“Fortunately, cataract is one of the most successfully treated vision impairments,” said Chi-Wah (Rudy) Yung, M.D., director of the comprehensive ophthalmology service at the Eugene and Marilyn Glick Eye Institute at the Indiana University School of Medicine and the ophthalmology service at Wishard Memorial Hospital.
“Cataracts occur over time, as we age,” said Dr. Yung. “Most people who live into their 70s will develop cataract on one or both eyes. There are specific risk factors for cataract and some steps you can take to reduce the risk, but cataract will develop in most individuals as the eye’s lens ages and becomes cloudy, less flexible and hardened. These changes on the lens, if severe, can block light from reaching the retina and interfering with vision.”
Risk factors for cataract include:
Extensive prolonged exposure to sunlight
Previous eye injury
Prolonged use of steroids
Cataracts are a common cause of vision loss yet are easily detected, Yung said. A dilated eye exam will allow an eye doctor to thoroughly examine the eye for cataract, glaucoma and other eye diseases and conditions. A baseline dilated eye exam is recommended at age 40; after age 65 your eye doctor will determine the frequency of the exams.
The timing of surgery to remove the cataract will depend on its severity and individual symptoms, Yung said. In the early stages, a cataract might pose negligible vision impairment. As it progresses, the impairment can become more severe.
“If a change in your prescription eye glasses is not adequate, and your vision impairment prevents you from enjoying normal day-to-day activities, surgery will be recommended,” Yung said.
The procedure most commonly employed today to remove cataract is called phacoemulsification, which is also known as small incision cataract surgery. In this procedure, the eye doctor makes a small incision in the side of the cornea and inserts a probe that uses high-frequency ultrasound to break up the lens. The lens fragments are then removed from the eye by suction.
The removed cataract is replaced with an intraocular lens (IOL) implant. The new lens, made of plastic, silicone or acrylic, allows light to pass through to the retina, in the back of the eye. The IOL is placed either behind the iris – called a posterior chamber lens – or in front of the iris – called an anterior chamber lens. Once in place, the incision is closed usually without stitches, Yung said.
“It’s an outpatient procedure and takes about 15 to 20 minutes.” Yung said. It’s performed using local anesthesia and recovery typically takes one to several days. Within a matter of days patients can return to normal daily activities, including work, driving or reading.
As with any surgical procedure, it’s important to tell your doctor if you are using or have ever used alpha-blocker medications which affect the iris and can cause complications. Also, patients should know that certain drugs can increase the possibility of developing cataracts, particularly inhaled steroids. Cholesterol-lowering drugs also may be linked to an increased risk of cataract, according to a study published in the May British online journal BMJ. The osteoporosis drug Actonel and the blood pressure pill Cozaar also have been linked to cataract development, Yung said.
Patients who are considering cataract surgery and who have already had LASIK, or other forms of refractive surgery, should inform their eye doctor of those procedures and provide him with as much information of the refractive surgery as possible prior to the cataract surgery.
“Patients need to know that there is a safe and effective treatment for cataract that requires little down time and features a great benefit to their vision,” Yung said. To reduce the risk of developing cataract, Yung suggests:
Wear sunglasses that block 100 percent of UV-A and UV-B rays, and consider wearing a wide-brimmed hat if you will be outside in the sun for extended periods.
Quit smoking or do not start, particularly if you have a family history of cataract or other eye diseases and have a good balanced diet.
If you are diabetic, control your blood sugar.
The Eugene and Marilyn Glick Eye Institute, the new home of the Department of Ophthalmology, will be completed in the spring of 2011 and formally dedicated on Aug. 19, 2011. For more than 100 years, doctors and staff in the Department have provided excellent patient care, educated physicians, advanced clinical and biomedical research in vision sciences and offered humanitarian service to the citizens of Indiana. Learn more about the Department of Ophthalmology at www.iueye.iu.edu