How can a cataract be treated?

The cataract may need no treatment at all if the vision is only a little blurry. A change in your eyeglass prescription may improve vision for a while. There are no medications, eye drops, exercises or glasses that will cause cataracts to disappear once they have formed. When you are not able to see well enough to do the things you like to do, cataract surgery should be considered. Surgery is the only way to remove a cataract.

Cataracts cannot be removed with a laser, only through a surgical incision. In cataract surgery, the cloudy lens is removed from the eye. In most cases, the focusing power of the natural lens is restored by replacing it with a permanent intraocular lens implant.

Before surgery

Once you and your ophthalmologist (eye physician and surgeon) have decided that you will have your cataract removed, a physical examination is necessary so that he or she may be alerted to any special medical risks. Ask your ophthalmologist if you should continue your usual medications. Your eye will be measured to determine the proper power of the intraocular lens that will be placed in your eye during surgery.

The day of surgery

Surgery is usually done on an outpatient basis. You may be asked to skip breakfast, depending on the time of your surgery. Upon arrival for surgery, you will be given eye drops, and perhaps medications to help you relax. A local anesthetic will make the operation painless. Though you may see light and movement, you will not be able to see the surgery while it is happening, and will not have to worry about keeping your eye open or closed. The skin around your eye will be thoroughly cleansed, and sterile coverings will be placed around your head. When the operation is over, the surgeon will usually place a shield over your eye. After a short stay in the outpatient recovery area, you will be ready to go home. You should plan to have someone else drive you home.

Following surgery

You will need to:

• Use the eye drops as prescribed;
• Be careful not to rub or press on your eye;
• Use over-the-counter pain medicine if necessary;
• Avoid very strenuous activities until the eye has healed;
• Continue normal daily activities and moderate exercise;
• Ask your doctor when you can begin driving;
• Wear eyeglasses or shield as advised by your doctor.

Under an operating microscope, a small incision is made into the eye. Microsurgical instruments are used to fragment and suction the cloudy lens from the eye. The back membrane of the lens (called the posterior capsule) is left in place. A plastic intraocular lens implant will be placed inside the eye to replace the natural lens that was removed. The incision is then closed. When stitches are used, they rarely need to be removed.

More information on cataract surgery techniques is available on this web site.

When is the laser used?

The posterior capsule sometimes turns cloudy several months or years after the original cataract operation. If this blurs your vision, a clear opening can be made painlessly in the center of the membrane with a laser. Laser surgery is never part of the original cataract operation.

Over 95% of cataract surgeries improve vision, but a small number of patients may have problems. Symptoms including infection, bleeding and swelling or detachment of the retina are some of the more serious complications that may affect your vision. Call your ophthalmologist immediately if you have any of the following symptoms after surgery:

• Pain not relieved by non-prescription pain medication;
• Loss of vision;
• Nausea, vomiting or excessive coughing;
• Injury to the eye.

Pre-existing conditions

Even if the surgery itself is successful, the eye may still not see as well as you would like. Other problems with the eye, such as macular degeneration (aging of the retina), glaucoma and diabetic damage may limit vision after surgery. Even with such problems, cataract surgery may still be worthwhile. If the eye is healthy, the chances are excellent that you will have good vision following removal of your cataract.