Cataracts

What is a cataract?

First, if you have cataracts, you’re not alone. It is a common vision disorder that happens to almost everyone as we get older. Most people will develop them by age 60 or 70. In fact, about 15 million people worldwide have cataract surgery every year.

So, what exactly is a cataract? The natural crystalline lens is made up of water and proteins that are normally arranged in a way that allows light to enter the eye.

As we age, the proteins begin to clump together, which causes the natural lens to become cloudy and discolored. When this occurs, light rays coming through the eye become scattered before they can be focused on the retina.

Signs of a cataract

With cataracts, you are likely experiencing the following vision problems:

bulletCloudy or blurry vision
bulletFaded colors
bulletGlare or sensitivity to light
bulletHalos around lights
bulletTrouble seeing at dusk or night
bulletDifficulty driving, especially at night
bulletDouble vision or multiple images in one eye
bulletFrequent prescription changes

What is presbyopia?

If you are in your mid-40s or early 50s, you may be beginning to have symptoms of a condition called presbyopia. As we age, this condition occurs as the crystalline lens inside your eye begins to harden and become less flexible, limiting the eye’s ability to switch from one focal point (objects at a distance, such as driving) to another focal point (objects that are close, such as reading).

The practical effect of this loss of flexibility in the crystalline lens is that we lose our ability to read or see close objects without reading glasses or bifocals. Almost everyone with cataracts also has presbyopia.

What are the signs of presbyopia?

With the hardening of your lens, you may be experiencing the following:

bulletLoss of ability to read up close
bulletHolding objects farther away to read
bulletHard time seeing objects near you
bulletDifficulty looking at a computer screen
bulletWearing reading glasses or bifocals
bulletHeadaches
bulletEye strain

normalvision, visionwithpresbyopia

Understanding your options

Fully understanding the treatment and technology options for your cataracts and presbyopia condition is important in making the right decision to regain clear vision.

We’ll take you through important information about your options, a cataract surgery overview, your choices in replacement lenses, and help in determining the best treatment for you.

What is cataract surgery?

Cataract surgery is a common procedure with more than 15 million performed worldwide every year. Today, presbyopia can be treated at the same time as a cataract procedure.

During cataract surgery, your clouded or hard natural crystalline lens is removed and then replaced with a new artificial lens. The entire procedure takes about 15 to 30 minutes and most people notice improvement in their vision immediately after the procedure. For some, there may be an adjustment period where they experience halos and glare around light. In most cases, this typically goes away over time.

Normally, only one eye is treated at a time. You will need to go at a later time for your other eye. The surgery is an outpatient procedure – we perform the surgery right here in our own ambulatory surgery centers (Idaho Falls, Pocatello, and Rexburg).

Once your cataract is removed, it can’t grow back or form again. For most patients, they will see with their new lenses for the rest of their lives. This is why choosing the right lens is a very important decision.

Since everyone’s vision health and lifestyle needs are different, there are many artificial replacement lens choices.

What are my lens choices?

The artificial replacement lens used to replace your cataracts is called an intraocular lens or IOL for short. These IOLs are very small and are highly advanced medical devices that are designed to mimic your natural crystalline lens.

tecnislens IOL size comparison

Different types of implantable lenses are designed to meet individual eye health and lifestyle needs, so be sure to ask which lens is right for you.

Monofocal lens: This traditional lens will give you good vision for seeing objects in the distance, such as when you’re driving. For near vision, such as reading or surfing the Internet, you will typically need to wear glasses. There are many types of monofocal lenses that you can choose.

At the Idaho Eye Center, while we use multiple different monfocal lens for our patients depending on need; our primary monofocal lens of choice is the TECNIS Aspheric IOL. 

TECNIS® IOL Traditional IOL TECNIS® IOL Traditional IOL
These are simulated images to represent the difference
between the TECNIS® IOL and a traditional IOL.

Traditional intraocular lenses can restore distance vision, but they aren’t designed to bring back the balance of youthful eyes. Images may not be as sharp as they could be, and you may be left with the functional vision of a healthy older person, not of a young adult.

Using innovative wavefront lens technology, the TECNIS® Lens can restore your vision to that of a younger person. The TECNIS® Lens can improve functional vision so you can see well, even in low-light situations like driving at night, dining by candlelight or walking in a morning fog.

Multifocal lens: These types of lenses are designed to be able to provide patients the ability to see objects clearly at different distances without glasses—near, far, and in between. The lens material distributes light to different distances, which the eye can focus on for sharper vision. For people who are active and find wearing glasses inconvenient, the multifocal lens can be the optimal choice. Multifocal IOLs are considered “premium” lenses, and will cost you extra because of benefits that are unavailable in conventional IOLs.

TECNIS®Multifocal Lens

Lenses with the most advanced technological innovations are designed to give nearly everyone independence from glasses. The TECNIS® Multifocal lens is intended to give people high-quality vision in a range of light conditions, including low light situations, such as driving at night and reading a menu in a dimly lit restaurant.

Some patients may notice rings or halos around light when driving at night right after surgery. But over time, the visual impression of these rings typically lessens or goes away, as your eye and brain adapt to the lens.

tecnislens IOL size comparison

*Artistic rendering of vision that may be possible with the TECNIS® Multifocal IOL.

AcrySof IQ ReSTOR® Multifocal Lens

AcrySof® ReSTOR® multifocal intraocular lenses are uniquely designed to improve vision at all distances, giving cataract patients the opportunity to experience life without glasses. ReSTOR® is modeled after microscope and telescope technology and focuses at both near and far distances, decreasing your dependency on glasses.

How does theAcrySof®IQ ReSTOR®work?

As we perform daily activities such as reading, watching television or working at the computer, our eyes are constantly focusing on objects at varying distances – up close, far away and in-between. The ability to quickly change focus throughout our range of vision is called accommodation.  Accommodation: The ability of the eye’s natural lens to change shape to focus on objects at various distances. Unfortunately, we begin to lose this ability as we grow older, gradually becoming more and more dependent on bifocals or reading glasses.

By combining the strengths of apodized diffractive and refractive technologies, the AcrySof® IQ ReSTOR® IOL can provide near, intermediate and distance vision, and increased independence from reading glasses or bifocals. And now, with the addition of proven aspheric technology, the AcrySof® IQ ReSTOR® IOL takes the advancements one step further, for a lens with enhanced image quality and clarity.

AcrySof® IQ Toric for Astigmatism

The latest in a long line of IOL innovations from Alcon, the new AcrySof® IQ Toric lens takes the most trusted platform for precise astigmatism correction and adds the enhanced image quality of an aspheric lens, taking the toric IOL to a whole new level.
 

Time to get cataract treatment

Here you will find out what to expect from the procedure, the different ways to pay for your cataract and presbyopia treatment, and what questions you should ask our doctor.

What to expect before your procedure

Routine exam and tests
After you have been examined and diagnosed you with cataracts, we will conduct a few tests to see if you are a candidate for surgery and decide which replacement lens is right for you.

The tests involve seeing how much your cataract has developed, measuring the curve of the cornea and the size and shape of your eye, and dilating your eyes to look inside at the back part where the retina is located.

After taking the tests and lifestyle questionnaire results into account, your doctor of choice will decide the best IOL for your vision and lifestyle.

Food and medications
We may ask you to not eat or drink anything 12 hours before your procedure. Also, remember to talk to us about any medications you are taking and if they will affect your surgery.

Day of surgery
Don’t forget to apply or take the prescribed medications to prevent inflammation and infection. You should ask someone to drive you to the Idaho Eye Center, as well as back home.

We will supply you with a complete set of instructions for you to follow.

What to expect during the procedure

You will most likely be awake for the procedure. We will apply anesthetic drops that will completely numb your eye. You may feel slight pressure in your eye, but you shouldn’t feel any pain. Remember, this is a safe, proven procedure. Our doctor and surgical staff will carefully monitor you throughout the entire surgery.

First, our doctor will make a tiny incision or slit in your eye. A very small needle-like device will be used to break up and remove the cataract, which is called phacoemulsification. After the cataract lens is completely removed, a new IOL will be placed in your eye. Because the incision is so tiny, there is usually no need for stitches, and it will heal naturally on its own.

During phacoemulsification, the doctor breaks up and removes the cataract and natural crystalline lens.

 

Once the doctor has completely removed the cataract, a new artificial intraocular lens or IOL will be inserted into your eye, replacing your natural crystalline lens.

Your surgery will last about 15 to 30 minutes. Afterward, your doctor will check your vision and then place a bandage over your eye. After a short time to make sure there are no complications, you will be given instructions to take home with you. Be sure not to touch or rub your eye.

My life after the procedure

The first day
Many patients have excellent vision thefirst day after surgery. As your eyes and brain adapt, your vision should continue to get better over time.

Your eyes may feel itchy and sensitive to light. All of this is normal, and it should go away after a day or two. Per insturctions, you will need to apply the medicated eyedrops that will help with the healing process and prevent infection.

You will probably see halos and glare, which is normal. Your eyes will begin to adjust and this sensation should lessen after a while, although it can be permanent in some patients.

You will be able to resume your light daily activities, such as reading, watching TV, using the computer, and walking. Remember to wear the protective eyewear outside in the sunlight and while sleeping. After the first day, you will see your doctor for a postop (after surgery) checkup.

You shouldn’t rub or touch your eyes, and driving is not recommended. Don’t do any strenuous activities or lifting because this will affect the pressure in your eye.

Regaining your vision. Resuming your life.
For the first year, you will check back with your doctor periodically so he or she can make sure you are healing properly. Usually after one month, your eye will be completely healed. You will also notice that everything is brighter and colors are richer with your new lens. This is because you have become used to seeing through a cloudy and yellow-brown cataract lens. Give your brain some time to get used to seeing with your new lens.

With your doctor’s approval, you can get back to your normal daily activities, including active ones, such as driving, golfing, jogging, gardening, and traveling. Many patients report feeling satisfied and a sense of well being with their renewed independence.

What are my payment options?

There are many ways to pay for cataract or presbyopia surgery. Usually insurance will cover all or most of the traditional costs. For any additional fees, you will be responsible.

Medicare willusually cover traditional or monofocal lenses (minus the normal co-pays and deducibles). If you choose a multifocal lens, you will need to pay for any extra costs associated with those premium lens upgrades.

Health insurance policies will differ in coverage for the different types of lenses. Usually, most of them will cover a traditional or monofocal lens. Because multifocal lenses are technologically advanced and designed to provide sharper vision, these types of IOLs will cost more. You will be responsible for paying for the additional costs.

Free Screenings for Cataracts

Every Friday at the Idaho Eye Centers in Idaho Falls and Pocatello between 8:00 AM  and 2:00 PM
(
no appointment necessary)

Any day at the Idaho Eye Center in Rexburg by appointment.