Cataract Care

Cataracts are a common age-related eye condition that affects the clarity of the lens in the eye. The lens is a clear part of the eye that helps to focus light and images onto the retina, which is then transmitted to the brain as visual information. As people age, the lens becomes less transparent, causing light to scatter and blur thus reducing the quality of vision. This can lead to a condition known as cataracts, which causes vision loss and affects daily activities.

Cataracts can be evaluated using various methods, but the most common is a comprehensive eye exam where visual acuity is measured.  A slit lamp exam is done that allows direct visualization of the opacified lens (cataract).  In addition, retinoscopy, and direct and indirect ophthalmoscopy can suggest an opacified lens as these views are impaired for the doctor.

Visual acuity is another measure that can be used to evaluate cataracts. This metric assesses the degree of impairment in the clarity of images.   The intensity of visual signals over time, and clarity will be impaired resulting in blurred vision.  In addition, there can be unwanted visual inputs like halos and glare that are generated by the cloudy lens.   Visual acuity can provide valuable information about the progression of cataracts. For example, lower levels of visual acuity in a patient’s exam may indicate that their cataracts are progressing more rapidly and may require prompt treatment.

There are various surgical and non-surgical treatments available for cataracts, including lens replacement surgery, laser therapy, and the use of artificial lenses. Lens replacement surgery is the most common and effective treatment for cataracts, and it typically involves removing the cloudy lens and replacing it with an artificial lens. Cataracts cannot be removed with lasers but the laser can assist with portions of the surgery.   Lasers are also used for “secondary cataracts”.   After the cataract is removed, a membrane is left behind to hold the vitreous back and the lens in position.   This film starts out clear, like saran wrap.  Over time this membrane or capsule opacifies resembling wax paper.   This is common and can be opened with the YAG laser with a procedure called a YAG laser capsulotomy.  This procedure is typically performed on an outpatient basis and can result in significant improvements in vision.

The femto Laser can be used to assist with the traditional cataract procedure.  Laser technology is used to break up the cloudy lens.  It can also be used to make incisions to enter the eye and to correct astigmatism.   This modification of the procedure has advantages and disadvantages and it may not be suitable for all patients.

The use of artificial lenses is a universal option for treating aphakia.  After the cataract is removed, the power must be replaced.  This is done with an artificial lens or intraocular lens  (IOL).  These lenses can be inserted into the eye to replace the cloudy lens and improve vision. Artificial lenses come in various shapes and sizes, and they can be designed to correct specific vision problems, such as nearsightedness, farsightedness, astigmatism, and presbyopia.   Multifocal or trifocal lenses or extended depth of focus or accommodating lenses are the most advanced technology and are generally not covered by insurance.  The multifocal lens allows for the reduction or elimination for the need for glasses after surgery.

Early cataracts can sometimes be treated with non-surgical methods, including the use of eyeglasses, magnifying lenses, and brighter lighting. Eyeglasses can help to improve vision by magnifying objects and reducing the amount of glare. Magnifying lenses can also be helpful, especially for patients with advanced cataracts who are having difficulty reading or performing other close-up tasks. Brighter lighting may also help to improve vision but may enhance glare while increasing contrast.

In conclusion, cataracts are a common age-related eye condition that can cause vision loss and affect daily activities. The use of metrics such as visual acuity can provide valuable information about the progression of cataracts and the effectiveness of treatment. There are various surgical and non-surgical treatments available for cataracts, including lens replacement surgery, and the use of artificial lenses. Patients should work closely with their eye doctor to determine the best treatment option for their individual needs.