Treatments for cataracts

by Kaiser Permanente |
An optometrist holds up glasses for a senior man and his wife, in an optometrist's office

What Is a Cataract?

The natural lens in your eye is normally clear. This lens focuses light rays onto the retina at the back of the eye, like a camera. A cataract is the clouding of this lens. It can scatter or block light coming into your eye. This prevents your eye from focusing clearly, which can lead to:

  • Blurry vision
  • Double vision in one eye
  • Glare or sensitivity to light
  • Needing frequent prescription changes
  • Poor night vision that can, in some cases, present as glare or halos

Cataract surgery is a common and safe type of surgery to treat this condition.

Causes of Cataracts

Cataracts are often part of the normal aging process. Most cataracts progress slowly. It can take months or years before they affect your vision. Along with aging, other factors that can cause cataracts include:

  • Long-term exposure to sunlight
  • Certain medical conditions, such as diabetes and eye trauma
  • Smoking
  • Some medications, mainly long-term use of injected, oral, or inhaled steroids

Protecting your eyes from sunlight can help. Wear sunglasses that filter out ultraviolet (UV) rays or clear glasses with an anti-UV coating.

Treatments for Cataracts

There are vision aids that can help your symptoms and reduce the impact they have on your daily life. These include:

  • New prescription glasses
  • A good, bright light for reading
  • Magnifying aids

Cataract surgery is very successful and improves vision for most people. We may recommend surgery if:

  • Vision loss is more severe
  • The cataract affects your ability to continue with your daily activities
  • Your eye is at risk for other complications

Cataract Surgery

Cataract surgery is an outpatient procedure and does not need a hospital stay. During the surgery, we’ll give you medications to numb your eye and help you relax during the procedure, but you’ll remain awake.

Selecting the lens implant

Before surgery, we measure your eye and talk about the best type of implant for you.

Removing the cataract

During cataract surgery, we:

  • Remove the cloudy, natural lens using a method known as phacoemulsification. This uses high-pitch sound vibrations to break the cataract into particles. These are then removed.
  • Replace the cloudy lens with an artificial intraocular lens (IOL) implant. The IOL helps your eye focus after it’s healed.

Recovering at home

After your surgery and a short stay in the surgery center, you’ll go home. You’ll receive specific instructions to help you recover from surgery.

Intraocular Lens Implant

We will place the intraocular lens (IOL) implant in your eye during surgery. It stays there permanently to focus the light entering your eye. Modern IOLs block ultraviolet (UV) light from the sun to protect your retina. We measure your eye before surgery to determine the best type of IOL for you. IOLs may be monofocal, toric, or presbyopia-addressing.

Monofocal lens

A monofocal lens can focus images in either the far, intermediate (computer), or near (reading) distance. It cannot correct all 3 distances. For example:

  • If we select a monofocal lens for far vision, you’ll still need glasses to see intermediate and near distances.
  • If we use a monofocal for near vision, you’ll still need glasses to see clearly at far and intermediate distances.

Sometimes, we can correct one eye for far and the other eye for intermediate or near vision. This is called monovision. It can reduce your need for glasses, although it will affect your depth perception and can take a few months to adapt. Monofocal lenses cannot correct for astigmatism (blurry vision).

Toric lens

This lens can help reduce the amount of astigmatism and your need for glasses for far vision. You’ll still need glasses for intermediate and near vision unless we use monovision.

Presbyopia-addressing lens

Presbyopia-addressing lenses help you focus on more than one working distance at a time and reduce your need for glasses. There are 2 types:

  • Multifocal lenses. These lenses help you see far, plus near or intermediate (or both) working distances by providing more than one point of focus like a trifocal.
  • Extended depth of field (EDOF) lenses. These lenses stretch your range of focus from far to intermediate or even closer working distances.

Both types can also reduce low levels of astigmatism. We’ll measure your eyes to help your surgeon recommend the lens that is best for you. Presbyopia-addressing lenses are amazing technology, but they aren’t ideal for everyone. Your doctor will let you know if they’re compatible with your specific vision needs and medical conditions. Note that some lens types are not covered by your health plan benefits and have an out-of-pocket cost.

What Are the Risks of Cataract Surgery?

As with all surgery, complications can occur. There is a very small possibility of:

  • Infection
  • Bleeding
  • Inflammation
  • Glaucoma
  • Retinal detachment
  • Swelling in the retina or cornea
  • Blindness

The natural lens of the eye is in a bag-like structure called a capsule. When we remove the cloudy lens, we leave this capsule in place to hold the IOL in position. Sometimes the capsule can become cloudy months or years after cataract surgery. If you have blurry vision after cataract surgery, let us know. We may need to do an in-office procedure, called a YAG capsulotomy, to clear the cloudiness.

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