At Discover Vision Centers, we provide various treatments for cataracts, a common condition characterized by the clouding of the crystalline lens of the eye. Cataract treatment involves the surgical removal of the cataract and then implantation of an intraocular lens (IOL). Cataract surgery is one of the most prevalent procedures performed in the world, and thanks to surgical advances, one of the most successful elective surgeries to date.
A cataract is the clouding of the crystalline lens of eye. The crystalline lens rests behind the iris, or the colored part of the eye. More than 50% of people over age 60, and some younger, have cataracts. If one lives long enough, they will develop cataracts. Cataracts are progressive in nature, and there is no medical cure at present for cataracts. Fortunately, there are safe and effective surgical procedures to remove cataracts and restore vision through the implantation of an intraocular lens (IOL).
As we age, the clear lens we are born with becomes thicker, less flexible, less transparent, and changes in color, resulting in changes in vision quality. Environmental factors (smoking, excess sunlight, radiation), medical conditions (diabetes), and the aging process can cause protein structures within the lens to break down and become opaque. Over time, this opacity can increase with clouding or discoloration of the lens, progressing to the point that images you look at become blurred. Not only does light get blocked from entering the eye, but it can also scatter and make reading fine print or driving at night very difficult, if not impossible. If one lives long enough, they will develop cataracts. The progression of cataracts can occur at different rates between the two eyes, but for most patients, they progress at about the same rate.
Cataracts that are visually significant and require surgery can involve one of several symptoms:
There are two major types of cataracts. The overwhelming majority that require surgery are age-related. Some children are born with congenital cataracts.
Nuclear Cataracts – Nuclear cataracts affect the central part of the crystalline lens. They are typically slow growing and tend to cause nearsightedness. Some people will report improved reading vision as nuclear cataracts develop. With time this type of cataract can change color, starting yellowish and then turning brown, and over time the lens becomes less transparent and vision decreases to the point of needing surgery.
Cortical Cataracts – Cortical cataracts occur on the outer coating of the front and back of the crystalline lens. These appear whitish and usually take the appearance of a spoke-like pattern. As they progress, they can cause light scatter and a starburst effect with point sources of light.
Posterior Subcapsular Cataracts – Posterior subcapsular cataracts, as the name implies, start at the back of the lens. This type of cataract tends to develop fast. They tend to reduce near vision early and affect night driving with oncoming headlights. Patients report glare, starburst and halos around point sources of light. This type of cataract is common in diabetic patients, nearsighted patients and patients treated with systemic or topical corticosteroids such as prednisone.
Congenital Cataracts – Congenital cataracts can be present at birth or develop soon after. They may be of genetic origin or be associated with infection during pregnancy. Congenital cataracts may not impair vision. If they do, they can be removed and a lens implant can be placed.
As we age, the proteins within the crystalline lens of our eyes naturally change. The structure and alignment of the proteins has to be perfect to give optimal vision. Metabolic changes and damage to these proteins lead to clouding of the lens and decreased vision.
Doctors do not know the exact cause of cataract development, but doctors at Discover Vision Centers do know that there are several conditions associated with cataract progression.
There are several health problems and medical treatments that are associated with cataracts, which include:
Cataracts are diagnosed with a complete eye exam. Your vision will be checked and it will be found to be reduced in differing lighting conditions. The power of your eye will be assessed to see if your vision can be improved with new glasses. Your pupil will be dilated and the doctor will be able to directly see if a cataract has developed. The doctor will also make sure other structures in your eye are healthy, such as the optic nerve and retina.
To date, there is no evidence that cataracts can be completely prevented, nor is there any evidence that anything can be done to reverse cataracts that have developed. There are, however, several associations with cataract development. If these issues are minimized or eliminated, cataract development can potentially be slowed down.
There are several life-style related issues that have been associated with cataract development. Excessive tobacco smoking and alcohol consumption have been linked to cataract development. Certain health conditions can predispose patients to cataracts. Posterior capsular cataract formation is very common with patients with diabetes diagnoses and patients who have been on long-term or several rounds of systemic prednisone or topical ocular prednisone therapies. It is believed that ultraviolet B sun rays contribute to cataract formation, so sunglass usage is likely beneficial in reducing cataract formation. A healthy diet rich in a variety of colored vegetables and fruits will provide an array of vitamins and minerals that will optimize the health of your eyes in general. Antioxidants in pill form have to date not been proven to prevent cataracts, but a diet rich in organic vitamins and minerals has been proven to reduce the risk of cataract development.
Surgery is the only permanent solution for cataracts. As cataracts develop, there are some strategies to help facilitate or optimize vision until a patient decides to proceed with surgery.
As cataracts develop, they tend to change the glasses prescription over time. One can “chase the refraction” with new glasses every few years or even months. At some point, changing glasses will no longer help because the crystalline lens has become too cloudy. There are some things a patient can do to help improve function besides changing glasses. Anti-glare coatings on lenses can help with night driving, improved lighting can help with reading, and some patients resort to magnifying lenses to allow them to read printed material. When these options fail to help your vision when carrying out daily activities, your eye doctor may recommend surgery.
When a patients activities of daily living are decreased to the point that they simply can not function the way they would like, then cataract surgery should be considered. Discover Vision Centers sure that the appropriate first step is a complete eye examination to confirm that cataract development is the cause of the vision decrease and that other eye structures are healthy. If the presence of cataracts is confirmed, then the patient, with the help of their doctor, will determine when to proceed and what type of lens should be selected based upon the patient’s desires for visual function after surgery. Contact us for additional information!