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What You Need to Know About Cataracts

Cataract surgery is one of the most common surgeries performed in the United States, with approximately 4 million procedures performed annually. The surgeons at Fichte Endl & Elmer Eyecare have performed over 100,000 cataract surgeries to date. While cataracts are a natural part of aging, many people don’t feel well-informed about the signs, risks, and surgical options available to them.

Below, we’ve compiled our best cataract resources and information to explain what you need to know about cataracts.

What Are Cataracts?

Eyes are made up of a variety of parts, including the lens. The lens of an eye is a transparent film located behind the iris (the colored area surrounding the pupil). Light rays are bent by the lens to allow them to pass through to the retina (located in the back of the eye), which sends nerve signals to the brain, resulting in vision. The lens has the ability to change shape, like the zoom function of a camera, to clearly focus on near and far objects.

As you age, the lens can lose its elasticity, becoming hard, yellow, and cloudy. This phenomenon is known as a cataract. Cataracts usually don’t develop overnight, but instead form slowly, causing vision to gradually worsen and become blurrier.

How does this occur? Over time, natural proteins can build up on the lens of your eye. This build-up causes the lens to become cloudy, allowing less light to pass through to the retina and resulting in blurred vision. Most age-related cataracts are caused by protein build-up.

In other circumstances, the lens may slowly develop a yellow or brown tint. This tinting develops very gradually and does not impact the clarity of the image transferred through the lens to the retina, although it can cause difficulty reading or seeing blues and purples.

It is possible to have both cataracts and other vision problems such as astigmatism, presbyopia, or all three. Cataracts in combination with these other conditions can be resolved with advanced lenses prescribed after cataract surgery, such as the TECNIS® Multifocal Lens and Symfony lens (to treat presbyopia) and AcrySof® IQ Toric lens (for astigmatism and monovision).

Types of Cataracts

Most cataracts are age-related, but there are a variety of other types of cataracts.

Secondary Cataract – Secondary cataracts can be caused by other health problems such as diabetes or steroid use. They can also begin to form after surgery to treat other eye conditions like glaucoma.

Congenital Cataract – Congenital cataracts appear in babies or young children, typically in both eyes. Some children are born with congenital cataracts or develop them in their early years. Sometimes, the cataracts are small enough that vision is not affected. If it is, the lens can be removed.

Traumatic Cataract – Traumatic cataracts can form after experiencing an eye injury. This development can occur years after the incident.

Radiation Cataract – Radiation cataracts are developed as a response to radiation exposure.

The risk for cataracts increases as we age, but there are other factors that increase the risk of developing cataracts. Certain health factors, such as diabetes or high blood pressure, can elevate your chance for cataract development. Smoking or drinking alcohol, as well as prolonged sun exposure, can also increase your risk for cataracts.

There is currently no way to prevent cataracts because they are a natural protein build-up caused by aging. That being said, the National Eye Institute is conducting a variety of studies looking at how sunlight exposure, vitamins, and genetics affect cataract development.


People tend to form cataracts as early as their 40s, but symptoms typically aren’t prevalent until their 60s or later. Approximately 20.5 million Americans over 40 years old are affected by cataracts, and by the time they turn 65, over 90 percent of Americans will develop cataracts.

Once cataracts begin to negatively affect your quality of life or cause difficulty performing daily activities, you should speak to your ophthalmologist to see if you are a candidate for cataract surgery.

A variety of cataract symptoms show it may be time for surgery.

Signs of cataracts include:

  • Clouded, blurred, or dim vision
  • Increasing difficulty seeing at night
  • Sensitivity to light and glare
  • Halos around lights
  • The need for brighter light while reading and engaging in other activities
  • Difficulty watching TV, driving, or reading
  • Frequent changes in eyeglass or contact lens prescription
  • Fading or yellowing of colors
  • Double vision in a single eye

Cataracts are sometimes described as mature or advanced, which means they are well-developed, causing the lens to seem mostly opaque. Mature or advanced cataracts cause difficulty seeing and typically require surgery.

What Happens During a Cataract Eye Exam?

To determine if you require cataract surgery, your ophthalmologist will conduct an eye exam, including dilation (widening of the pupils), to determine the level of your cataracts. There are three steps to a cataract exam.

Slit-lamp Exam – During this exam, the ophthalmologist will use a slit-lamp microscope to look at the front of your eye, including the cornea, iris, and lens.

Refraction and Visual Acuity Test – During these tests, each eye will be tested to determine the clarity and sharpness of your vision by individually reading letters of differing sizes.

Retinal Exam – After your eye is dilated, your ophthalmologist will use a slit-lamp or ophthalmoscope to see through the pupil to the back of your eye. This will allow him or her to examine your retina and optic nerve while looking for signs of cataracts and glaucoma.

Tonometry Exam – The intraocular pressure (IOP) of your eye is measured to check for your risk of glaucoma.

If your ophthalmologist recommends that you have cataract surgery, you may be prescribed eye drops to begin taking prior to the procedure. These reduce swelling during and after the surgery and prevent infection. You may also be asked to temporarily stop using certain oral medications, vitamins, or supplements that can increase the risk of bleeding during the surgery.

What Happens During Cataract Surgery?

Before the procedure begins, your eye will be numbed with eye drops. You will be awake during the surgery, but you will not feel or see the surgeon working on your eye. Instead, you may see light or movement, but will not feel any pain.

During the procedure, the surgeon will create tiny incisions with a blade or laser near the edge of your cornea to access the lens of your eye. Then, he will remove the cataract and replace it with an Intraocular (IOL) lens. This lens is a synthetic lens that replaces your eye’s natural lens. It can be a monofocal lens, which creates corrected vision for one distance while requiring corrective lenses for driving or reading, or a premium lens, which corrects astigmatism as well as near- and far-sightedness and gives a greater range of vision.

After resting for 15 to 30 minutes in the outpatient recovery area, you will be able to go home. The law mandates that you cannot operate a motor vehicle for 24 hours after anesthesia. This means you will need to have someone drive you home after the procedure and back to the office for your follow-up appointment the next day. Our office will provide sunglasses to wear on the way home and a clear, protective shield to wear while sleeping.

Surgical Risks

It is rare to have problems after cataract surgery, but there are risks with any procedure. Potential problems after cataract surgery can include bleeding, infection, inflammation, loss of vision, low eye pressure, IOL slippage, or double vision. Each of these problems can be successfully treated with quick medical attention.

It is also possible to develop an after-cataract months or years after the procedure. This occurs when the eye tissue that holds the IOL lens becomes cloudy, potentially blurring vision. This can be treated with an outpatient laser procedure. This, along with the development of secondary cataracts, is less likely to occur when undergoing a laser cataract surgery as opposed to bladed surgery.

What is the Recovery Process?

After the procedure, you will be prescribed eye drops to use for a few weeks.

Directly following the surgery, avoid getting soap or water in your eye. In addition, do not rub your eye or bend over. This will help you avoid putting pressure on your eye.

You should be able to perform light computer work, watch television, and bathe within a few hours of your procedure.

It is important to avoid strenuous activity, swimming, or outdoor activities that could result in dust, pollen, or grime entering your eye for at least two weeks after the procedure. Your ophthalmologist will tell you when you can safely engage in these activities again.

You will have a follow-up exam one day, one week, one month, and three months after the cataract surgery.

If you think you may have cataracts, come to one of our free Cataract Surgery Lunch and Learn sessions, or Evening Vision Solutions Open House events available every month at our Amherst office. These meetings will allow you to see our facilities, meet the doctors, and ask any questions you may have. You can also contact our office at (800) 309-2020 for additional questions or to schedule an appointment.

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