Cataract
© 2019 American Academy of Ophthalmology

A cataract is a clouding of the lens in our eye which over time can cause blurry vision. Most cataracts are age-related and are unrelated to lifestyle choices made by the individual. Eventually, everyone will develop cataracts. Certain situations can lead to a quicker progression of cataract formation or the development of cataracts at a younger age such as genetics, diabetes, trauma, or long-term steroid use. To slow the formation of cataracts, take care of your body and your eyes by wearing sunglasses, avoiding smoking, and controlling your diabetes.

Most cataract patients will notice changes in the vision as the cataract develops.

  • blurry vision
  • frequent changes in glasses prescription
  • a difficulty with night time vision
  • glare and halos especially with nighttime driving
  • loss of vision

Many people have mild cataracts which do not affect the vision. In this case, your physician will monitor your eye’s lens. Surgery is only necessary when cataracts become visually significant.

Progressive images depicting blurry, hazy vision with halos.
© 2019 American Academy of Ophthalmology

Surgery for Cataracts

Cataract surgery involves softening the lens with a mechanism called phacoemulsification. Ultrasonic power is used to break the cataract up into little pieces, and then Dr. Ngo aspirates the emulsified cataract through a tiny incision. The incision for cataract surgery is about 2.2 – 2.4 millimeters in size. There are usually no stitches involved. The procedure takes about 10-15 minutes and only requires light sedation with medication administered by our anesthesiologist through an intravenous. Your anesthesiologist will monitor your breathing, heart, and blood pressure the entire time. You will not be completely asleep, however many people may not remember the procedure due to the amnestic effects of the sedation medication.

Cataract surgery not only entails removal of the cloudy lens but also replacing it with an intraocular (within the eye) lens implant. The new lens in the eye has a designated focus power designed individually for each patient. There are many types of lenses that help people focus. Monofocal lenses allow you to see well at a particular point, such as distance or near, but not both. Monofocal lenses are great for people who do not have much astigmatism, want sharp distance eyesight, and are okay with wearing glasses for near work. Multifocal or extended-depth of focus lenses are for patients who wish to optimize their vision at a range of distances and want to be less dependent on glasses for both distance and near. Toric lenses are great for correcting astigmatism and vision at the same time. Dr. Ngo may also utilize a limbal relaxing incision of the cornea to correct astigmatism at the time of cataract surgery depending on the severity of astigmatism. Femtosecond lasers can help improve the precision and accuracy with surgery. Dr. Ngo will take time with you to help you navigate the landscape of traditional and modern options. No matter which lens or procedure you choose, your vision can be expected to be better after cataract surgery. Dependency on glasses for distance and reading after surgery is variable and has much to do with the intraocular lens you choose and the unique characteristics of your eye. Multifocal or extended-depth of focus lenses help minimize the need for glasses after surgery. Of course, cataract surgery cannot give you something you’ve never had or change eyesight issues unrelated to cataracts. If someone has poor vision from other problems with the retina or optic nerve, we expect limitation in results because surgery improves the cloudiness or blurriness related only to cataracts. Additionally, dry eye does not improve after cataract surgery. It is possible to develop dry eyes at any point in time with or without surgery. Surgery can worsen existing dry eye disease. Thus, it is essential to treat dry eye symptoms before and after any eye surgeries. Be sure to bring up you concerns and discuss your medications (especially blood thinners) with Dr. Ngo at your office visit.

Day of the Cataract Procedure

Before your surgery, It’s important to have nothing to eat or drink after midnight. On procedure day, you will arrive at the surgery center where nurses will put eye drops in the eye to dilate the pupil. They will place an IV in your hand to allow the anesthesiologist to administer medication to help you stay calm and relaxed during the procedure. The surgery takes about 10-15 minutes and then a nurse will observe you in the recovery area for another 15-30 minutes. Most people do not experience pain with or after surgery. It is normal to have a scratchy sensation after any eye surgeries which resolves with time. Vision will be blurry the day of the operation due to the dilation drops. It’s essential to have someone to drive for you on the day of your procedure. Most people can drive the following day and go back to work depending on the line of work they do. Each day the vision will continue to improve. Maximum visual improvement can take one month; hence the use of eye drops for one month.

Most people are pleased after cataract surgery. You can expect your vision to be clearer, brighter, and sharper. It is a very safe procedure. However, every operation has its risks. Deterioration or loss of eyesight is extremely rare and unlikely to occur. Some people can encounter higher risks of surgery due to their natural anatomy of the eye or weakness of eye structures from other pathology or trauma. Dr. Ngo will counsel you regarding your unique risk profile so that you can make an informed decision.