Cataract Surgery Consultation and Co-management

Cataracts are one of the leading causes of vision loss in people over 45. A condition that commonly develops as the eye ages, by the time we reach 80, more than half of us will have developed a cataract.

A cataract is a clouding of the lens in your eye which is normally transparent. The lens, located inside the eye, behind the iris and the pupil, focuses light onto the retina at the back of your eye, where it is converted to nerve signals that are passed to the brain, allowing you to see. When your lens becomes cloudy, the images projected onto your retina become blurry and unfocused and therefore the signal to the brain is also unclear. You can compare this to looking through a dirty or cloudy window. If the window is not clear, you can’t see well.

Usually cataracts develop slowly over time so your vision gradually worsens. While the majority of cataracts are a result of the aging process, there are also congenital cataracts that are present at birth, secondary cataracts that result from eye surgery or diseases such as glaucoma or diabetes and traumatic cataracts that result at any age from an injury to the eye.

While you may be able to live with mild or moderate cataracts, severe cataracts are often treated with surgery. The procedure involves removing the clouded lens and replacing it with an intraocular lens (IOL) implant. Cataract surgery is a common procedure that has a very high success rate of restoring vision to patients. Modern cataract surgery is frequently done as an outpatient procedure. Patients will have greatly improved vision the next day, and will continue to improve over the next few weeks. Surgery is often done in one eye first, and surgery on the second eye, if needed, may be done 2 weeks later.

Causes of Cataracts

Cataracts are part of the natural aging process of the eye and therefore, if you live to an old age, you will likely eventually develop one. While most cases of cataracts develop as part of this process, there are instances of congenital cataracts which are present at birth. Further, secondary or traumatic cataracts can occur at any age as a result of an eye injury, surgery or disease.While the risk of developing a cataract does increase as you age, it is not the only risk factor. Research shows that there are environmental, health and behavioural risk factors that can also play a role in cataract development. Many of these risk factors are avoidable and preventable. These risk factors include:

• Smoking and excessive alcohol consumption
• Prolonged exposure to ultraviolet (UV) radiation from the sun or other sources
• Obesity
• Diabetes
• Hypertension
• Certain medications such as steroids or statin medications
• History of eye injury or eye surgery
• Family history

Since they are largely a part of the the natural aging process of the eye, cataracts can’t necessarily be avoided, however knowing if you have additional risk factors can help you to take preventative steps to delay the onset of the condition.

Cataract Surgery

Treatment for cataracts involves surgery, but being diagnosed with a cataract does not mean that you need to have surgery immediately, or maybe ever. You may be able to live with symptoms of early cataracts for a while by using vision aids such as glasses, anti-glare sunglasses, magnification lenses, strong bifocals or brighter lighting to suit your needs.

Surgery should be considered when the condition begins to seriously impair your vision to the extent that it affects your daily life such as reading or driving, playing golf, playing cards, watching TV, etc. Sometimes surgery is also necessary if the cataracts are preventing treatment of another eye problem. The good news is that cataract surgery is typically very successful in restoring your vision. Together with your eye doctor, you will decide if and when the time for surgery has arrived.

Cataract surgery is one of most common surgeries performed in North America and has a 90% success rate (meaning the patient has improved vision, between 20/20 and 20/40 vision, following the procedure).

The surgery involves removing the clouded natural lens and usually replacing it with a clear, plastic intraocular lens (IOL) that becomes a permanent part of the eye. It is a relatively quick and painless procedure and you will not feel or see the IOL after the implant.

Preventing Cataracts

While development of cataracts is largely associated with age, there are other factors that can increase the risk of developing the condition. By knowing these risk factors, there are steps you can take to delay or prevent the development of cataracts:

• Sun Protection: Ultraviolet radiation can be a factor in the development of cataracts. It is recommended to protect your eyes from ultraviolet sunlight by wearing 100% UV protective sunglasses and a hat with a brim when you are exposed to the sun.
• Stop Smoking and Limit Alcohol Intake: These habits have been shown to increase the chances of developing cataracts, so if you smoke or regularly consume large amounts of alcohol – stop these habits.
• Proper Nutrition: Research shows that maintaining good health and nutrition can also reduce the risk of age-related cataracts, particularly by eating foods rich with vitamins A (beta-carotene), C and E and other antioxidants found in green leafy vegetables, fruit and a diet rich in Omega-3s.
• Regular Eye Exams: Once you reach the age of 50, or if you have diabetes or other eye conditions, it is important to have a comprehensive eye exam every year to check for signs of cataracts and other age-related eye conditions such as age-related macular degeneration or glaucoma. Early detection and treatment for many of these eye and vision disorders is often essential to save your vision.

‍