To understand cataract surgery and IOLs, let's first understand what a cataract is. A cataract is one of the most common eye conditions that usually develops with age. When we're young, we have a clear and transparent lens inside our eye, and light can pass through the lens and land at the back part of our eye and allow us to see clearly. As we get older, the color of the lens tends to change a bit, becoming yellower, denser, milkier, cloudier so now light has a harder time getting through this less transparent lens, impairing our vision and causing glare. It is a completely normal part of aging, just as our hair color changes when we age and becomes grayer. The color of the lens inside our eye also changes from a more clear and transparent to a yellowish, denser one.
Certain eye conditions accelerate the growth of a cataract, such as diabetes or having a very high minus prescription. A patient with such conditions should be examined every six months or even sooner instead of being examined every year for an annual eye exam.
What symptoms do patients with cataracts experience?
One of the symptoms patients may experience is a blur in their vision, which cannot be corrected by glasses or contacts. Additionally, they will notice a dimming of their vision and need to turn on the lights more often. Additionally, they may experience double vision in one eye and may have difficulties with glare. Their vision can be reduced when they drive at night as the headlights of the car can be really bright.
When does an optometrist refer a patient with cataract to a surgeon?
Typically, when the patient is in the milder stages of their cataracts there's no need to refer the patient out for any cataract surgery evaluation. In this case, Dr. Pinkhasov will see the patient every year and dilate them, and she will observe their cataract and how it is progressing. She would just suggest such patients wear UV light protection, when they go outside so that then the UV rays will not cause the cataract to increase at a faster rate.
There are two things Dr. Pinkhasov considers when she should refer a patient for cataract surgery. One is assessing the actual lens and comparing it to what it was before, looking at the changes. In addition, there are different types of cataracts, so you need to consider how fast the cataract is growing and whether it's dense enough to require cataract surgery. However, another important factor to consider is how a cataract affects the patient's quality of life. Some patients are less sensitive than others to the symptoms associated with cataracts. Dr. Pinkhasov asks her patients whether their cataracts affect their ability to do their daily tasks. If the answer is no, then she may hold off on recommending cataract surgery for them. In certain instances, however, if the lens looks like it's getting very dense, then even if my patient isn't experiencing any difficulties, she may recommend the patient to have cataract surgery, as the longer they wait, the harder it will be to remove the cataract. It may also lead to a little bit more complications. If her patients have more severe symptoms, they are really unhappy about the loss of vision, and they want clear vision, she will refer them to cataract surgery.
What are intraocular lens (IOLs) ?
IOLs, or intraocular lens, are artificial lenses implanted into the eye. While the surgeon removes the lens with the cataract, the sack in which the lens was placed is kept. They would then implant an artificial lens (IOL), into the same sack, which allows the patient to see clearly. Before surgery, the surgeon must measure the eye's front part as well as the length of the eyeball. The patient would have to use certain eyedrops for this procedure. Together, you and your eye doctor will decide which artificial lens is right for your lifestyle and your budget. Your eye doctor will explain the various types of artificial lenses. The IOL can be made from various types of materials, such as plastic, silicone, or acrylic. Today, intraocular lenses can provide a number of different kinds of optics, such as:
Monofocal IOL: This is the most commonly used IOL, which allows clear vision at a single distance. Typically, Dr. Pinkhasov's patients get their distance vision corrected and then for a close up, they wear reading glasses.
Multifocal IOL: Another type of IOL is the multifocal IOL, which is made up of concentric rings of differing strengths, allowing you to see clearly both far away and up close.
Toric IOL: This is a type of IOL that can be used for patients who suffer from astigmatism and wish to have their astigmatism corrected.
Accommodative IOL: IOLs that can accommodate to both near and far distances, similar to a natural lens, are called accommodating intraocular lenses.
What happens after the surgery?
A cataract surgery is an outpatient procedure that takes less than an hour. Following surgery, the patient is typically given an eye shield and eye drops to put in their eyes. In order to fully recover, it takes about eight to twelve weeks, but after just a few hours, the patient can notice a dramatic change. A patient can go from seeing 20/40, 20/50, or even 20/60 to seeing 20/20 after surgery which is just astonishing. To find out if cataract surgery is right for you, make sure you speak with your eye doctor today.
