Cataracts are a clouding of the lens in your eye that affects your vision. The most common form of cataracts, that which occurs as a natural part of aging, is not preventable. Most people will develop some degree of cataract as they become older. Visual symptoms of cataracts include blurry vision, difficulty reading in dim light, poor vision at night, and glare or halos around lights.  The only treatment for cataracts that significantly impair your vision is surgery. 

When is Cataract Surgery Necessary?

Simply having a cataract does not always require surgery. Sometimes a change in eyeglasses or contact lens prescription is enough to restore adequate vision. When a cataract becomes visually significant by making it difficult to participate in normal activities such as reading, driving, working, and other things important to you, may be the time to consider and discuss cataract surgery with your eye doctor. 
Without cataract surgery, as your vision declines, your participation in day-to-day activities may be affected. Keep in mind however that cataracts usually develop slowly so there is generally no need to rush into a decision about surgery. If you are not bothered by the symptoms of cataracts and they don’t interfere with your activities, you may choose to wait for cataract surgery. 
The decision to have cataract surgery is one you and your eye doctor should make together.  It is based on several considerations and the timing is different for each person. 
“Is my cataract ‘ripe’?” is the most common question asked about the timing for cataract surgery. Contrary to popular belief, a cataract does not have to be ‘ripe’ in order to have surgery. Rather, the time to consider surgery is when the vision problems caused by cataracts are interfering with your daily living activities, i.e., Is poor or worsening eyesight from cataracts affecting your ability to do your job or restricting your ability to participate in normal leisure or social activities? Is the glare from the sun during the day or headlights in the evening severe enough to bother you while driving? 
If you are concerned about cataracts, contact the eye doctors at Ophthalmic Physicians, Inc. for a complete, dilated eye exam during which your cataracts can be assessed. Your eye doctor can also discuss with you all latest cataract surgery options. 

The Cataract Surgery Procedure

Cataract surgery is generally a simple, outpatient procedure performed by specially trained ophthalmologists.  Surgery is done one eye at a time so that each eye can heal and adjust individually. The surgery usually takes only 10-15 minutes, is painless, and is performed under monitored anesthesia care which means you are not put to sleep but in a light level of sedation. Sedation can be titrated to meet the anxiety level of each patient; some requiring more, some less.
Cataract surgery is performed in an operating room using a microscope, specially designed instruments, and other modern technology.  Traditional cataract removal involves making a small incision at the edge of the cornea.  A tiny, high-frequency ultrasound instrument is then inserted that breaks up the cataract into pieces.  This is called phacoemulsification.  The broken-up lens pieces are removed and then a new intraocular lens implant, or IOL, is inserted.  Today’s technology offers the option of choosing a bladeless, computer-controlled laser to perform several of the most critical steps of cataract surgery.  There is also the option of special intraoperative measurement technology to help confirm that the IOL implant in your eye is of the precise power and properly oriented if correcting for astigmatism.
After surgery, you will be instructed to use eye drops and postoperative visits are scheduled to check your eye as it heals.  Within a few days after surgery, many are back at work, driving, and doing all but the most strenuous of activities.  

Cataract Surgery – The Results 

Cataract surgery generally proceeds without complications and often results in immediate improvement in vision.  You may need an eyeglass prescription to obtain your clearest vision following surgery depending on the intraocular lens implanted and your particular vision needs.  There may be situations, though, where other eye problems such as glaucoma or macular degeneration that can detract from good vision even after a successful cataract surgery. Talk with your Ophthalmic Physicians doctor about how much cataract surgery cold improve your vision, and which options are best for you. 
The best way to prepare for your cataract surgery is to talk with your eye doctor or surgeon 
who will help you understand the procedure and answer all your questions and concerns. 
The more you know about what to expect, the more comfortable and confident 
you will feel having cataract surgery.

After Surgery – Is My Cataract Coming Back??

Can cataracts grow back? The answer is no, however there is a condition that can occur after cataract surgery called posterior capsule opacification, or PCO, which may seem like another cataract.  
The natural lens of the eye is enclosed in a thin, clear membrane called the capsule. During cataract surgery, the front of the capsule is opened.  The cloudy lens inside the eye, the cataract, is removed replaced with an intraocular lens implant (IOL) that is placed at the front of the capsule.  During surgery, the surgeon makes every attempt to maintain the integrity of the capsule itself as it holds the lens in place. In some cases after cataract surgery, the back of the capsule can become thickened or cloudy causing visual difficulties such as haziness, problems with glare, and decreased vision often like pre-cataract surgery.  It can take anywhere from a few weeks to a few years for the posterior capsule to turn cloudy enough to interfere with clear vision. 
Fortunately, PCOs can be treated effectively with a YAG Capsulotomy Laser procedure.  The YAG laser creates an opening in the center of the cloudy posterior membrane allowing light to pass through for clear vision.  This outpatient procedure takes only a few minutes and is entirely painless.  The YAG Capsulotomy is considered very safe and your Ophthalmic Physicians surgeon will review with you all the advantages and risks of this procedure in advance.  PCOs do not close up or grow back.  After a successful YAG Laser Capsulotomy, the procedure should not ever need to be repeated.                                                                                                               

Diagram of YAG Laser Capsulotomy 


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