Cataract is the most common cause of blurred vision in Americans over age 65. As an eye doctor, John Henahan of Spectrum Eyecare in Peachtree City works with many local residents in understanding what a cataract is and it’s treatments. In the past few years, a number of new options have become available, such as multifocal implants and astigmatism correcting implants. Moreover, new surgical advances have occurred that are making cataract surgery more precise.
What are cataracts?
Cataract is a clouding of the natural lens in the eye. Contrary to popular belief, it is NOT a disease, rather it is a natural part of the aging process. Cataracts can develop at any age, but are most common after the age of 70. Before the 1980’s cataract surgery was a risky procedure that often resulted in less than perfect vision after surgery even with thick glasses.
Advances in cataract surgery
Thankfully, over the past three decades a number of major advances in surgical technique has made cataract surgery one of the most successful surgical procedures ever devised. Smaller and smaller incisions in the eye allow most procedures to be done without stitches, as well as minimizing inflammation in the eye. This allows for more rapid visual recovery and reduces the chance of long term visual problems. The use of ever more advanced instruments for breaking up and removing the cataract have also reduced complications as well.
The biggest advances have been in the lens that is inserted into the eye after the cataract is removed. These implantable lenses are called Intra-Ocular Lenses or IOL’s. “When my grandmother had cataract surgery, there was no such thing as an IOL”, says Dr. Henahan. “She spent several days in the hospital and required thick glasses after surgery. Even with those she did not see very well.”
Now cataract surgery is (in most cases) a fifteen minute procedure performed on an outpatient basis. Most people see an obvious improvement in vision within minutes of completing the surgery. Eye drops are used for several weeks. After a few weeks new glasses are often prescribed to clear up any residual blur and to help with reading vision.
The new horizon in cataract care is advanced IOL’s. The two main advances include lenses that act like bifocals and lenses that correct for astigmatism.
The multifocal design IOL’s promise to act much like a pair of bifocal glasses, improving vision far away and near. This can lead to reduced need for reading glasses to see up close.
These designs do have a direct patient cost beyond what medical insurance will pay of up to $2500 per eye. If pursuing this option, be sure that cost includes any kind of LASIK touch-up that might be required for optimal vision.
The designs continually improve, but there are sometimes complaints that include halos, “shadowy” vision or difficulty with glare. Currently, multifocal IOL’s should be considered with a full understanding of the benefits and potential risks. If you don’t mind wearing reading glasses, consider the traditional IOL, which is covered by Medicare and has a long track record of providing excellent distance vision. If you are pursuing multifocal IOL’s, be sure to match the brand with your needs. Different designs excel at different tasks. For example, a golfer would likely be best served by a different design than a librarian.
Toric IOL’s correct for astigmatism. For people with astigmatism, using this extra cost IOL can substantially improve their distance vision to the point that distance glasses are no longer needed. Cost is around $1800 per eye and should include touch up LASIK if needed. Even with this IOL, reading glasses are usually needed for close tasks. Nevertheless, other than the additional cost there are no real drawbacks to this design.
Complete exam to understand total eye health
Once you reach your fifties it is important to have an eye exam annually to rule out cataracts as well as a host of other eye diseases including glaucoma and macular degeneration. “Many of these disease have limited treatment options once they are advanced, so early detection is key”, says Dr. Henahan. “Even though the glasses prescription changes more slowly in our fifties and beyond the need for thorough eye care is actually increased. When you have an eye exam be sure that you receive a comprehensive exam that includes dilation of the pupils. Try to choose an eye doctor that has access to imaging machines that can help differentiate between early eye diseases like glaucoma and normal variations (learn more).
If you are diagnosed with cataracts, it is not an emergency. In most cases cataract surgery is not required until the vision is blurry enough to prevent you from doing things you want to do (like driving at night for example). If you are unsure about whether you need cataract surgery or can wait, never hesitate to seek a second opinion.
Dr. John Henahan is a fellowship trained doctor of optometry practicing and living right here in Peachtree City with his wife and two sons. You may call his office at (770) 487-0667 or visit him on the web at www.speceye.com.