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Cataracts - let's talk about this!

Let’s talk about cataracts!

Cataracts are one of the most common and treatable causes of vision loss in the world. Poor vision from cataracts affects over 60 percent of all people over 60. In fact, over one million Americans have cataracts removed every year making it one of the most common surgeries in America today. Surgery takes about 20 minutes per eye. One eye will be done with the following eye being done the next week to ensure quality care is given to prevent infection. Dr. Risma performs cataract surgery using small incision technique right here at Grant Regional Health Center in Lancaster.

Each birthday party we have, chemical changes occur causing the lens of our eye to become cloudy, forming what we call cataracts. A cataract is a painless, gradual clouding of the normally clear transparent crystalline lens inside the eye. Contrary to popular belief, they are not caused by eyestrain or wearing improper glasses. A cataract is something that is going to start to develop if we are lucky enough to live to the age of 60. However, when they develop, light transmission through the eye becomes increasingly scattered, causing vision clarity to decrease. Common symptoms include difficulty reading, while others have more trouble seeing in brightly lit conditions, such as being outside on a sunny day. Many people notice that colors are not as vivid, while most find night driving especially bothersome. Lights often seem to have a smoke-like appearance.

By using the latest techniques and most modern, high-tech equipment, Dr. Risma can perform the entire surgery through the smallest possible incision, providing greater safety, faster recovery and minimal post-operative restrictions. The small incision, often less than one-eighth of an inch, is made in the sclera (the white part of the eye) or cornea (the clear front layer of the eye). This incision is specially constructed to seal without stitches when the operation is completed. Next, he opens the lens capsule (capsulotomy), a clear membrane like a cellophane wrapper which surrounds the cataract-clouded lens.

Once the lens capsule is opened, the entire cataract inside is removed. We use a special ultrasonic surgical instrument called a phacoemulsifier to do this. This instrument vibrates more than 40,000 times each second, separating the cataract so, with gentle suction, it can be easily removed from the eye through the small incision.

Once the cloudy, natural lens has been removed, we need to restore the eye’s focusing power. Years ago, thick eyeglasses were used. Today, we insert intraocular lens implants into the eyes of nearly all our patients. These synthetic lenses, made of high-grade plastic or silicone material, are permanent and non-toxic. Since we use specially shaped or foldable implants, we can insert them through the small incision. Although you may need corrective eyeglasses after your surgery for activities such as reading, a strong prescription is generally not required.

Frequently Asked Questions about Cataracts

Are both eyes done at the same time?

No, each eye is operated on separately, usually about 1-4 weeks apart.

Am I asleep during the procedure?

No, you are awake the entire time. You will be given some medication to relax you during the surgery. In some cases, eye drops are the only anesthesia needed.

Will my glasses need to be changed?

Yes, your prescription will change following cataract surgery. In most cases, you will still require at least a reading prescription to do near work. If you still require a distance prescription after surgery, it will be a few weeks until the eye is stable enough to obtain this prescription. Your optometrist will provide this prescription for you. Wearing your old glasses in-between the first and second eye will not hurt either eye, however, some patients find it more comfortable to go without their glasses or even pop out a lens of the glasses before the second surgery is completed. If you plan on driving within a few days of surgery, ask your doctor.

How long does it take to recover and see again?

Eye surgery is like surgery on any other body part, there will be a period of recovery. Fortunately for cataract surgery, this time is minimal. Your vision will be blurry right after surgery. No two patients are the same, but most patients notice an improvement in their vision within the first few days of surgery. The eye typically takes a month to heal completely, but the majority of healing takes place within the first week. In most cases, the eye will be blurry for reading and near work. You will probably need help to see up-close and it is fine to use your old glasses for reading until the eye is stable enough for a custom glasses prescription (often this takes 3-4 weeks). The second eye may seem blurrier or even better than the first eye right after surgery. This is normal and the distance vision will usually improve with time.

Will it hurt?

No pain during the actual surgery. Most patients feel mild to moderate irritation for the first few days after surgery, “like an eyelash or a grain of sand” in the eye. This feeling should get better with each passing day. Artificial tears may be used as often as necessary to reduce irritation. It is important to remember that no two eyes are exactly the same, even if they are both your eyes! One eye may be more blurred, redder, and feel scratchier than the other after surgery. This is normal, as one eye may take a bit longer to heal than the other.

Can cataracts grow back?

Once removed, cataracts cannot return. In some cases, however, cloudiness (posterior capsule opacification) may occur in the lens capsule months or even years after the initial cataract surgery. To correct this, we use the beam of an ophthalmic laser to open the capsule. This procedure, using a high-tech YAG laser, is normally safe and painless and takes just a few minutes to complete.

Fuerste Eye Clinic at Grant Regional Health Center in Lancaster.

Tyler Risma, MD

Call 563-582-0769 for an appointment. Clinic open Tuesday, Wednesday, Thursday weekly.