Cataracts & Surgery (Eyes)


A cataract is an area of cloudiness in the lens of the eye, and the result is that light is blocked from entering the eye. Cataracts grow slowly over time and will cause progressive vision loss. Cataracts most often develop in people over 50; about 70% of those 75 and older have cataracts that affect their vision. The reasons age-related cataracts develop are not well understood. Many people with cataracts have no change in their vision, but once the cloudy area in the lens becomes large enough, it can cause blurred or cloudy vision, poor night vision, and sensitivity to glare. People with cataracts make frequent changes in their eyeglass prescription. Surgery is the treatment for cataracts that interfere with the ability to safely perform and enjoy everyday activities, such as driving, cooking, reading, or watching television. The clouded lens is removed and replaced by a permanent lens implant. Cataract surgery is done under local anesthetic on an outpatient basis. It is a very safe procedure and, in almost all cases, restores clear vision.

Almost All Cataract Surgery Is Successful

Cataracts develop slowly, and it may take years before one causes vision to be poor enough to warrant surgery. When it does make vision poor, an ocular implant restores vision.

Most cataracts are related to the aging process. Less often, cataracts can form in younger people or can even be present at birth. Cataracts in adults form slowly and painlessly. They are usually noticed first during an eye examination. In the early stages, the cataract often does not have an effect on vision. As it progresses, visual problems may send the patient to an eye doctor (ophthalmologist) to find the cause of the eye discomfort. Commonly, a patient with cataracts may complain of fuzzy vision or double vision, poor night vision, or glare or halos from bright lights, lamps, or the sunlight. Patients often visit their eye doctor to request a new eyeglass prescription to correct the problem. Contrary to popular belief, cataracts are not caused by excess reading or close work and do not spread from one eye to the other.

Risks for Cataract Formation: Cataract formation is quite common, with about one half of people ages 65 to 74 suffering from some degree of vision change due to this cloudiness of the lens. The risk of developing cataracts is increased if there is a history of cataracts in the family, or if the patient has a chronic disease such as diabetes. Catatacts may form after an eye injury or if previous eye surgery has been performed. It is also thought that chronic exposure to sunlight without eye protection can increase the risk of cataract formation. Certain drugs, such as corticosteroids taken for a long period of time, can increase the risk of cataracts. Once a cataract is diagnosed, it may take many years before it worsens to the point where vision is poor and surgery is necessary. The rate of cataract development varies with each person and is difficult to predict. Protecting the eyes from ultraviolet light with sunglasses or an anti-UV coating on regular eyeglasses may help slow rhe progression of cataracts.

Treatment: Cataract surgery is a routine procedure in the U.S., with over 1.4 million surgeries each year. More than 95% of these procedures are successful and result in improved vision. Many patients no longer require glasses for distance afrer cataract surgery, although they may still need reading glasses. For most people, cataract surgery is an outpatient procedure performed under a local anesthetic. Before the procedure, the eye is measured to determine the lens needed for vision correction. During the surgery, the cloudy lens is removed and an intraocular lens is permanently implanted. In most cases, the back of the lens, called the posterior capsule, remains in place. If at some point this capsule becomes cloudy, it may require separate laser surgery to restore clear vision. After surgery, a covering is worn over the eye. Medicated eyedrops are prescribed, and return visits are scheduled to ensure the eye is healing properly.

Complications of Surgery: Although cataract surgery is safe and successful in most cases, there is a small chance of complications. After surgery, it is important that the patient follow special instructions from the eye doctor. These instructions explain how and when to use the prescribed eyedrops and usually advise the patient to avoid rubbing the eye or performing strenuous physical activity. Some patients are prescribed pain medication. The ophthalmologist will tell the patient when to remove the eye covering, wear glasses, or begin driving. Although not likely, rare complications such as bleeding, swelling, and infection can occur after surgery. It is very important to notify the ophthalmologist at the first sign of any unusual symptoms after surgery, such as intense pain that is not relieved by pain medication, or a loss of vision.

Your pharmacist can show you the proper way to instill eyedrops and answer any questions you may have about medications used to treat pain after cataract surgery.

US PharmacistCopyright 2003 Jobson Publishing, LLC