Cataracts

Care & Treatment

Prevention 

Research suggests that you may be able to lower your risk of cataracts, or slow down their formation, by following the below recommendations. 

  • See your eye doctor regularly. Ask your healthcare provider how often you should have an eye exam.
  • Quit smoking. Your healthcare provider can help you find the best way to quit.
  • Wear sunglasses. Sunglasses can block ultraviolet B (UVB) rays when you're outdoors,  You can also wear a broad-brimmed hat to block the sun.
  • Take care of other health problems. This is especially important if you have diabetes or other medical conditions that can increase your cataract risk.
  • Maintain a healthy weight. Try to reduce calories if you are overweight, and exercise regularly.
  • Eat plenty of fruits and vegetables. Try to eat colorful fruits and vegetables, which have the most vitamins, minerals, antioxidants, and other nutrients. 

Treatment 

In mild cases

If your cataracts are small and not bothersome, simply using eyeglasses or contact lenses, brighter lighting, anti-glare glasses, or magnifying lenses may be all that you need. 

Follow all the steps listed above in the Prevention section to slow down cataract growth. Have regular check-ups with your eye doctor. You may not need cataract surgery for several years. In fact, you may never need surgery.  

Make sure that your eyeglasses or contact lenses have an up-to-date and accurate prescription.  This will help you deal with cataract symptoms until surgery is necessary.

When to consider cataract surgery

Most eye doctors recommend cataract surgery if your quality of life or ability to perform normal daily activities are affected (such as reading, watching TV, or driving at night).

In some cases, you may need to have a cataract removed even if it is not affecting your vision. For example, if the cataract blocks the examination or treatment of a different eye disease such as age-related macular degeneration, or diabetic retinopathy. 

Surgery 

The only effective treatment for cataracts is surgical removal. This surgery has been carried out safely and effectively for many decades. It is one of the most common operations performed in the US. For 9 out of 10 patients, vision improves after surgery, and visual acuity is usually 20/40 or better. Cataract surgery has also been found to enhance mental outlook, ability to carry out daily functions, and quality of life in general. 

If you decide to have surgery, your doctor will perform some tests and eye measurements a few days before. You may have to stop taking certain medications temporarily, and must not eat or drink for twelve hours beforehand. 

The operation usually takes about an hour and is performed under local anesthetic or a topical preparation applied directly to the eye. You will probably be awake during the surgery. It is an outpatient procedure, so you will come home the same day. If you have cataracts in both eyes, you will normally have one eye done at a time with a period of a few weeks between surgeries.

The two types of cataract surgery are:

  • Phacoemulsification (phaco) or “small incision cataract surgery.” This is the most common method.  In phacoemulsification, your surgeon makes a small incision on one side of your cornea, the covering on the front of your eye. The surgeon inserts a tiny probe through the incision that emits extremely high sound waves. This breaks up the discolored lens. It can then be easily removed by suction.
  • Extracapsular surgery. If the surgeon decides to use extracapsular surgery, a longer incision will be made on your cornea and the core of the lens will be taken out in one piece. Suction is used to remove the rest of the lens. The surgeon will replace your old discarded lens with an artificial plastic lens, called an intraocular lens (IOL). The IOL becomes a part of your eye, fulfilling the same function as your old lens when it was healthy. You won’t feel any difference.

If you are not able to have an IOL because of another eye condition or problems during surgery, you may use a special soft contact lens, or high-magnification glasses, after your own discolored lens is removed, to make up for the missing lens. 

After the operation, your eye will be covered with a patch and you will rest while the medical team monitors you for any problems, such as bleeding. You will not be able to drive home after the operation and will need someone to help take you home. There may be some mild pain which should be gone within a day or two. You will probably be told to use eye drops for a few days, and must avoid rubbing or touching your eyes, bending from the waist, or lifting anything heavy. 

Although cataract surgery is usually very safe, there is always a risk of infection and bleeding, as with any surgery. Cataract surgery also increases the risk of a detached retina, which must be treated immediately to avoid serious vision loss. If you have a sudden increase in flashes or floaters, inform your provider immediately. This may be a sign of retinal detachment, and must be treated as a medical emergency. 

In about 15% of people, a part of the eye called the posterior capsule becomes cloudy within three years of cataract surgery. This is called an “after-cataract” and can easily be corrected using a special laser. No surgery is needed. 

Contact your healthcare provider immediately after your cataract surgery if you have any inflammation (pain, redness, swelling), bleeding, signs of infection, loss of vision, or double vision.

 

 

 

Last Updated November 2016