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Cataract Treatment

Your Options for Cataract Treatment

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Updated June 26, 2014

If you are diagnosed with a cataract, there are other treatment options that can be considered before surgery to replace your clouded lens. Cataract treatment consists of both non-surgical methods of improving symptoms of vision deterioration as well as surgical removal of the cataract. You and your eye doctor should develop a cataract treatment plan based on the type and severity of your cataracts. Below are several methods of cataract treatment.

Non-surgical Cataract Treatment

Early cataract treatment is aimed at improving your quality of vision. When cataract symptoms appear, you may experience cloudy or blurry vision, light sensitivity, poor night vision, double vision, and changes in your eyewear prescription. Certain changes can significantly reduce these symptoms.

Cataract symptoms may be improved with new eyeglasses, anti-glare sunglasses, or magnifying lenses. Certain tints and coatings can also be added to lenses to reduce symptoms. Even better positioning of lamps or reading lights can help. Your eye doctor may recommend that you wear a hat when outdoors in addition to quality sunglasses to help prevent further cataract development.

Certain lifestyle changes may improve your vision enough to delay cataract surgery. Surgical removal of cataracts is recommended when your vision loss interferes with everyday activities, such as driving, reading, or watching TV. However, it is very important that your cataract treatment plan includes proper counseling regarding the impact of reduced vision. For example, if your vision is reduced significantly, even with best corrected prescription, you should be advised of the many risks associated with driving and operating large equipment or machinery. If one eye has a significant cataract and the other eye does not, you may lack the ability to accurately judge distances. If your doctor does not discuss this with you, ask him to.

Surgical Cataract Treatment

If non-surgical measures do not help, surgery is the only effective treatment. It is considered when a cataract progresses and decreases vision to a point that it interferes with your lifestyle and daily activities. However, if you have other eye conditions in addition to cataracts, talk with your doctor about the risks, benefits, alternatives, and expected results of cataract surgery. You and your eye care specialist should make the decision together.

Cataract surgery involves removing the clouded lens and replacing it with an artificial lens. Most eye surgeons who perform cataract surgery consider surgery when corrected vision is 20/50 or worse. Vision of 20/50 impacts occupational performance as well as daily activities, especially driving.

Surgery is usually performed on one eye at a time. This is done to minimize potential complications. Cataract surgery is performed in an outpatient surgical center with local anesthesia. Patients are generally released directly after surgery.

You'll be instructed to wear an eye patch during your first night after surgery to protect your eye. After your first post-operative visit, you will usually be advised to wear a night guard patch for the next several nights. You should take it easy for the first week or two after surgery and limit any heavy lifting and bending over. Post-operative medications are prescribed for about three or four weeks.

There are three major methods of removing cataracts:

  1. Phacoemulsification
    Phacoemulsification (phaco) is the most common type of cataract removal procedure performed today. An ultrasonic device vibrating at a very high speed is inserted into the eye through a very tiny incision. This device emits ultrasound waves to soften and break up the lens carefully, allowing it to be removed by suction. The surgeon then inserts an artificial lens into the eye. Depending on the type of incision used, only one stitch (or none at all) may be required to close the wound. This cataract treatment is also called "small incision cataract surgery."


  2. Extracapsular Cataract Surgery
    This procedure is similar to phacoemulsification but a much larger incision is made so that the nucleus, or the center part of the lens, is removed in one piece. (The back half of its outer covering is left in place.) Because the incision is larger, several stitches or sutures are required to close the wound. This is less commonly performed today because of possible complications, slower healing and induced astigmatism.


  3. Intracapsular Cataract Surgery
    During this rare procedure, the entire lens and its capsule are removed through a large incision. Surgeons may reserve this method for extremely advanced cataract formation or trauma.

Remember, cataract treatment involving surgery may not be necessary if your lifestyle is not affected by cataracts, your vision will not improve because of other eye problems, or glasses or contact lenses could significantly improve your vision.

Source:

Optometric Clinical Practice Guideline Care of the Adult Patient with Cataract. American Optometric Association, 1995. Approved by the AOA Board of Trustees June 28, 1995, Revised March, 1999, Reviewed 2004.

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