It is estimated that cataracts affect more than twenty-million individuals in America today. While some individuals experience them earlier than others, a majority of all people will eventually develop cataracts, beginning as early as the age of forty.
Simply put, a cataract is a tinting or clouding in the eye’s natural lens, which can obstruct the passage of light. This clouding of the eye typically worsens with time and, if left untreated, can severely impair one’s vision and even cause eventual blindness.
Cataract Treatment Options
When symptoms or vision changes are minor, one may not require any treatment at all for their cataracts, but should ensure to have their eyes regularly examined by a qualified ophthalmologist or optometrist to monitor the progression of the condition.
For those experiencing noticeable vision loss, cataract surgery is the only option. Fortunately modern day advancements in eye care have changed what is possible for patients afflicted with cataracts. Cataract surgery can now be done swiftly and painlessly and with little to no downtime. By taking advantage of a cutting edge surgical procedure known as refractive lens exchange, patients can have their cataracts treated with ease and dramatically improve their vision.
The procedure is done by replacing the natural cataract afflicted lens of the eye with an artificial one, known as an intraocular lens or IOL. There are several different lens options available, which can assist you to see clearly at all distances and greatly reduce or even eliminate the need for glasses. Here at Cornea and Cataract Specialty Center, we specialize in this procedure and offer a variety of high quality artificial lens options.
Top Refractive Lens Surgeons
Our refractive surgeon is among the most experienced in the state and he is a national leader on the topic of cataract surgery. He is highly trained, board certified and an expert in his field. Equipped with the full array of leading-edge advancements in cataract surgery, he can quickly and painlessly treat cataracts, dramatically improving vision and often greatly reducing dependence upon eyeglasses. With state-of-the-art cataract centers centrally located in Pershing and Piedras and at the far east on Trawood and Montwood , we are proud to provide the best cataract surgery with the best results.
Some vision conditions like nearsightedness, farsightedness and astigmatism affect us from birth because they are related to irregularities of the cornea. Others, like cataracts and presbyopia, creep up on us as we age. Both can be effectively treated with cataract surgery and intraocular (within the eye) lens implants, also called IOL’s.
Cataracts are the result of the eye’s lens becoming tinted and cloudy. This accounts for over 48% of the world’s correctible blindness. Sooner or later cataracts affect just about everyone.
Studies show that cataracts affect:
- 42% of those between the ages of 52 to 64
- 60% of those between the ages of 65 and 74
- 91% of those between the ages of 75 and 85
With these statistics, it is easy to see why cataracts are commonly associated with age. However, you don’t have to be a senior citizen to have cataracts. They can start developing at age 40, though usually at this stage, they’re not serious enough to have a significant effect on your vision.
The term “cataract” comes from a Latin word meaning “waterfall” and describes the whitening or cloudy effect of rushing water. The eye’s lens is made mostly of water and protein. In a healthy lens the protein is normally clear and permits light to pass through. As we age, the protein can clump and begin to cloud a small section of the lens, forming a cataract.
Over time, the cataract may grow larger and cloud more of the lens, making it harder and harder to see.
Types of Cataracts
- Nuclear: the most common type of cataract that affects the center of the eye
- Cortical: begins in the periphery (outer edges), and grows toward the center
- Subcapsular: affects the back of the lens and develops rapidly
Symptoms of Cataracts
So how do you know if you have a cataract?
The following are symptoms of cataracts:
- Blurred or cloudy vision
- Colors appear faded or dull
- Lamps such as headlights or streetlights have glare or halos; sunlight may appear too bright
- Poor night vision
- Double or multiple vision in one eye; this effect may disappear as the cataract grows
- Frequent prescription changes in your eyeglasses or contact lenses
Important Note: These symptoms can indicate other eye problems that may also result in blindness if left untreated. If you have any of these symptoms, make an appointment with Atlantis Eyecare immediately for a complex eye examination.
Causes of Cataracts
Cataracts appear as we age. Everyone will eventually develop cataracts, though some can experience cataracts earlier than other people.
Other than age, researchers believe that there are several causes to cataracts:
- Long-term exposure to ultraviolet light
- Exposure to radiation
- Alcohol Abuse
- Eye injuries/trauma
- Genetic factors (a parent or grandparent who had cataracts)
In the early stages of cataracts, one sees colors less vibrantly. In the later stages, the lens becomes almost opaque and has to be replaced with a clear artificial lens. This procedure is called refractive lens exchange.
A simple exam can determine if you have cataracts. Call us if you think you may suffer from cataracts and would like a solution to see clearly again.
Cornea and Cataract Specialty Center surgery
90% of the patients who have had cataract surgery enjoy improved vision. Many patients find that their vision improvement begins immediately and they can often resume normal activities within hours after surgery.
Some find their vision better than ever after cataract surgery, while others may need to wear glasses for reading (known asPresbyopia) and other activities.
During the initial healing period after cataract surgery, there may be a few limitations on strenuous activities, but most people can return to normal life quickly. They are surprised to find that they can also engage in activities that were once off-limits due to cataracts, such as reading and social activities.
If you choose to have an intraocular lens implanted, you will have the benefit of improved distance and near vision. This lens will further reduce your dependency on glasses. Our cataract specialists can help you determine if you are a candidate for the procedure.
Make sure you discuss cataract surgery in detail with your doctor and get all of your questions answered. At Atlantis Eyecare, we have a team of experienced surgeons offering some of the best Cornea and Cataract Specialty Center has to offer. Our cataract specialists will ensure you fully understand your options for cataract surgery.
The Cataract Removal Procedure
More than three million cataract surgeries are performed in the United States each year. Cataract removal is considered one of the safest and most effective of all medical procedures. The cataract procedure is quick, simple, and allows for fast healing.
Cataract removal is performed with small incision micro-surgery through a process known as phacoemulsification. The cataract removal and surgical process is actually done using the smallest possible incision, and removal of the lens material is accomplished using an ultrasonic probe.
Before a new man-made lens can be implanted, the hardened cataract needs to be removed. A micro-incision about the size of 3 millimeters is created at the junction of the cornea and the white part of the eye known as the sclera. The lens capsule is then opened and the ultrasonic probe is inserted so that the cataract can be removed. The ultrasonic probe pulverizes the cataract and suctions out the cataract material.
After the cataract is removed, the surgeon is ready to implant a man made intraocular lens. This is a crucial point of understanding for patients. Patients can either have a monofocal lens which will only correct vision for one distance or they can opt to upgrade to premium lens implant that can reduce or eliminate their need for glasses after cataract removal surgery. There is an additional cost to upgrade Refractive IOLs, while traditional monofocal lenses are covered by Medicare.
The intraocular lens (IOL) is a foldable lens that slides through a tube, like a fruit roll-up and unfolds in the capsular bag. The Cornea and Cataract Specialty Center surgeon may center the new lens with the lens capsule if necessary. Once the lens is centered, the surgery is complete. In most cases no stitches are required to seal the incision due specifically to the 3 mm size. This is why it is called micro-surgery by many eye doctors
The cataract removal procedure is virtually painless and usually takes 10-25 minutes. Patients can usually return to their normal activities the following day. Contact one of our offices in Orange County to learn if cataract removal surgery is right for you.
Refractive Lens Exchange
Refractive Lens Exchange is a very successful technique for resolving vision problems using multifocal IOLs (Intra-Ocular Lenses) and is a popular option for patients who prefer to replace the eye’s lens before cataracts make this a necessity.
The beginnings of cataracts or the onset of presbyopia are both signs that eventually your vision will be affected enough to require surgery and replacement of the eye’s aging or clouded lens.
Rather than endure the inconveniences of close-up vision problems or the gradual deterioration due to cataracts, many of our patients choose to have the affected natural lens replaced with a multi-focal or accommodating IOL.
The advantages of pre-empting the aging process are:
- Eliminating the need for readers and bifocals
- Solving common vision problems such as astigmatism, nearsightedness and farsightedness
- The cornea is untouched making this an excellent option for patients whose corneas are too thin for LASIK
- The IOL can be removed and exchanged at any time to adjust for any future changes in the patient’s vision
- There is no future possibility of developing a cataract or presbyopia
While cataract surgery is often covered by Medicare or other insurance plans, Refractive Lens Exchange, if there is no significant cataract present, is considered an elective procedure and costs can range from about $2,500 to $4,500 per eye or higher, depending on the type of artificial lens used.
Aside from this economic consideration, the RLE procedure is identical to cataract surgery, one of the most commonly performed of all surgical procedures.
When having cataract surgery you now have a few different artificial intraocular lenses (IOLs) to choose from. Currently, during cataract surgery your natural lens is removed and replaced with an artificial intraocular lens. The technology of these IOLs have vastly evolved from people having to wear very thick glasses after surgery to patients now being able to see 20/20 after surgery without wearing glasses.
IOLs have been around since the mid 1960’s, though the first FDA approval for one occurred in 1981. Before that, if you had cataracts removed, you had to still wear very thick eyeglasses or special contact lenses in order to see afterwards because there was no artificial one to replace it. The cataract surgery itself was considered very dangerous and would have patients hospitalized for many days with sandbags on both sides of their head so they wouldn’t go blind. Now the surgery is painless, done in minutes, and has you seeing great and feeling great in an hour.
Today, the IOLs that are offered solve more vision problems than ever, and doctors are advising their patients to have the surgery a lot sooner because of the great outcomes and for the overall safety that great eyesight gives you.
Choosing the right lens depends on your overall eye health and your visual needs. Below is some information we hope you can find useful, but overall it is best to make an appointment to come see our outstanding cataract surgeons and discuss what options are best for you.
Monofocal IOL gives patients the option to see at a single point, usually at distance. This option requires the need for glasses for near, intermediate, and astigmatism correction.
Monofocal IOL are usually covered by the insurances including Medicare.
Tecnis Multi-focal Lens
Designed to give patients back their youthful vision, the TECNIS® Multifocal Lens provides patients with high-quality vision at any distance, and in any light condition—even in low light.
The advanced TECNIS® Multifocal is an implantable lens that restores vision after cataract surgery and corrects presbyopia (the need for reading glasses). It delivers results superior to those of a standard multifocal lens and offers an excellent chance to become spectacle independent.
Exceptional Full Range of Vision
Only the advanced TECNIS® Multifocal Lens enables you to see clearly at near, intermediate, and far distances without glasses in all light conditions.(2)
Compare the following images. In the first image, which demonstrates vision with the TECNIS® Multifocal Lens, you can see the coffee cup close up, the dashboard at intermediate, as well as road signs in the distance—all clearly.
Now, compare the second image. This image demonstrates what you might see with a monofocal lens. Although the intermediate and distance vision is clear, notice how the coffee cup is now blurry.
Crystalens is an accommodating intraocular lens that can treat cataracts and presbyopia.
Accommodating means the action of the eye’s tiny ciliary muscles flexing and changing the position of the eye’s lens for focusing at different distances. With presbyopia the natural lens becomes less flexible due to aging.
The Crystalens IOL is uniquely fitted to the eyes’ muscles and uses them to flex and accommodate in the same way your natural lens once functioned.
Crystalens flexes as you focus your vision.
Crystalens HD, utilizes an optic design that is optimized to increase depth of focus – as a result it is designed to improve near vision without compromising intermediate or distance acuity. It features an enhanced accommodating optic that is designed to yield: improved depth of focus and improved near vision.
- The first and only FDA-approved accommodating intraocular lens
- The only FDA-approved intraocular lens that uses the natural focusing ability of the eye
- The only FDA-approved presbyopia correcting IOL for cataract patients that provides a single focal point throughout a continuous range of vision
Crystalens patients have reported less problems with glare, halos and night vision. Crystalens focuses only one image to the back of the eye, unlike a multifocal lens that projects multiple images, requiring your brain to “adjust” to the differences.
Many patients hardly ever wear glasses after surgery.
The unique Crystalens is designed to allow you to enjoy a fuller, more natural range of vision for most activities, including: reading a book, working on a computer, and driving a car.
Astigmatism is caused by the cornea being more curved in one direction than the other, causing blurred vision. Toric intraocular lenses (IOLs) are specially shaped IOLs designed to offset that imbalance.
Toric IOLs offer cataract patients or patients with presbyopia vision correction that reduces or eliminates corneal astigmatism and delivers significantly improved distance vision without the need for glasses or contacts.
Approximately 95% of patients with astigmatism see clearly with a Toric IOL.
Patients with a standard IOL who have astigmatism have about a 25% chance of seeing clearly without glasses.
Once implanted and aligned inside the eye, Toric IOLs stay fixed in place, which then results in eliminating pre-existing astigmatism.
Trulign Toric Lens
Cornea and Cataract Specialty Center surgeons now offer the ultra-advanced TRULIGN® toric lens implants and are one of the first surgeons to be offering this outstanding lens which was just approved by the FDA on May 21, 2013.
What is TRULIGN® Toric IOL?
The TRULIGN is one of the newest and most advanced types of intraocular lens implants. Intraocular lenses (or IOLs) are used to replace the natural lens of the eye following removal of a cataract. The TRULIGN® Toric lens is ideal for patients that have significant astigmatism and would like to see better up close. There is currently no other lens on the market that corrects up to three diopters (a unit of optical strength) of astigmatism and gives you the near vision that TRULIGN® can. If you want to be free from glasses and greatly improve your astigmatism, TRULIGN is the lens for you.
One of the greatest advantages of the TRULIGN® Toric IOL is that it is designed to allow the eye to focus on objects at a range of distances not just at far away, as is the case with many monofocal lenses.
Comparison to other lens options:
Standard Monofocal Lens:
The standard monofocal IOL that is fully covered by most insurances can deliver improved vision, however this is only at one distance, usually far. As a result, patients who receive the standard monofocal lens implants after cataract surgery more often require glasses for near vision. This can even occur for patients who didn’t require glasses prior to cataract surgery.
Multi-focal lenses are a great option which can enable you to see well at all distances: far, intermediate, and near. The one downfall of the multi-focal lenses is that they cannot correct astigmatism, which affects nearly one in every three individuals.
Standard Toric Lens:
The standard toric IOL is a lens that corrects for any astigmatism one may have. In addition, it will deliver improved distance at one distance, usually far. As a result, you will most likely require glasses for intermediate and near vision. This option is recommended for people with a good amount of astigmatism in which cannot be corrected through the standard monofocal lens. The difference between the standard toric lens and the Trulign toric lens is that the Trulign lens can correct your near and intermediate vision.
Is TRULIGN Right For Me?
The best way to determine if you are a good candidate for TRULIGN® is to have a cataract consultation with one of our surgeons. Our cataract surgeons (Dr. Mario Di Pascuale) are both among the most experienced cataract surgeons in the country and have contributed to numerous publications on cataract surgery and the many new lens options that exist today. Both have been recognized by Premier Surgeon as one of the top 250 leading innovators in the field of Premium IOL surgery.
Cataract Surgery FAQ
What is a cataract?
When you are born your natural lens inside of your eye is clear. As you get older a cataract forms, the natural lens begins to ‘cloud’, which is also known as an opacification. While some environmental factors can cause cataracts, traditionally it is the normal aging process that causes changes in the lens, which cause it to become cloudy.
Left untreated, a cataract can become so dense that it causes blindness. In fact, cataracts are the leading cause of blindness in the world. The original meaning of cataract is ‘waterfall’ and the name was chosen because distorted vision caused by a cataract reminded people of the distorted view is obtained when looking through a waterfall.
Who gets cataracts?
Eventually everyone develops cataracts. They usually do not appear prior to 60 years of age, though there are cases of congenital cataracts (see below). Among the major conditions related to cataracts are diabetes or injury to the eye. Medications such as steroids can also cause cataract formation.
In rare cases, congenital cataracts are present at birth. These cataracts are usually related to the mother having German measles, chickenpox, or other infectious diseases during pregnancy or to the child having certain syndromes (e.g. Marfan’s). Some cataracts are inherited.
What are the symptoms of a cataract?
Typical Symptoms can include:
- Cloudy, fuzzy, foggy, or filmy vision
- Changes in the perception of colors
- Problems driving at night because headlights seem too bright
- Problems with glare from lamps or the sun
- Frequent changes in your eyeglass prescription
- Double vision
These symptoms can also be signs of other eye problems. If you have any of them, consult us here at Cornea and Cataract Specialty Center for an eye examination.
When should I decide to have cataract surgery?
Most people have plenty of time to decide about cataract surgery. Your doctor cannot make the decision for you, but talking with your doctor can help you decide.
Tell your doctor how your cataract affects your vision and your life. Read the statements below, see which ones apply to you, and tell your doctor if:
- I need to drive, but there is too much glare from the sun or headlights
- I do not see well enough to do my best at work
- I do not see well enough to do the things I need to do at home
- I do not see well enough to do things I like to do (for example, read, watch TV, sew, hike, play cards, and go out with friends)
- I am afraid I will bump into something or fall
- Because of my cataract, I am not as independent as I would like to be
- I cannot see well enough with my glasses
- My eyesight bothers me a lot
You may have other specific problems you want to discuss with your eye doctor
How can cataracts be treated?
The natural lens of the eye that has been damaged by a cataract is surgically removed and then replaced with a clear artificial lens. During the cataract removal surgery, usually done on an outpatient basis, a tiny incision is made in the eye and the cataract-damaged natural lens is removed through the incision. An artificial lens is then inserted through the same incision. Most patients have significantly improved vision after the procedure.
What are the benefits of cataract surgery?
Cataract surgery restores quality vision for millions of patients each year. Good vision is vital to an enjoyable lifestyle. Numerous research studies show that cataract surgery restores quality-of-life functions including reading, working, moving around, hobbies, safety, self-confidence, independence, daytime and nighttime driving, community and social activities, mental health, and overall life satisfaction.
What are the risks of cataract surgery?
Cataract surgery is performed millions of times every year in the United States. In fact, it is the most commonly performed surgery in the U.S. About 98 percent of patients have a complication-free experience that results in improved vision. Nevertheless, cataract surgery has risks and complications. Most complications resolve in a matter of days to months. In rare cases, patients lose some degree of vision permanently as a result of the surgery.
Is it still necessary to wear thick glasses after cataract surgery?
No. Today, cataract patients who have artificial or intraocular lenses (IOLs) implanted during surgery, may only need reading glasses for close vision. Patients who do not receive IOLs wear contact lenses for distance vision and reading glasses for close vision. Some patients choose to wear multifocal contact lenses for all distances.
Are there options if I do not want to wear glasses or contacts after surgery?
Yes. “Premium lenses” such as the Tecnis® multifocal lens and Crystalens® accommodating lens are FDA approved to significantly decrease or eliminate the need for reading glasses or multifocal contacts after surgery. Ask your doctor if you are a candidate.
How successful is cataract surgery?
Cataract surgery has an overall success rate of 98 percent. Continuous innovations in techniques and instruments allow cataract surgeons to treat more patients while keeping costs down and improving quality of patient care.
- Cataract Consultation – schedule your surgery dates
- A-Scan appointment
- Surgery (1 eye at a time)
- Post operative appointment (Day 1)
- Post operative appointment (Week 1)
- Post Operative appointment (Month 1)
- Post Operative appointment (Month 3)
- Post Operative appointment (Month 6)
* Optimal vision at 6 months
* Post operative appointments done by co-managing doctor (not surgeon)
What is an A-Scan Appointment for?
An A-Scan machine is an ultrasound device for diagnostic testing in ophthalmology practices. The A-Scan appointment determines eye length and shape of your eye before cataract surgery. These measurements helps your calculate and choose the best intra-ocular lens power for your lens.
Do I have to remove contact lenses?
Yes. Soft contact lenses (1) one week prior to A-scan appointment. Hard contacts 3 weeks prior to A-scan appointment.
Will I still have to pay co-pays?
Yes. Regardless if you choose the standard or premium lens you are still responsible for your insurance co-pay at every visit. Please be aware your insurance also has a surgery co-pay in which will be collected at the surgery center.
Does the procedure hurt?
No, it is a painless procedure. Local Anesthetic is used along with numbing drops.
When can I shower/work/play?
You can resume normal activities the following day. However, avoid direct water in the eyes and avoid heavy lifting over 20 lbs.
Should I stop blood thinners/other medications?
In general, No. You will be notified if change is required
Post Operative Glasses
Most insurances will have a post operative glasses benefit for you to use. Our office will let you know your glasses benefit at your post operative visit.