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What You Should
Know
| What is a cataract? |
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A cataract is a clouding of the lens in the eye that
affects vision. Most cataracts are related to aging. Cataracts
are very common in older people. By age 80, more than
half of all Americans either have a cataract or have had
cataract surgery. A cataract can occur in either or both
eyes. It cannot spread from one eye to the other. |
| What is the lens? |
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The lens is a clear part of the eye that helps to focus
light, or an image, on the retina. The retina is the light-sensitive
tissue at the back of the eye.
In a normal eye, light passes through the transparent
lens to the retina. Once it reaches the retina, light
is changed into nerve signals that are sent to the brain.
The lens must be clear for the retina to receive a sharp
image. If the lens is cloudy from a cataract, the image
you see will be blurred. |
| How
do cataracts develop?
Age-related cataracts develop in two ways: |
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1 |
Clumps
of protein reduce the sharpness of the image reaching
the retina.
The lens consists mostly of water and protein. When the
protein clumps up, it clouds the lens and reduces the light that reaches
the retina. The clouding may become severe enough to cause blurred vision.
Most age-related cataracts develop from protein clumpings.
When a cataract is small, the cloudiness affects only
a small part of the lens. You may not notice any changes
in your vision. Cataracts tend to "grow" slowly,
so vision gets worse gradually. Over time, the cloudy
area in the lens may get larger, and the cataract may
increase in size. Seeing may become more difficult.
Your vision may get duller or blurrier. |
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2 |
The clear lens slowly changes to a yellowish/brownish color,
adding a brownish tint to vision.
As the clear lens slowly colors with
age, your vision gradually may acquire a brownish shade.
At first, the amount of tinting may be small and may
not cause a vision problem. Over time, increased tinting
may make it more difficult to read and perform other
routine activities. This gradual change in the amount
of tinting does not affect the sharpness of the image
transmitted to the retina.
If you have advanced lens discoloration, you may not
be able to identify blues and purples. You may be wearing
what you believe to be a pair of black socks, only to
find out from friends that you are wearing purple socks. |
Who is at risk for
cataract?
The risk of cataract increases, as you get older.
Other risk factors for cataract include: |
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Certain diseases (for example, diabetes). |
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Personal behavior (smoking, alcohol use). |
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The environment (prolonged exposure to ultraviolet sunlight). |
What are the symptoms
of a cataract?
The most common symptoms of a cataract are: |
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Cloudy or blurry vision. |
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Colors seem faded. |
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Glare. Headlights, lamps, or sunlight may appear
too bright. A halo may appear around lights. |
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Poor night vision. |
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Double vision or multiple images in one eye.
(This symptom may clear, as the cataract gets larger.) |
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Frequent prescription changes in your eyeglasses
or contact lenses. |
| These symptoms also can be a sign of
other eye problems. If you have any of these symptoms,
check with your eye care professional. |
Are there other types
of cataract?
Yes. Although most cataracts are related to aging,
there are other types of cataract: |
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Secondary cataract.
Cataracts can form after surgery for other eye problems, such as glaucoma.
Cataracts also can develop in people who have other health problems, such
as diabetes. Cataracts are sometimes linked to steroid use. |
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Traumatic cataract.
Cataracts can develop after an eye injury, sometimes years later. |
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Congenital cataract.
Some babies are born with cataracts or develop them in childhood, often
in both eyes. These cataracts may be so small that they do not affect vision.
If they do, the lenses may need to be removed. |
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Radiation cataract.
Cataracts can develop after exposure to some types of radiation. |
How is a cataract
detected?
Cataract is detected through a comprehensive eye exam
that includes: |
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Visual acuity test.
This eye chart test measures how well you see at various distances. |
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Dilated eye exam.
Drops are placed in your eyes to widen, or dilate, the pupils. Your eye
care professional uses a special magnifying lens to examine your retina
and optic nerve for signs of damage and other eye problems. After the exam,
your close-up vision may remain blurred for several hours. |
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Tonometry.
An instrument measures the pressure inside the eye. Numbing drops may be
applied to your eye for this test. |
Your eye care professional also may do
other tests to learn more about the structure and health
of your eye. |
| How is a cataract treated? |
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The symptoms of early cataract may be
improved with new eyeglasses, brighter lighting, anti-glare
sunglasses, or magnifying lenses. If these measures do
not help, surgery is the only effective treatment. Surgery
involves removing the cloudy lens and replacing it with
an artificial lens. |
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A
cataract needs to be removed only when vision loss interferes
with your everyday activities, such as driving, reading,
or watching TV. You and your eye care professional
can make this decision together. Once you understand the
benefits and risks of surgery, you can make an informed
decision about whether cataract surgery is right for you.
In most cases, delaying cataract surgery will not cause
long-term damage to your eye or make the surgery more
difficult. You do not have to rush into surgery. |
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Sometimes a cataract should be removed
even if it does not cause problems with your vision. For
example, a cataract should be removed if it prevents examination
or treatment of another eye problem, such as age-related
macular degeneration or diabetic retinopathy. |
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If you choose surgery, your eye care
professional may refer you to a specialist to remove the
cataract. |
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If you have cataracts in both eyes that
require surgery, the surgery will be performed on each
eye at separate times, usually four to eight weeks apart. |
Surgery
| Is cataract surgery effective? |
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Cataract removal is one of the most common
operations performed in the United States. It also is
one of the safest and most effective types of surgery.
In about 90 percent of cases, people who have cataract
surgery have better vision afterward. |
Are there different
types of cataract surgery?
There are two types of cataract surgery. Your doctor
can explain the differences and help determine which
is better for you: |
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Phacoemulsification,
or phaco. A small incision is made on the side of the cornea, the
clear, dome-shaped surface that covers the front of the eye. Your doctor
inserts a tiny probe into the eye. This device emits ultrasound waves that
soften and break up the lens so that it can be removed by suction. Most
cataract surgery today is done by phacoemulsification, also called "small
incision cataract surgery." |
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Extracapsular surgery.
Your doctor makes a longer incision on the side of the cornea and removes
the cloudy core of the lens in one piece. The rest of the lens is removed
by suction. |
After the natural lens has been removed,
it often is replaced by an artificial lens, called an
intraocular lens (IOL). An IOL is a clear, plastic lens
that requires no care and becomes a permanent part of
your eye. Light is focused clearly by the IOL onto the
retina, improving your vision. You will not feel or see
the new lens.
Some people cannot have an IOL. They may have another
eye disease or have problems during surgery. For these
patients, a soft contact lens, or glasses that provide
high magnification, may be suggested. |
| What are the risks of cataract surgery? |
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As with any surgery, cataract
surgery poses risks, such as infection and bleeding. Before
cataract surgery, your doctor may ask you to temporarily
stop taking certain medications that increase the risk
of bleeding during surgery. After surgery, you must keep
your eye clean, wash your hands before touching your eye,
and use the prescribed medications to help minimize the
risk of infection. Serious infection can result in loss
of vision. |
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Cataract surgery slightly
increases your risk of retinal detachment. Other eye disorders,
such as high myopia (nearsightedness), can further increase
your risk of retinal detachment after cataract surgery.
One sign of a retinal detachment is a sudden increase
in flashes or floaters. Floaters are little "cobwebs"
or specks that seem to float about in your field of vision.
If you notice a sudden increase in floaters or flashes,
see an eye care professional immediately. A
retinal detachment is a medical emergency. If necessary,
go to an emergency service or hospital. Your eye must
be examined by an eye surgeon as soon as possible. A
retinal detachment causes no pain. Early treatment
for retinal detachment often can prevent permanent loss
of vision. The longer the retina stays detached, the less
likely you will regain good vision once you are treated.
Even if you are treated promptly, some vision may be lost. |
| Talk to your eye care professional about
these risks. Make sure cataract surgery is right for you. |
| What if I have other eye conditions and
need cataract surgery? |
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Many people who need cataract surgery also have other
eye conditions, such as age-related macular degeneration
or glaucoma. If you have other eye conditions in addition
to cataract, talk with your doctor. Learn about the risks,
benefits, alternatives, and expected results of cataract
surgery. |
| What happens before surgery? |
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A week or two before surgery, your doctor will do some
tests. These tests may include measuring the curve of
the cornea and the size and shape of your eye. This information
helps your doctor choose the right type of IOL. You may
be asked not to eat or drink anything 12 hours before
your surgery. |
| What happens during surgery? |
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At the hospital or eye clinic, drops will be put into
your eye to dilate the pupil. The area around your eye
will be washed and cleansed.
The operation usually lasts less than one hour and is
almost painless. Many people choose to stay awake during
surgery. Others may need to be put to sleep for a short
time. If you are awake, you will have an anesthetic to
numb the nerves in and around your eye.
After the operation, a patch may be placed over your eye.
You will rest for a while. Your medical team will watch
for any problems, such as bleeding. Most people who have
cataract surgery can go home the same day. You will need
someone to drive you home. |
| What happens after
surgery? |
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Itching and mild discomfort are normal after cataract
surgery. Some fluid discharge is also common. Your eye
may be sensitive to light and touch. If you have discomfort,
your doctor can suggest treatment. After one or two days,
moderate discomfort should disappear.
For a few days after surgery, your doctor may ask you
to use eye drops to help healing and decrease the risk
of infection. Ask your doctor about how to use your eye
drops, how often to use them, and what effects they can
have. You will need to wear an eye shield or eyeglasses
to help protect your eye. Avoid rubbing or pressing on
your eye.
When you are home, try not to bend from the waist to pick
up objects on the floor. Do not lift any heavy objects.
You can walk, climb stairs, and do light household chores.
In most cases, healing will be complete within eight weeks.
Your doctor will schedule exams to check on your progress.
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| Can problems develop after surgery? |
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Problems after surgery are rare, but they can occur.
These problems can include infection, bleeding, inflammation
(pain, redness, swelling), loss of vision, double vision,
and high or low eye pressure. With prompt medical attention,
these problems usually can be treated successfully.
Sometimes the eye tissue that encloses the IOL becomes
cloudy and may blur your vision. This condition is called
an after-cataract. An after-cataract can develop months
or years after cataract surgery.
An after-cataract is treated with a laser. Your doctor
uses a laser to make a tiny hole in the eye tissue behind
the lens to let light pass through. This outpatient procedure
is called a YAG laser capsulotomy. It is painless and
rarely results in increased eye pressure or other eye
problems. As a precaution, your doctor may give you eye
drops to lower your eye pressure before or after the procedure.
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| When will my vision be normal again? |
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You can return quickly to many everyday activities,
but your vision may be blurry. The healing eye needs
time to adjust so that it can focus properly with the
other eye, especially if the other eye has a cataract.
Ask your doctor when you can resume driving.
If you received an IOL, you may notice that colors are
very bright. The IOL is clear, unlike your natural lens
that may have had a yellowish/brownish tint. Within
a few months after receiving an IOL, you will become
used to improved color vision. Also, when your eye heals,
you may need new glasses or contact lenses. |
What You Should Do
| What can I do if I already
have lost some vision from cataract? |
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If you have lost some sight
from cataract or cataract surgery, ask your eye care professional
about low vision services and devices that may help you
make the most of your remaining vision. Ask for a referral
to a specialist in low vision. Many community organizations
and agencies offer information about low vision counseling,
training, and other special services for people with visual
impairments. A nearby school of medicine or ophthalmology
may provide low vision services. |
| What research is being
done? |
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The National Eye Institute is conducting
and supporting a number of studies focusing on factors
associated with the development of age-related cataract.
These studies include: |
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The effect of sunlight exposure, which may
be associated with an increased risk of cataract. |
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Vitamin supplements, which have shown varying
results in delaying the progression of cataract. |
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Genetic studies, which show promise for better
understanding cataract development. |
| What can I do to protect
my vision? |
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Wearing sunglasses and a hat with a brim to
block ultraviolet sunlight may help to delay cataract. If you smoke, stop.
Researchers also believe good nutrition can help reduce the risk of age-related
cataract. They recommend eating green leafy vegetables, fruit, and other
foods with antioxidants. |
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If you are age 60 or older, you should have
a comprehensive dilated eye exam at least once every two years. In addition
to cataract, your eye care professional can check for signs of age-related
macular degeneration, glaucoma, and other vision disorders. Early treatment
for many eye diseases may save your sight. |
What You Should Ask
| What should I ask my eye care professional? |
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You can protect yourself against vision
loss by working in partnership with your eye care professional.
Ask questions and get the information you need to take
care of yourself and your family. |
| What are some questions to ask... |
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About my eye disease or disorder... |
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What is my diagnosis? |
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What caused my condition? |
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Can my condition be treated? |
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How will this condition affect my vision now
and in the future? |
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Should I watch for any particular symptoms
and notify you if they occur? |
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Should I make any lifestyle changes? |
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About my treatment... |
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What is the treatment for my condition? |
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When will the treatment start and how long
will it last? |
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What are the benefits of this treatment and
how successful is it? |
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What are the risks and side effects associated
with this treatment? |
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Are there foods, drugs, or activities I should
avoid while I'm on this treatment? |
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If my treatment includes taking medicine, what
should I do if I miss a dose? |
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Are other treatments available? |
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About my tests... |
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What kinds of tests will I have? |
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What can I expect to find out from these tests?
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When will I know the results? |
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Do I have to do anything special to prepare
for any of the tests? |
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Do these tests have any side effects or risks?
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Will I need more tests later? |
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Other suggestions: |
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If you don't understand your eye care professional's
responses, ask questions until you do understand. |
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Take notes or get a friend or family member
to take notes for you. Or, bring a tape recorder to help you remember the
discussion. |
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Ask your eye care professional to write down
his or her instructions to you. Ask for printed material about your condition. |
| If you still have trouble understanding
your eye care professional's answers, ask where you
can go for more information. Other members of your health
care team, such as nurses and pharmacists, can be good
sources of information. Talk to them, too. Today, patients
take an active role in their health care. Be an active
patient about your eye care. |
For
More Information.
| For more
information about cataract, you may wish to contact: |
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American Academy
of Ophthalmology*
P.O. Box 7424
San Francisco, CA 94120-7424
415-561-8500
www.aao.org |
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American Optometric
Association*
243 North Lindbergh Boulevard
St. Louis, MO 63141-7851
314-991-4100
www.aoa.org |
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National Eye
Institute*
National Institutes of Health
2020 Vision Place
Bethesda, MD 20892-3655
301-496-5248
E-mail: 2020@nei.nih.gov
www.nei.nih.gov |
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Prevent Blindness
America
500 East Remington Road
Schaumburg, IL 60173-4557
1-800-331-2020
847-843-2020
E-mail: info@preventblindness.org
www.preventblindness.org |
| For more
information about IOLs, contact: |
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U.S. Food and
Drug Administration
Office of Consumer Affairs
Parklawn Building (HFE-88)
5600 Fishers Lane
Rockville, MD 20857
1-888-463-6332
www.fda.gov |
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American Foundation
for the Blind
11 Penn Plaza, Suite 300
New York, NY 10011-2006
1-800-232-5463
212-502-7600
E-mail: afbinfo@afb.net
www.afb.org |
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Council
of Citizens with Low Vision International
1-800-733-2258
Lighthouse International
111 East 59th Street
New York, NY 10022-1202
1-800-334-5497
For more information about low vision services and
programs, you may wish to contact:
1-800-829-0500
212-821-9200
212-821-9713 (TDD)
E-mail: info@lighthouse.org
www.lighthouse.org |
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National Association
for Visually Handicapped
22 West 21st Street, 6th Floor
New York, NY 10010-6943
212-889-3141
www.navh.org |
| * These
organizations also provide information on low vision. |
The National Eye Institute
(NEI), part of the National Institutes of Health (NIH),
is the Federal government's principal agency for conducting
and supporting vision research. Inclusion of an item in
this publication does not imply the endorsement by the
NEI or the NIH.
http://www.nei.nih.gov/ |
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Testimonials.
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Each and every person I came in contact with made me feel special and cared for.
- G.S. age 35, male.
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Office of Dr. Don Pegueros OD at 4527 Mattos Drive, Fremont, CA 94536 is accessible from:
Fremont, Union City, Hayward, Newark, Sunol.
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