Cataract Surgery: Not Just for Old Folks

About half of the population has a cataract by age 65, and nearly everyone over 75 has at least one. Cataracts are associated with aging but may also be caused by diseases such as diabetes, as a side effect of certain medications, or from trauma like a sports injury. People tend to think of cataract surgery as something for senior citizens, but even those in their forties can benefit.

Cataract surgery is a simple, relatively painless procedure which is very successful in restoring vision. In fact, it is the most frequently performed surgery in the , with over 2.5 million cataract surgeries done each year. Nine out of 10 people who have cataract surgery regain very good vision, somewhere between 20/20 and 20/40.

A cataract is a clouding of the lens of the eye that reduces vision. The lens works much like a camera lens, focusing light onto the retina at the back of the eye. The lens also adjusts the eye's focus, letting us see things clearly both up close and far away.

The lens is mostly made of water and protein. The protein is arranged in a precise way that keeps the lens clear and lets light pass through it. As we age, some of the protein may clump together and start to cloud a small area of the lens. This is a cataract, and over time, it may grow larger and cloud more of the lens, making it harder to see.

Most people with cataracts describe a gradual decrease in vision. They say their vision is "fuzzy," or "filmy". It often seems worse when there is glare from bright sunlight or headlights at night. Sometimes they see colors differently, blue becomes duller, objects take on a yellow or gray tinge.

There are no medicines to treat cataracts. Doctors suggest that if you smoke, try to quit. Cigarette smoking contributes to the development of cataracts. Sunglasses and wide-brimmed hats may slow down growth. Changes in eyeglass prescriptions, such as strong bifocals, magnification or other aids might help, but if your vision gets bad enough cataract surgery may be your best bet.

Consider surgery when your vision interferes with your everyday activities, hobbies or leisure-time pursuits. Difficulty driving, especially at night, often helps people to decide to go ahead with the procedure.

You can either begin with your primary care provider, an optometrist or an ophthalmologist. Before you have surgery, you will have to get a basic physical exam to assess your general health, so your primary care provider is probably a good place to start. As with any surgical procedure, there are risks. You and your doctor will consider the potential risks and benefits, and determine if cataract surgery is right for you.

Cataract surgery is done on an out-patient basis. That is, patients go home the same day. It usually takes three or four hours from walking through the front door to getting in the car with the person driving you home. You can't drive yourself because of the mild anesthesia involved. It goes away within minutes after surgery, but may leave you a bit groggy.

During surgery, the surgeon removes your clouded lens, and in most cases replaces it with a clear, plastic intraocular lens (IOL). New IOLs are being developed all the time to make the surgery less complicated for surgeons and the lenses more helpful to patients.

You leave with a patch over the eye that had the surgery, which your doctor will remove the next day. As soon as it comes off, you'll notice a remarkable difference in vision.

A typical follow-up after surgery is to be seen by the surgeon after 1 day, 1 week, and again in 3 to 4 weeks. This may vary depending on individual circumstances. If you need to have both eyes done, you will have to have separate surgeries. Some doctors will do them one day apart, others recommend waiting at least six weeks to be sure no infection develops in the first eye. Infection is rare, but it does happen.

When your cataract has been removed it may seem like a miracle. All the things you couldn't see clearly are bright, clear, and vivid again. In fact, many people say they haven't seen life so clearly in years.