision — especially in low light conditions and for people with large pupils.

The latest innovation in cataract surgery is now available with Dr. Ronald Frenkel. The ORA System,state-of-the-art “smart” eye surgery allows your expert surgeon Dr. Frenkel to take precise measurements and evaluate accuracy during the procedure. If needed, he can instantly make any adjustments, such as refining the incisions, fine-tuning the power of the Intraocular Lens implant or even performing a lens exchange if the pre-selected lens isn’t a perfect fit. Fully customizing the entire procedure to each patient’s eyes helps ensure optimum clarity and focus, making the ORA System instrumental in achieving the best outcomes for cataract surgery.

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