A cataract is a clouding of the normally clear lens of the eye. You can think of the eye as a camera. In a camera, there is a lens which focuses light onto the film. Similarly, in the eye there is a clear lens that focuses light onto the retina. In a camera if you were to smear the lens with grease and then take a picture, the picture would come out blurry. By the same token, if the normally crystal clear lens of the eye becomes cloudy, the"pictures" the eye sees will also be blurry.
Below is a list of Educational Animations to help you understand cataracts. To view in Spanish, select Spanish from the Languages drop down menu.
A cataract is most often related to aging of the eye. A family history of cataract can be important. In addition, a history of diabetes, eye injury or use of certain medications (most notably steroids) can also play a role in the development of cataract. Frequent and extensive exposure to ultraviolet light has also been shown to hasten the development of cataracts. No specific evidence exists that links diet and the development of cataracts.
What are the symptoms?
The most common symptom of cataracts is a painless, gradual blurring of the vision. Other symptoms include glare, double vision in one eye, poor night vision, fading or yellowing of colors, frequent eyeglass prescription changes, and need to use brighter light to read.
The rate at which a cataract grows is highly variable, even between the two eyes of the same individual. The typical age related cataract usually grows slowly, whereas the cataract associated with diabetes may grow more quickly. It is impossible to predict how fast a cataract will grow in any given person.
In order to detect a cataract, a thorough medical examination by your ophthalmologist is recommended. This way, the ophthalmologist can tell if there are other reasons for the visual disturbance you may have.
If the cataract is causing only a mild blurring of your vision, a change in your glasses may be all that is needed to allow you to see better. If, however, the cataract is more advanced, correcting your vision fully may require removal of the cataract.
What is the surgical procedure for cataract removal?
The only way a cataract can be removed is through surgery. There are no medications, dietary supplements, exercises, or optical devices that have been shown to treat cataracts. Cataract surgery is an elective procedure in most instances. This means that the time to remove the cataract is when it interferes with your visual needs.
If you are still able to perform all of the daily tasks that you like and need to do, then you may not need to have the cataracts removed. If, however, your vision is preventing you from driving, cooking, sewing, reading, or doing anything you want to do, and if the reason for the decreased vision is your cataract, then surgery to remove the cataract may be indicated. Based on your symptoms, you and your ophthalmologist should decide together when surgery is appropriate.
Cataract surgery is usually performed under local anesthesia on an out-patient basis. Your ophthalmologist uses a microscope and delicate instruments to remove the cataract. In most cases, the focusing power of the eye is restored by placing a permanent lens implant inside the eye. This plastic lens implant is held in place inside the eye by a natural membrane. In approximately 20% of people, this natural membrane will become cloudy causing a decrease in vision. When this occurs, a laser can be used to open this cloudy membrane and restore vision. Thus, the laser is used after the initial cataract surgery, and only when that membrane becomes cloudy. Lasers are not used to remove the cataract itself!
Cataract surgery is highly successful. Improved vision occurs in over 90% of patients who have the surgery. Of course, no surgery is 100% successful, and it is imperative that you understand that complications can occur during or after the surgery. Some of these complications can be severe enough to limit vision. As with any surgery, a good result cannot be guaranteed. Make sure to discuss the surgery in detail with your doctor, and have all of your questions answered.
The surgery is usually performed under local anesthesia on an out-patient basis using a microscope and delicate instruments to remove the cataract. In most cases, the focusing power of the eye is restored by placing a permanent lens implant inside the eye. The plastic lens implant is held in place by a natural membrane in the eye. In approximately 20% of people, this natural membrane will become cloudy, causing a decrease in vision. When this occurs, a laser can be used to open this cloudy membrane and restore vision. The laser is only used after the initial cataract surgery. Lasers are not used to remove the cataract itself.
At Matossian Eye Associates there is more than meets the eye chart...
Snellen has been the first and last word in vision evaluation since 1862. But recent studies make it clear that Snellen is an incomplete gauge of functional vision. We now know that even a patient with 20/20 Snellen acuity can have difficulty seeing clearly in low-light conditions. The fact is, the Snellen high-contrast images and the well-lit testing environment are very different from the real-world situations that patients encounter every day.
Improved functional vision
The images below compare normal functional vision vs. reduced functional vision in patients with 20/20 visual acuity. As you can see, patients with reduced functional vision — who may still be able to read the letters on the chart — would be at a serious disadvantage in a low-light driving situation.
Normal Functional Vision
Artist rendering of normal functional vision
Reduced Functional Vision Artist rendering of reduced functional vision
Patients with reduced functional vision may:
Have lack of confidence in low-light situations that involve walking, climbing stairs, or unfamiliar settings
Experience trouble reading or doing work at close range
Have difficulty driving at dusk, at night, or in the fog
Below is an Educational Animations to help you understand YAG Laser Capsulotomy.
To view in Spanish, select Spanish from the Languages drop down menu.
New Technology Cataract Implants – presbyopia correcting and wavefront advantages
Our goal at Matossian Eye Associates (MEA) is to provide our patients with the highest quality eye care. We insure this by keeping current with the latest advances in ophthalmic surgical techniques. We offer some of the newest technologies in intraocular lens implants for cataract surgery.
The ultimate goal, for many years with cataract surgery, was to simply restore lost vision that was created by the cataract. However today, with new technology lens implants, cataract treatment has moved beyond just restoring vision loss. Today's lens implants offer better functional vision and the ability to reduce dependency on glasses for everyday visual tasks such as reading, working on a computer, driving at night or playing golf.
Accommodating Intraocular Lens for Cataract Surgery
MEA is pleased to offer the Crystalens® which is the first and only FDA approved accommodating intraocular lens implant for the treatment of cataracts. This second generation accommodating intraocular lens is unlike a standard intraocular lens implant because it not only treats your cataract but helps with the treatment of presbyopia (the age related inability to read up close without reading glasses). The unique design of the Crystalens® uses the eye muscles to flex and help focus on objects at distance, mid-range (computer distance) and up-close for reading. The Crystalens® will reduce your dependency on glasses for most activities such as reading a book, working on the computer, and driving a car.
Few patients with crystalens® have experienced glare, halos and night vision problems. Crystalens® focuses only one image to the back of the eye, unlike a multifocal lens that projects multiple images that are not entirely in focus, requiring “adjust” to the differences. In addition, Crystalens® vision is sharp and crisp because 100% of the light rays are available and distributed – when you need it.
The effectiveness of the Crystalens® was proven in clinical trials:
98.4% of patients implanted with crystalens® in both eyes could pass a driver's test without glasses
100% could see intermediate (24" to 30") without glasses, the distance for most of life's activities
98.4% could see well enough to read the newspaper and the phone book without glasses
74% of patients never or almost never wore eyeglasses
Significantly more patients implanted with a Crystalens ® (88.4%) could see better at all distances then patients implanted with a standard IOL (35.9%).
Long-term experience means a safe and effective procedure – some patients have continued excellent vision 5 years after implantation with the Crystalens® More than 40,000 crystalenses have been implanted worldwide
The Crystalens® Procedure
The Crystalens® procedure is simple and allows for relatively fast healing. After a small incision is made at the edge of the cornea, the lens is liquefied and the Crystalens®is implanted. Crystalens® can usually be implanted in about 15 minutes.
The recovery period is usually short. Most patients are able to pursue normal activities almost immediately after surgery. Patients usually have a follow-up visit scheduled with the surgeon to evaluate the patient’s recovery. Discuss with your doctor beforehand what to expect before, during, and after the procedure in terms of eye drops and office visits.
If you are like most patients who have the Crystalens®, you can expect to see everything more clearly. Your focus will be sharper than it has been in years, and you can expect to see improvements over time.
Listen to a testimonial from Florence Henderson here.
Patient Experience Video
Watch a video of a patient's experience with the Crystalens® procedure: Select a video format (your web browser must have pop-up windows enabled to view this video). Windows Media QuickTime
Each Crystalens® is polished with “polishing beads” which are individually inspected by hand and undergoes a 3-step cleaning process:
Is checked for power accuracy
Is individually inspected before packaging
Is the only premium lens available in 0.25 diopters, allowing the surgeon to make a precise match with patients needs
This means that both you and your surgeon can be assured that you have a premium quality lens.
Below is an Educational Animations to help you understand Accomodative IOL's.
To view in Spanish, select Spanish from the Languages drop down menu.
See the big picture without missing the details
There was a time when cataract surgery could only restore a patient’s distance vision. But today, thanks to the breakthrough AcrySof®ReSTOR® intraocular lens (IOL), we can help you enjoy crisp, clear, vision from near to far with little dependence on glasses.
How does the AcrySof® ReSTOR® lens work?
The AcrySof® ReSTOR® lens is a breakthrough because it corrects cataracts with or without presbyopia. Presbyopia is the reason many patients need reading glasses as their eyes age. In fact, 4 out of 5 patients in the supporting clinical study who had the AcrySof® ReSTOR® lens in both eyes reported never having to wear glasses.
The AcrySof® ReSTOR® lens is also a breakthrough because, unlike traditional monofocal IOLs, it’s a multifocal IOL, designed to restore your full range of vision, from the pages of a book, to your computer screen, to scenic landscapes. As the name implies, monofocal lenses can only give you clear distance vision–you still need reading glasses.
Life-changing results in minutes
Whichever IOL you choose, rest assured cataract surgery is one of the safest and most effective procedures performed today. We simply make a tiny incision in your eye, remove its natural clouded lens, and replace it with a new lens. The actual surgery can take minutes and the results are permanent and life changing. Most patients are back to their normal activity the very next day. Your eye doctor will implant the lens in one eye at a time.
AcrySof® Toric -- The leading choice for cataracts and astigmatism.
If you have astigmatism and cataracts, we may recommend another advanced lens called the AcrySof® Toric lens. It’s the first IOL that treats preexisting astigmatism at the same time it corrects cataracts, so you don’t have to undergo two separate procedures.
If less dependence on eyeglasses for distance vision is important to you, you now have a better option. The unique design of the AcrySof® Toric lens provides significantly improved distance vision and may reduce the need of corrective lenses.
What is the AcrySof® Toric IOL?
The AcrySof® Toric lens is a foldable, single-piece lens that an eye surgeon implants during cataract surgery to replace the clouded lens. The unique design of the AcrySof® Toric IOL makes it possible to reduce corneal astigmatism and significantly improve uncorrected distance vision.
We’re proud to offer AcrySof® lenses as part of our ongoing commitment to our patients who want the latest advances, the best vision, and the highest quality of life.
Below are more Educational Animations to help you understand how
the Toric lens helps in the treatment of astigmatism.
To view in Spanish, select Spanish from the Languages drop down menu.
Tecnis Intraocular Lens Implant
Another new"High Tech" lens implant we offer is the TECNIS. This is the first and only lens approved by the FDA for improved functional vision in low light conditions such as night driving. This lens was designed using wavefront technology to restore safer and sharper vision after cataract surgery. In a clinical driving simulator study, the TECNIS lens implant allowed drivers to identify a pedestrian 45 feet sooner than those with a traditional lens implant.
Contrast enhancement versus traditional spherical IOLs
The clinical trial with the night driving simulator demonstrated significant contrast enhancement. Patients with the TECNIS™ IOL were able to detect and identify a pedestrian hazard in low light conditions significantly faster than with the control lens.
Whether climbing stairs, reading a menu by candlelight or even driving at night, the contrast enhancement with this technological advance allows the eye to function more like that of a younger person's eye, improving functional vision in varying light conditions.
Simulated Image Contrast sensitivity with the TECNIS™ IOL was up to 31 percent higher
in bright light conditions compared to traditional lens.
Simulated Image Contrast sensitivity with the TECNIS™ IOL was up to 53 percent higher
in low light conditions compared to traditional lens.
Light blocking intraocular lens technology
In addition to these new lens implants, we also offer the latest in light blocking intraocular lens technology. Light blocking is a new concept especially in the area of ocular implants. The idea behind light blocking is to prevent potentially harmful wavelengths of light from damaging the retina and macula. First generation light blocking lens implants only blocked blue light since blue light was thought to be the most harmful. Now it appears that blue light has some beneficial aspects which include helping with low light vision and maintaining proper circadian rhythm and sleep patterns.
Bausch and Lomb's newest lens implant SofPort Advanced Optics with Violet Shield technology blocks potentially harmful violet wavelengths of the visual light spectrum without compromising vision in low light. This implant also has an aberration free design to provide exceptional post cataract surgery quality of vision and enhanced contrast sensitivity.
If you would like more information about these new lens implants or would like to schedule a cataract evaluation please contact us at any of our three offices listed below.
Limbal Relaxing Incisions for Astigmatism Correction Almost everyone has a small amount of astigmatism; however for some the amount is significant enough to create some visual problems. Astigmatism means that the cornea (which is the clear dome over the colored portion of the eye) is shaped more like a football instead of being round like a basketball. This causes the light rays entering the eye to be bent in a manner that prevents them from focusing at one point, leading to blurred and distorted vision for both distance and near.
Limbal relaxing incisions (LRIs) are a form of astigmatic keratotomy for the correction of mild to moderate amount of astigmatism. The procedure entails creating small arc incisions in the peripheral portion of the cornea usually at the steeper parts to create a “relaxing” or flattening effect with healing to allow the cornea to become more round.
Limbal relaxing incisions (LRIs) have gained widespread acceptance amongst cataract surgeons where it is often combined with the cataract operation. The procedure is safe and serious complications are extremely rare. There is usually little or no, post-operative discomfort and usually no associated glare or starbursts which can be seen with other procedures.
Limbal Relaxing Incisions are for those:
who have astigmatism
want to minimize their dependence on glasses or contacts
have no health issues affecting their eyes
In regard to what can be expected after the procedure, a fair amount of patients appreciate a dramatic improvement in their vision the first day after surgery. Since everyone heals differently some patients may note improvement days to weeks after the procedure.
Below are Educational Animations to help you understand astigmatism and it's cause. To view in Spanish, select Spanish from the Languages drop down menu.
Click on the image to the right to download a short testto determine which distances you wish to see after surgery.
The test is an PDF file which require a PDF reader, such as Adobe Acrobat. You can download a free copy of the Acrobat Reader at the Adobe site. Click here forACROBAT.