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Cataracts

The eye's natural lens is located in the eye behind the iris and the pupil. This lens works much like a camera lens, focusing light onto the retina at the back of the eye. It helps us to focus on things up close and far away. Clouding of this natural lens is called a cataract.

Our natural lens is made mostly of water and protein. In our early years, lens is clear and light passes through it easily. However, as we age, some of the protein may clump together and start to cloud the lens and start to develop into a cataract. As time passes, the lens may become even cloudier, further impairing your vision.

There are three types of cataracts. A nuclear cataract is formed as a part of the natural aging process. It forms in the center of the natural lens. When a nuclear cataract first develops it often brings temporary improvement to your near vision, called "second sight." Unfortunately, the improved vision will disappear as the cataract worsens. A cortical cataract may be developed by some people with diabetes. Spokes of opacity start at the outside edge of the lens and extend inward toward the center. A subcapsular cataract begins at the back of the lens. People with various eye health problems such as retinitis pigmentosa and diabetes may form this type of cataract, as might people who are taking high doses of steroids.

When a cataract begins to form, it may be barely noticeable. If the cloudiness is not near the center of the lens, you may not be aware that a cataract is present. But as time passes, you may become aware of changes in your vision.

Common symptoms of cataracts may include one or more of the following:

- A painless blurring of vision
- Glare, or light sensitivity in sunlight or from oncoming headlights
- Frequent eyeglass prescription changes
- Double vision in one eye
- Needing brighter light to read
- Poor night vision
- Fading or yellowing of colors

If you are experiencing these symptoms, please make an appointment with your eye doctor so that a comprehensive eye exam may be performed. Should you have a cataract, you and your eye doctor can make good decisions together about your eye health.

Cataract Surgery
Dr. Scott Jaben has been performing cataract surgery since 1979. Cataract surgery is one of the most commonly performed surgeries in the United States. For years, monofocal lens implants have been available to correct distance vision, however, patients still need glasses to read. Some of these lenses also have the ability to block both ultraviolet and blue light rays which may damage the retina.
The first multifocal implants were used in the US in the 1980s. These lenses improve both distance and near vision without the aid of glasses. Dr. Jaben was the first surgeon to use the AMO Array multifocal implant in the Charlotte area in 1997. The newest multifocal lens implant, Acrysof® ReSTOR®, introduces the newest technology to date and received FDA approval in 2005. This technology was developed by Alcon Surgical and uses an optical technique called apodized diffraction to achieve correction for both distance and near vision activities. Dr. Jaben has been trained to use this new lens and has implanted patients with excellent results. Now that you know a little about the lenses, let's discuss the surgery.

When cataract symptoms appear, visual aids such as new glasses, strong bifocals, magnification, and appropriate lighting may help improve your vision for a while. If you are seeing well enough using any of these vision aids with your present level of vision, it is appropriate to leave the cataracts alone for as long as you wish. Cataracts tend to get cloudier with time and make your vision worse. However, it is difficult to reliably predict how quickly and to what degree they may worsen. If you are having trouble seeing to perform your daily activities and either need or want to improve your vision, then the cataracts may be removed at any time. Whether the cataracts are removed in an early stage or a later stage, both the results and the risks of the surgery will be the same. It is not true that cataracts need to be ripe before they can be removed.

You and your doctor should discuss the surgery and, when you are ready, the two of you will decide which lens, the monofocal or multifocal, is appropriate for your lifestyle. Remember, the procedure is a simple, relatively painless procedure to improve your vision. In surgical outcome surveys, nine out of 10 people who have cataract surgery regain very good vision, somewhere between 20/20 and 20/40. And 80% of people choosing the ReSTOR® multifocal lens implant are completely spectacle independent for life's daily activities.

Cataract surgery is usually performed at an outpatient surgical facility. You may be at the facility for a few hours, but the surgery usually takes less than 10 to 15 minutes. During surgery, the surgeon will remove your clouded lens by making a small incision in your eye. A tiny instrument breaks up and gently removes your clouded lens, leaving the lens capsule. Dr. Jaben uses the new Infiniti Vision System by Alcon. This high-tech instrument offers the surgeon two ways to remove your cataract: with gentle pulses of fluid called Aqualase or with ultrasonic waves called Phacoemulsification. Once the clouded lens is removed, the clear, plastic intraocular lens (IOL) will be inserted back into your eye's lens capsule through the same incision that removed your natural lens. Patients may notice improved vision almost immediately but every patient should expect that it may take 2 to 3 weeks for the vision to stabilize and usually, if needed, new glasses are fitted at about one month after surgery.

Before leaving the surgery center, you will receive specific post-operative instructions. You will be asked to use special eye drops to prevent infection and help with healing. You may also be asked to wear clear eye shields when you sleep to prevent accidental rubbing of the eye. Non-prescription pain medication may be taken if necessary. Dr. Jaben sees his patients for post-operative care the day after surgery in his SouthPark, Monroe or Huntersville offices.

Usually only one eye is operated on at a time. Most people schedule surgery for their second eye within 1 to 6 weeks. You and your eye surgeon can determine a time frame that is appropriate for you. Depending on your eye's health, routine activities can begin the day following surgery in most cases.

Driving is restricted until your doctor gives you permission to return to the road.

copyright Scott L. Jaben, M.D.