common eye conditions

Cataracts

What is it?

Inside the eye is a lens which can change in shape to bring your vision into focus and allow you to see clearly at both distance and near.  As we grow older the lens changes and the once clear lens may gradually become cloudy which reduces the sharpness, clarity or brightness of your vision.  Glare in bright sunlight is frequently a symptom caused by cataracts.

Causes

The most common cause of cataracts is simply aging.  Cataracts seldom affect the vision until after the age of 40 and most commonly aren’t visually significant until after the age of 60. Cataracts can, however, also be caused by medical problems like diabetes, trauma, or the chronic use of steroid medications.  

Treatment

Early or mild cataracts may have very little or almost no effect on vision for years. There are no eye drops or medications that can reverse or treat cataracts. Cataracts may sometimes cause a change in the eyeglass prescription and new glasses can sometimes improve vision for some time, but the changes to the lens that occur with cataracts are progressive and irreversible. Only an ophthalmologist—an eye physician and surgeon—can perform cataract surgery to fix the problem when the cataract has progressed and your vision decreased.

Cataract Surgery

Cataract surgery is considered the most successful operation in medicine.

In cataract surgery, the cloudy lens (cataract) is removed and replaced by a new clear artificial lens called an intraocular lens implant (IOL) to restore your vision. The power of the lens implant can be calculated so that the eyeglass prescription previously worn may either be weaker or possibly not needed at all after the cataract surgery. 

There are different types of IOL implants and your ophthalmologist can help you decide which is best for you and your lifestyle.

Some decisions include continuing to use bifocals for reading, monovision (where one eye is more clear for reading and one eye is more clear for distance), or using a multifocal IOL which can provide clear vision both at distance and near. Multifocal IOLs do have optical trade-offs to provide that range of vision; these should be carefully explained to you by your ophthalmologist so you can make an informed decision on what is best for you.

Multifocal IOLs and IOLs that correct for astigmatism (a common optical condition that causes blurred vision and is corrected with glasses) are considered “premium” IOLs and their cost is not covered by Medicare or private insurers.  There is typically an added out-of-pocket cost to the patient when they are used.