Frequently Asked Questions
About Cataract Surgery
A cataract is a clouding of the natural crystalline lens inside your eye. The native lens is located behind the iris (the colored part of the eye) and works just like the lens of a camera, focusing light images on the retina, which then sends the images to your brain. The human lens, made mostly of protein and water, can become clouded – so clouded that it keeps light and images from reaching the retina. Cataracts are an extremely common side effect of growing older. In fact, if you live long enough, chances are high you will develop the condition in one or both eyes.
The most common symptom of cataract is blurring of the vision, including difficulty reading, driving and watching television. Other important symptoms may include night vision glares, halos around bright lights, double vision, dim vision and distorted vision. Dr. Rush will examine your eyes to diagnose cataract and determine if it is the reason for your vision loss. A visually significant cataract is based on how bothersome the vision defect caused by the cataract is for your daily activities. No two patients are exactly alike. The threshold point for favoring surgery depends upon what type of activities you do and how limiting the vision is for successfully performing them.
During cataract surgery, the eye's natural lens is removed and replaced with a clear, artificial intraocular lens implant or IOL. Basic IOLs, or monofocal lenses, are covered by insurance when used to replace a lens clouded by cataracts. These lenses restore clarity and can help patients achieve clearer near vision or distance vision, but not both. Most patients will still need reading glasses after cataract surgery with standard IOLs.
The main goal of cataract surgery is to get rid of cataract, not get rid of glasses and contact lenses. But with new technology lens implants can reduce your dependency on glasses and contact lenses. This is especially advantageous to those with high prescriptions who are used to thicker glasses.
We use the most advanced and commonly used implants in the field of ophthalmology, which have been successfully implanted in tens of millions of patients. There are several options and models to consider, each with its own relative merits.
Single Vision Distance
This is the most common option with the standard wavefront lens implant. Most prefer their best distance vision with both eyes working together for optimized depth perception. But with this option, you will always need reading glasses to see up close.
Monovision
This scenario allows for your dominant eye to be set for distance and your fellow eye aimed for near. This option makes you less dependent on glasses for distance and near but has a relative disadvantage of decreasing depth perception since both eyes are not focused together as a team. Patients that have used this in the form of contact lenses for many years adapt to it and love it. Not everyone will tolerate the two eyes being slightly off balance. We would recommend experimenting with this using contact lenses to see how you are able to tolerate it before consideration.
Astigmatism-Correcting Intraocular Lens Implant This premium technology implant is necessary for all patients with significant astigmatism who want to have the least amount of dependency on glasses post-operatively. Having either clear distance or near vision will make you less likely to need bifocals afterward.
Multifocal Lens Implant
This premium technology implant is the absolute best option to make you completely independent from glasses for both distance and near. Multifocal technology uses a lens implant that provides the largest range of vision from distance to intermediate and near by, splitting the light to focus some of it near and some of it at a distance.
Extended Depth-of-Focus
This implant offers patients a more seamless range of vision without splitting light into different sectors of the lens. This allows the lens to deliver the same high quality of vision and contrast of a single focus lens implant, but with the added benefit of excellent intermediate at arm’s length. It has the ability to make you much less dependent upon reading glasses, especially when working on a computer.
Yes, medical insurance including Medicare, Medicare supplements, and private commercial carriers, covers treatment for visually significant cataracts. They do not, however, cover the additional expense for upgraded intraocular lens implants. This expense must be paid out of pocket, something for which there are financing options available.
No, with successful removal of the cataract, it is gone for good. Over time you may develop a cloudy film behind the lens implant that can blur the vision, like looking through a cloudy windshield. This is not a regrowth of the cataract but rather a posterior capsular opacity. During the original cataract procedure, a thin portion of the cataract is intentionally left behind to allow for a support system to position the intraocular lens implant. The capsule usually starts off crystal clear but may tend to cloud over with time. A specialized laser treatment performed in the office that takes 60 seconds or less is able to polish off this cloudy film and restore vision. Patients who develop blurry vision later should be evaluated for this condition.
When your eyes were young, your natural lens was both transparent and flexible. Because of this, your vision was most likely stabilized until you reached your forties. Around that time, you may have noticed that you had to hold a menu or a book farther and farther away to read it, even with your best distance glasses prescription. Many people end up wearing a pair of reading glasses or bifocals to compensate for this aging process of the eye. This condition of not being able to focus up-close with one’s distance prescription is called “presbyopia”, and eventually affects everyone, including those who are nearsighted, farsighted, have cataracts, or had perfect vision most of their life. There are lens implant options during cataract surgery that will mitigate the effects of presbyopia after your surgery.