Treatment of Cataracts

A cataract is a clouding of the lens of the eye. A cataract may be very small with little effect on your ability to see or may be large or central, obstructing your vision. According to the National Eye Institute, most cataracts are age-related, but children may be born with congenital cataracts. Cataracts may develop after eye trauma (injury, over-exposure to sunlight and ultraviolet rays) or radiation to the eye. Secondary cataracts can develop from previous eye surgery, other eye disease (glaucoma), diabetes and medications (such as chronic use of steroids).

Prevention/Conservative Treatment

• There is no non-surgical treatment for cataracts, but the National Eye Institute and Mayo Clinic outline risk factors that can be controlled by wearing sunglasses to protect your eyes from ultraviolet light, maintaining appropriate weight, controlling diabetes and quitting smoking and drinking. Additionally, you can minimize the effects of small or early cataracts. If you wear glasses, you should make sure your prescription is current. Providing adequate lighting and using magnifying glasses for reading or fine work can also maximize your vision.

Surgery

• In the past, cataracts were routinely left in place to "ripen" until vision was markedly impaired, but newer surgical techniques now allow earlier surgical repair and fewer adverse effects. The National Eye Institute describes two surgical procedures currently used for cataract removal. Phacoemulsification (phaco) is the newer technique. Phaco utilizes micro-instruments and a very small incision into the side of the cornea. The surgeon inserts an ultra-sound probe into the incision and uses sound waves to emulsify (break up) the cataract and the rest of the lens, which are then suctioned from the eye. In the extracapsular approach, the surgeon makes a longer incision into the cornea and removes the cataract intact and then removes the remaining lens by suctioning.

Intraocular Lens Implantation

• With either technique for surgical repair, you may have an intraocular lens (IOL) implanted. This plastic lens fits permanently into your eye and functions as your natural lens, focusing light. Segre and Hadrill in 'All About Vision' note that there are different types of IOLs to choose from. Monofocal lenses correct vision for only one distance, so you may need to wear glasses for some tasks. Multifocal lenses can correct vision at multiple distances, reducing the need glasses. Premium lenses (not usually paid for by Medicare or insurances) can correct for presbyopia (far-sightedness) and astigmatism (distorted vision). You may not be a candidate for IOL if you have eye disease or surgical trauma. Without a lens implant, you will need to wear a contact lens or glasses to replace your lens.