Is Your Vision Suffering from Cataracts?
Gradual changes in vision can often go unnoticed if you do not have regular eye exams. If you are age 60 or older, your vision may be suffering from cataracts. However, you may be compensating for these vision changes or simply think that you have to live with inferior vision as you grow older.
This could not be farther from the truth. Although cataracts affect half of all Americans by age 75, this is a treatable condition with cataract surgery. At Eye Associates of Tucson we perform cataract surgery in Tucson to help patients restore their clear vision. Cataract surgery is considered a safe and effective procedure when performed by an experienced doctor.
What is a cataract?
A cataract is clouding that develops inside the natural lens of your eye. This cloud blocks the light passing through the lens, which may impair and distort your vision
How do you know if you have a cataract?
Often, the first sign of a cataract is cloudy or distorted vision. The cloud is often perceived as yellow-brown or gray. You may be bothered by poor depth perception, halos around lights at night or glare. Some patients complain of difficulty seeing street signs and reading.
What do people with cataracts often say about their vision?
This may include the following:
- “I have trouble reading small print.”
- “I have trouble driving because of poor vision.”
- “I had difficulty passing the vision test for a driver’s license.”
- “I have trouble seeing my phone or tablet”
- “Glare at night or in bright sunshine affects my vision.”
- “My glasses prescription needs to be changed frequently.”
- “My glasses always seem dirty.”
- “I can’t see street signs when I’m driving.”
- “It’s hard to see the golf ball.”
- “I’m having trouble sewing or with other fine work.”
- “I see halos around light or have double image vision.”
- “Colors do not look right.”
- “I have trouble recognizing faces.”
- “It’s becoming more difficult to write checks or fill out forms.”
- “I can’t read the computer screen.”
- “Television is not clear. I can’t read the words on the screen.”
What causes cataracts?
Cataracts have many causes. They may include the following:
- Aging (most common cause)
- Diabetes and some other diseases
- Medicines (especially steroids- like prednisone)
- Past eye infections
- Previous eye injury
- Previous eye surgery
- Possibly excessive sunlight or UV radiation
Who needs cataract surgery?
Years ago, patients were told to wait until the cataract was “ripe.” Ripe meant blind. No one should wait for blindness. Today we have modern techniques that can help long before blindness. Most patients request surgical treatment for cataracts when they cannot function adequately due to poor eyesight.
How is a cataract removed?
We use a small incision phacoemulsification (ultrasound) method. The surgeon, aided by a computer controlled ultrasonic device, removes the cataract. The surgery is done under a local anesthetic and for most patients is painless. It takes about 15 minutes to perform.
Are cataracts removed with lasers?
Yes. The surgeons at Eye Associates of Tucson are among a select group of doctors to perform laser assisted bladeless cataract surgery in the United States. Dr. Diesenhouse and Dr. McCarty have been performing laser cataract surgery since 2012. Dr. Diesenhouse and Dr. McCarty were among the first surgeons in Southern Arizona to offer laser cataract surgery.
How does surgery differ with laser vs traditional surgery?
Laser assisted cataract surgery is a bladeless technology. The Femtosecond laser is a computer- guided, surgeon-controlled laser that is used for greater surgical precision. It decreases the depending on surgical blades during cataract surgery. A custom-guided laser is programmed for the most precise treatment on each individual patient. The femtosecond laser automates what are typically very challenging steps in traditional cataract surgery. It also helps to decrease astigmatism via laser rather than a manual incision during the time of cataract surgery. This can lessen the dependency on glasses post operatively.
Are there new lens impants that will work for both near and far vision?
Yes. There are now new advanced technology lens implants that can provide patients with an increased freedom from glasses. These implants are called multifocal or accommodating lenses. The doctor will let you know if you are good candidate for a premium lens.
I once had contact lenses that allowed one eye for near and one for distance (monovision). Can this be done with cataract surgery?
Yes. This is known as monovision. You can have one lens implant set for distance and the other for near. We often don’t’ suggest this option unless you have experienced this in the past.
Are there any lens implants that will work if I have astigmatism?
Yes. There is a lens called the Acrysof Toric implant that can correct corneal astigmatism. The reduction of astigmatism can decrease your dependency on glasses for distance vision. You will still need glasses for reading however most patients are able to read comfortably with over the counter reading glasses.
Many years ago, I had Lasik or Radial Keratotomy (RK). Can this affect my cataract surgery?
Lasik and RK both work by changing the shape of the cornea. This can make selecting the lens implant for you more difficult.
Can I have laser assisted cataract surgery if I’ve had Lasik or RK?
This is not usually recommended.
Can I have a multifocal lens implant after Lasik or RK?
This is usually not recommended.
What are the risks of cataract surgery?
As you know, all surgeries carry some risk. With respect to cataract surgery, there is always the possibility that a complication may arise during or after surgery. We always explain these risks before surgery. The major risks of surgery include: bleeding, infection and problems with the retina.
How small is a small incision?
With use of foldable intraocular lens implants, the incision has been reduced to about 1/10th of an inch. This allows for a faster recovery from surgery. Like with other types of surgery, the small incision technique has made a good operation even better.
What about no stitch surgery?
With the older conventional cataract surgery, a large incision was needed. This larger incision required several nylon sutures to safely secure the eye. The use of multiple sutures can cause a change in the shape of the eye or astigmatism. The stitches can be irritating and sometimes need to be removed. We use a self-sealing incision that usually does not require any suture at all.
Will I need a lens implant?
Yes, after your cataract is removed you will need a lens implant to see properly. A new lens is implanted at the time of cataract surgery. This restores your eye to a near natural state. The lens should last the rest of your life. The lens implant is a new manufactured lens and is not a transplant or donated lens.
How is the lens implant held in place?
The new lens is not stitched or clipped in place. It is designed to fit into the capsule or shell remaining from the original lens (cataract). Your new implant will most likely never need to be changed or replaced.
How long will it take to recover from surgery?
You may see clearly on the very first day after surgery. Most patients agree that vision returns quickly. Some patients may experience slightly blurred vision for a few weeks.
What limitations will I have after surgery?
We recommend that you do not do any heavy lifting, bending or strenuous activity for one week. It is also recommended that you do not swim for two weeks. We will provide you a more detailed list of limitations.
Will I be able to drive myself home after surgery?
No, you will be unable to drive the day of surgery. We also recommend that you be driven to your first day postoperative appointment. Most patients, after checking with their doctor, return to driving 24 hours following surgery.
Will I need any new eye drops after surgery?
Yes. We ask that you start 2 eye drops one day before surgery. There will be one additional eye drop to start after surgery. You will need to continue all the drops after surgery. Instructions will be provided.
What happens on the day of surgery?
Surgery is done on an outpatient basis. You may not eat or drink anything eight (8) hours before surgery. You should wear comfortable clothing and avoid eye makeup. Wear a loose-fitting shirt. When you arrive for surgery, you will be given eye drops and perhaps a sedative to help you relax. A local anesthetic will numb your eye. The skin around your eye will be cleansed, and a sterile covering will be placed. You may see light and movement but you will not be able to see the surgery while it is happening.
Will I be asleep during surgery?
General anesthesia is unnecessary for routine cataract surgery. Nearly all cataract surgery can be done by putting only the area operated on (local) to sleep. For this reason, we use a local anesthesia with sedation (twilight). Most patients do not experience pain.
Will I be able to see the surgery?
You may see light and sense some movement but you will not see the surgery while it is happening. Many patients report seeing colorful lights.
Do you check my eyes after surgery?
Yes. We ask that you return to the clinic the day after surgery, or sometimes, the same day as surgery if your surgery is in the morning. One of the other doctors in our group will check your eye and the technician will go over postoperative instructions with you.
Will I see 20/20 after the cataract is removed?
You should be able to see as well as you saw before you developed the cataract. Many people do see 20/20. This is not true for everyone. Examples of factors that sometimes prevent perfect vision are: glaucoma, diabetes and macular degeneration. It is not uncommon for vision to be blurry in the days after surgery.
After my first postoperative visit will I need to return?
Yes, another visit two weeks later and then several months after that. Of course, you can have as many appointments as you need. A prescription for a new pair of glasses will be given when your eye is stable. This is usually at the two week visit.
Will I need glasses after surgery?
Most people will require glasses to fine-tune their vision after surgery. However, it is common for patients after cataract surgery to require glasses only for all close activities, with the standard (monofocal) lenses and not for distance vision. It is more likely to require glasses if you have an astigmatism in your glasses prescription.
Are both eyes operated on at the same time?
No. To be safe, only one eye is operated on at a time. You can have surgery on the second eye as soon as one to two weeks later. There are certain circumstances when we do recommend waiting longer.
Can the cataract come back?
No. But later, some patients notice their vision isn’t as good as it was after surgery. This is usually due to what we call a secondary cataract. It is a hazy area that sometimes develops on a normal membrane inside your eye. This is normal and happens eventually in all patients. This can happen months or even years after successful cataract surgery. A secondary cataract can be corrected quickly and easily using the YAG laser. The laser procedure takes just a few minutes. It is painless and does not require anesthesia.
How soon after surgery can I be an airplane passenger?
If needed you can fly right after surgery.
After surgery when can I travel from Tucson?
We prefer if possible, you be available for follow up visits the first week after surgery. If you need to travel out of state or out of country, we can offer suggestions for follow-up.
I want to have surgery. What else do I need to do?
Prior to surgery we need to do an A-scan. This test measures your eye to allow us to select the lens implant for your eye. If you wear contact lenses please remove them 3 days prior to the ASCAN measurements. Leaving contact lenses out allows your cornea to return to its natural shape and gives us more accurate readings.
What does my insurance company pay for?
The insurance company pays for multiple things aside from copays or deductibles for surgeon fees, anesthesiologist fees and out patient surgery center costs.
What’s not covered by my insurance?
Insurance does not pay for laser assisted cataract surgery or premium lens implants.
Am I required to have laser assisted cataract surgery?
No. The standard cataract surgery is covered by your insurance. The standard cataract surgery is still an excellent sight restoring procedure. The laser is not covered since it helps to decrease your dependency on glasses by decreasing astigmatism.
If I have the standard surgery that is covered by my insurance will there be any cost?
Our surgery coordinators can help you understand the costs associated with this. If your insurance requires any copay, deductible, or co-insurance we will discuss this with you prior to your surgery.
Do you offer financing?
Yes. We are registered with Care Credit. If you would like an application please ask our receptionists. You can also apply online at www.carecredit.com or call 800-365-8295 to apply today.