Cataracts

1) Everyone Gets Cataracts

2) Not Everyone Needs Cataract Surgery

Inside of your eye is a lens which is built like an onion – it has many layers.  The human lens has the highest concentration of protien of any part of your body and it is one of the first structures to be developed in your embryonic state.  For most people, the human lens is transparent when you are born and remains clear until about age 50 when the lens typically changes from clear to yellow to brown.  When it is too brown, less light gets through the lens to the back of your eye.  A good analogy is this: when you are born your lens is clear like water.  When you have advanced cataracts your lens is brown like chocolate milk – and you can’t see through chocolate milk!  You can get cataracts at any time in your life and you can be born with cataracts – but for most people most of the time, age 50 is when an optometrist or ophthalmologist can see and grade the discoloration of your lens.  The real truth though is this.  With cataract development, the human lens not only loses transparency but it also loses its elasticity.  So when people start to need reading glasses at age 40, that is actually the beginning of the cataract process.

What Causes Cataracts?

Cataract development is attributed to UV light exposure, dehydration, environmental chemical exposure, poor nutrican and to many medications such as steroids, diuretics (used to treat high blood pressure), and anti-cancer drugs.

Depending on which source you read, there are about 99 different types of cataracts.  But even so, cataracts are often classified in four categories (brunescent, cortical, nuclear, capsular).  The LOCS III grading system from Harvard Medical School grades cataract development into six different levels.  When a cataract gets to level four it becomes visually significant.  Cataract surgery is generally beneficial at level four or five.  As a rule-of-thumb – most 63 year olds are at about a level three.

Treatment

Most people can see through their cataracts for many years without requiring action.  They may experience a change in their eyeglass prescription from time to time.  Cataract surgery is generally not indicated until your vision drops off to about 20/40 best corrected vision – or if you become sensitive to bright lights and glare – or if you become frustrated with your quality of vision.  When necessary and appropriate, a cataract lens is surgically removed and an artificial lens is placed inside.  When that is complete, most people will find their world to be brighter, clearer and in its true colors.  Like any other surgery, cataract surgery is evolving.  Today, cataract surgery is the most common surgery in the world with the lowest rate of complications.  Because surgical outcomes are surgeon dependent, our clinic will have strong recommendations of who you should see to do your cataract surgery based on your individual needs.

Most eye surgeons ask you to decide what type of lens you want – sphere, toric, bifocal, mono-vision…. and you are not alone if you are frustrated that your eye surgeon did not adequately help you decide what implantable lens is best for you.  If you make an appointment with one of our doctors, we will take the time to fully explain the options you have and how your vision will be after cataract surgery.  In these cases, your surgery will still be with the surgeon you are scheduled with, but we will fully explain the lens options you have and what each will mean for your vision.

New Technologies

Today, most cataract replacement lenses are a “fixed focus” lens.  With that, most people enjoy clear distance vision after cataract surgery without the need for glasses but still need glasses to read.  The Ocumetics company is releasing a promising new cataract replacement lens that will allow people to see far away, upclose and midrange and never need glasses again at any distance for the rest of their life.  You can read about this promising technology at www.ocumetics.com/bioniclens.  It is anticipated that the Ocumetics Bionic Lens will not only be used to fix cataracts but it will also replace laser eye surgery.

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