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Cataracts & What to Expect?

What is a Cataract?

A cataract is an eye condition that develops slowly as we age. All of us have a lens in our eye to help focus the light or an image onto our retina, so we can see.  As over time as we get older, the protein around the lens will start to clump together and cloud the lens.  This protein growth and clouding on the lens is called a cataract.

At the early stages of cataracts, a new eyeglasses prescription, brighter lighting, and anti-glare sunglasses may help.  However, over time the cataract will grow larger and cloud more of the lens. Then, the only effective way to remove the cataract is to remove the lens.  Your cataract surgeon will remove the clouded lens and replace the old lens with a new one.  This is where the fun begins, choosing your new lens.  This new lens will greatly improve your vision.  At Pacific Eye Associates, we have access to the newest and best lenses available.  There are three different lenses to choose from and determining which correct lens for your eyes is important for your visual outcome.

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What are the Symptoms?


  • Blurry, cloudy vision
  • Increased sensitivity to glare, especially from the sun or oncoming car headlights
  • A sudden, temporary improvement in vision of close objects called second sight
  • Sudden inability to focus on far away objects, known as nearsightedness
  • Changes in perception of color, particularly yellow tones
  • Double vision

What to expect during a Cataract Consultation?


 

First, the technicians will review your medical history and symptoms, and perform a routine eye examination. The eye exam will measure how well you can read the series of letters and if your eyes show signs of impairment.  The technician may ask whether or not if you’ve had any difficulties with your eyesight.  After the routine eye exam has been completed, your doctor’s technician will dilate your pupils.  It’s not uncommon for the technician to guide you back to the waiting room as you dilate.

Next, you’ll meet your doctor.  Your doctor will check the lens and the health of your eyes using different instruments.  With these different instruments and devices, your eye doctor will examine the front structures, as well as, the back interior of your eye, to detect any abnormalities.

If your vision can be corrected with glasses or contacts, then your doctor will provide prescription glasses to clear your vision. If your vision can’t be corrected with glasses or contacts, then cataract surgery will most likely be the solution. 

Cataract Surgery at Pacific Eye Associates


If cataract surgery is the right option for you, then the next steps will be determining which clear artificial lens is the right choice for you and your lifestyle.  Cataracts surgery involves removing the clouded lens and replacing it with a clear lens.  These new clear lenses are often times referred to as Intraocular Lens (IOLs). 

Cataract surgery is a simple and safe procedure that is quick and relatively pain-free.  The doctor will make a small incision to break up and remove the cataract.  Remember, in order to remove your cataract means that your old lens will be removed.  This step may sound intimidating, but there are different ways to move the cataract / your old lens depending on your cataract, eyesight and lens chosen. 

Depending on the type of your cataract, the lens removal may be in one of the following ways:

  • Phacoemulsification: A very small incision is made and your doctor uses a tool that produces sounds waves to break up the cataract into small pieces.  Then, the small pieces are sectioned out.  
  • Extracapsular Extraction: Depending on the cataract and the circumstances, your doctor may remove your cataract in one piece. This option uses a larger incision. 
  • Refractive Laser-Assisted Cataract Surgery (ReLACS): In this option, your doctor will guide a machine that uses a femtosecond laser to make the incisions.  This laser will also soften and break up the cataract.  Then like, phacoemulsification, your doctor will use a small tool to any remove the cataract with sound waves. 

Most patients are back to their normal activities and lifestyle the very next day.  The surgery does not require an overnight stay, the procedure itself takes around 30 minutes, and the whole process takes only one to two hours.  Usually, just one eye is done.  If you have cataracts in both eyes, your doctors may suggest waiting at least 1 to 2 weeks between each surgery. 

Replacement Lens Options 


Once your doctor removes your old lens, a new lens is gently placed into your eye.  With technology and advances in medicine, there are now many different types of lenses to choose from.  With the right lens, you may greatly improve your vision and reduce your dependency on glasses.  In fact, many of our patients are able to see as well as they did during their youth.  At your cataract consultation, you and your doctor will discuss your lens option in detail so you can choose the right one for your lifestyle and vision goals. 

Monofocal Lens (IOL):  These IOLs have one point of clear focus.  The one point of focus will usually give you clear distance vision, but you will need glasses for near and intermediate vision. 

Multifocal Lens (IOL): These lenses will have more than one point of focus.  Multifocal lenses may correct near, far and in-between vision, which will lead to less dependency on glasses. There are many different types of multifocal lens. Depending on your eyes, eyesight and your vision outcome, one of the following multifocal lens below will be fitting into your eye.  

Bifocal Intraocular Lens (IOL) Example
  • Bifocal Diffractive IOLs
    Bifocal diffractive IOLs provide two distinct images at a near and far point.  The center of a bifocal diffractive lens is surrounded by tiny concentric rings. These tiny concentric rings will decrease in height, which will result in the diffraction of light at both distance and near.  Bifocal diffractive lenses are similar to contact lenses because near and far add powers are available through the bifocal lens depending on your vision.
  • Refractive IOLs
    Refractive IOLs are lenses that have multiple focal points that allow for viewing at all distances.  The progressive silicone IOL consists of five concentric zones alternating between distance- and near- viewpoint.  In addition to the first generation, there is a second-generation refractive IOL available, that enhanced some aspects of the distance and near viewpoints, such as enlargement of certain parts your vision so that visual disturbances could be reduced.

Extended Depth of Focus Lens (IOLs): Extended depth of focus (EDF) IOLs are a newer category of lenses that aims to create a single elongated focal point to enhance a range of vision.  Intermediate vision is improved compared to standard bifocal multifocal IOLs, but near vision may only be modestly improved.  While EDF IOLs sounds like the easy choice because of the elongated focal point, this lens option is not for everyone.  Many people may experience a unique visual phenomenon typically described as “starbursts.”

Accommodative IOLs: The lens is placed and fitted with the eye in such a way that the lens will flex with the muscle of the eyes.  Because of the unique way this IOL is fitted within your eye, this lens will imitate your natural lens and changing power in response to how you view the world.  Patients may still require reading glasses for near vision. 

Imagine being able to read your smartphone or tablet, drive at night or play golf all without worrying about glasses.  Like we mentioned before, cataract surgery is actually quite an exciting procedure.  With so many different lenses to choose from precise vision is at your fingertips at Pacific Eye Associates. Take our IOL test to discover which IOL may be right for you. 

Take Our IOL Test

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415-923-3007

2100 Webster St, San Francisco, CA 94115