Cataracts and IOL
A cataract is a clouding of the normally clear lens of your eye. For people who have cataracts, seeing through cloudy lenses is a bit like looking through a frosty or fogged-up window. Clouded vision caused by cataracts can make it more difficult to read, drive a car — especially at night — or see the expression on a friend’s face. Most cataracts develop slowly and don’t disturb your eyesight early on. With time, however, cataracts will eventually interfere with your vision.
Stronger lighting and eyeglasses can help you deal with cataracts at first, but when impaired vision begins to interfere with your usual activities, you might need cataract surgery and having by Dr. Chirag Parikh is one of the best decisions you will make.
Cataract surgery is performed to remove the cloudy natural lens from the eye. After that, in most cases a permanent refractive intraocular lens (IOL) implant is inserted to replace the natural lens thereby restoring focusing power. Your surgeon will work with you to decide when to have cataract surgery, based on how well you are able to see during routine activities. Many patients are able to drive, watch TV and work for a number of years after being first diagnosed with cataracts. However, if you have cataracts, you will eventually start to notice declining visual clarity – often with ghost images – which are not correctable with glasses or contacts. Colors often look faded as well.
Our initial consultation to design your cataract surgery will be driven by your current health, medical history, and unique needs. In this process, a detailed examination will be performed. Ask your surgeon if you should continue your usual medications and nutritional supplements during the period between the exam and surgery. As just one example, common drugs that treat men with enlarged prostates known as Alpha Blockers may cause problems associated with Intraoperative Floppy Iris Syndrome (IFIS) during cataract surgery.
Dr. Parikh may present you a choice of implantation with a regular single-vision (monofocal intraocular lens (IOL) or a presbyopia-correcting intraocular lens. This decision will be based on many factors. If you are interested in correcting, which all people begin to face at around age 40, you may partially of fully restore your ability to see at all distances by choosing either a or accommodating IOL. These premium IOLs are a great option that may reduce or eliminate your dependency on eyeglasses altogether.
How the Eye Sees
Light rays enter the eye through the clear cornea, pupil, and lens. These lights rays are focused directly on to the retina, the light-sensitive tissue lining the back of the eye. The retina converts light rays into impulses sent through the optic nerve to the brain, where they are recognized as images. Seventy percent of the eye’s focusing power comes from the cornea, and thirty percent from the lens.
In the healthy eye, the lens is clear and allows light rays to pass through unobstructed. As a cataract forms, the lens gradually becomes cloudy. As light passes through this cloudy lens, it is no longer clearly focused on the retina, causing images to appear hazy or blurred.
Usually, with cataract surgery, a small incision is made in the eye. The front portion of the thin outer covering of the lens is opened, to allow removal of the cataract inside. The cataract is gently broken up and vacuumed out. Then, a folded lens implant is inserted through the small incision and into the capsule, where it unfolds and permanently takes the place of the clouded natural lens. With the cataract removed, the new lens implant clearly focuses light rays onto the retina. The power of the lens implant is selected for your individual eye.
Converging laser beams are aimed directly at the hazy lens [00:00:04 capsule] and as they meet, they cut a small hole in the [capsule]. This allows light to pass through again, restoring your vision to the way it was not long after your cataract surgery.
Like your eye’s natural lens, an IOL helps you see by focusing the light that comes through the cornea and pupil. The lens focuses light onto the retina, a light-sensitive tissue lining the back of the eye. The retina converts the light rays into signals that are sent through the optic nerve to the brain, where they’re interpreted as the images we see.
The traditional IOL’s that have been used for several decades, are called monofocal lens implants because they focus the light entering your eye at a single focal distance. This means that you will see best at either far, near, or intermediate distance when you aren’t wearing glasses (depending upon the lens power selected by your or your eye surgeon.) Most people who have cataract surgery with a traditional IOL choose to have a lens that provides good distance vision without glasses.
Presbyopia develops when our eyes’ natural lens loses its flexibility. Focusing up close becomes more difficult. The auxiliary muscle contracts, which causes a flexible lens to thicken or change shape. This change in shape allows us to see objects up close. As we age, our lens becomes less flexible and resists changing shape, so our ability to see up close is diminished. Usually, the first sign of presbyopia is the need to hold a newspaper or other reading material at arm’s length, to be able to read them.
Monofocal Correction Options
With a monofocal IOL set for distance, you will need to wear reading glasses for close-up vision. If you choose to have a monofocal IOL set for near vision, allowing you to read without eyeglasses, then you will need glasses to see clearly in the distance.
Toric IOL’s are monofocal lens implants that have astigmatism correction built into them. Toric IOL’s may not completely eliminate the need for eyeglasses, however, people with astigmatism who have Toric IOL’s implanted, should have less astigmatism and better vision without glasses than if a traditional IOL was used.