What is a cataract?

A cataract is the clouding of the natural crystalline lens inside the eye. The lens remains clear most of our lives, and becomes more opaque as we age. It is a universal condition and everyone gets cataracts when they are old enough, usually in their 60’s and up. Cataracts cause vision to deteriorate. Patients who have cataracts developing often cite their symptoms as vision being “darker” than before. Paradoxically, sometimes they do see better in dim light than in bright light. This is because most cataracts develop in the central region of the lens. In dim light, when the pupil is wider, more light can come in the eye through other parts of the lens that are still relatively clear. Cataracts can also be secondary; that is, they can be caused by other conditions, such as blunt and sharp injuries to the eye, electric shocks, or prolonged inflammation in the eye. Some medicines such as steroids can also cause cataracts.

 The Treatment of Cataracts

The only way to cure a cataract is to surgically remove it. No medication has been proven effective in curing or preventing a cataract. During cataract surgery, a small opening is made at the edge of the cornea, and a probe is inserted into the eye. This probe emits ultrasonic energy that softens, or “emulsifies”, the cataract, which is then aspirated out. This part of the procedure if called “Phacoemulsification”. A very thin, clear membrane which the cataract was sitting in is left in place to act as a support for the artificial intraocular lens (IOL) that is inserted when the cataract has been removed.
Cataract surgery is a very safe and effective surgical procedure. Infections occur in less than one percent of cases, and 99+ percent of the patients see better after the surgery. However, not all cataracts have to be removed once they are diagnosed. A cataract can be left for years if the patient still feels that his or her vision is still functional for everyday life. Cataract surgery is sometimes referred to as an “elective” procedure, because there is usually no urgency to the matter, and the patient can decide when the surgery will take place. However, there is a point at which if the cataract becomes too advanced, there is an added risk of complications. At this point, the doctor may feel cataract surgery is necessary for the safety of the patient.

Cataract surgery is a very safe and effective surgical procedure. Infections occur in less than one percent of cases, and 99+ percent of the patients see better after the surgery. However, not all cataracts have to be removed once they are diagnosed. A cataract can be left for years if the patient still feels that his or her vision is still functional for everyday life. Cataract surgery is sometimes referred to as an “elective” procedure, because there is usually no urgency to the matter, and the patient can decide when the surgery will take place. However, there is a point at which if the cataract becomes too advanced, there is an added risk of complications. At this point, the doctor may feel cataract surgery is necessary for the safety of the patient.         
An ”after cataract” is a term used to describe a condition that occurs after a cataract has been removed. During the cataract operation, the capsule of the lens, which is a very thin, clear membrane, is intentionally left in place in order to support the artificial lens. Months to years after the operation, however, this clear membrane can become opacified. The medical term for this is posterior capsular opacity, or PCO. Some 20% of the post-cataract surgery patients experience this change, which degrades their vision and may feel like the cataract is returning. The cloudy membrane can be left alone if the degradation of vision does not significantly affect the patient’s life. If treatment is indicated, a special kind of laser called the YAG laser can reach through the membrane to clear this clouding without the need for any surgical instruments. The procedure takes 5 minutes, does not require an operating room, and is totally painless.