The Truth About Cataracts – 8 Things
As you get older and your vision begins to deteriorate, you may start to notice a number of not-so-pleasant changes. If you experience cloudy vision, diminished color vibrancy and difficulty reading without the aid of bright lights, you might have a cataract.
The clouding of the lens associated with cataracts occurs when protein fibers break down and begin to clump together. The exact cause of this breakdown is unclear (no pun intended) but it is suspected that an oxidative imbalance between free radicals and the antioxidants that help offset them could be the culprit.
Cataracts affect more than 24.4 million Americans over the age of 40 (according to the American Academy of Ophthalmology). And with people living longer than ever, this number is expected to increase significantly over the next 30 years. Fortunately, there are many things you can do to lessen your risk for developing cataracts, such as wearing sunglasses, limiting alcohol consumption, quitting smoking, and maintaining a healthy weight and diet. Perhaps most importantly, you should have regular eye exams to measure visual acuity and check for disease risk factors.
Better Vision Guide has compiled a list of eight things we think you should know about cataracts:
1. There are Different Types
There are three varieties of cataracts:
Nuclear Sclerotic – This is the most common type of cataract and the one most typically associated with aging. Nuclear cataracts develop in the center of the lens (also called the nucleus).
Posterior Subcapsular – Cataracts that develop at the back of the lens (posterior) are referred to as subcapsular. Diabetics, people taking high doses of steroids and those who are extremely nearsighted are at greater risk of posterior subcapsular cataracts. PCS cataracts, as they are called, typically generate the greatest level of visual discomfort in glare or low contrast situations, even when patients maintain good visual acuity.
Cortical – Clouding that affects the lens cortex (outer edge of the lens) is called a cortical cataract. The edge clouding creates fissures in the lens fibers, resulting in a spoke-like appearance towards the center of the eye. Diabetics are at greater risk of cortical cataracts.
2. Are They Inevitable?
Yes and no. More than half of Americans over the age of 80 either have cataracts or have had cataract surgery. If you live long enough, you will eventually develop cataracts. However there are plenty of 80- and 90-year-olds that do not have cataracts, and will likely not develop one in their lifetime.
3. Risk Factors
There are a number of other risk factors (beyond your age) for developing cataracts. These include:
- – Diabetes
- – Genetic predisposition (family history)
- – Overexposure to sunlight
- – Smoking and alcohol abuse
- – Nutritional imbalance
- – Obesity
- – High blood pressure
- – Long-term steroid use
- – Eye surgery
- – Eye injury/inflammation
It’s important to maintain regular checkups with your eye doctor to catch any early warning signs of cataract development.
4. Cataracts and LASIK
If you have undergone cataract surgery, LASIK is not recommended. However, if you have small, stable congenital cataracts (present at birth), LASIK may still be an option.
On the flip side, you can have cataract surgery after having LASIK surgery.
5. Surgery and Recovery
Cataract surgery is an extremely safe and effective procedure that is performed on an outpatient basis. It takes approximately 15 minutes to remove the cloudy lens and replace it with an intraocular lens (IOL). The procedure causes minimal pain and discomfort, with most patients finding the surgery easier than expected.
Driving is prohibited until you have received the green light from your eye doctor after a follow-up examination, so you will need someone to drive you home after surgery.
Complete recovery should take less than a month thanks to the modern treatment advancements that require smaller incisions and no stitches. During the month immediately following surgery, you should avoid strenuous activity, getting water in the eyes (keep them closed in the shower!) and dusty, dirty environments.
6. Cataract Dissolving Eye Drops
Currently, the only approved treatment for cataracts is surgery. However, there is a great deal of ongoing research surrounding eye drops that can dissolve cataracts without the need for surgery. Researchers found that certain children who developed cataracts were missing a natural chemical called lanosterol. Eye drops developed using lanosterol have been tested on a number of animals and have shown promise in shrinking the size of cataracts.
These drops would yield an incredible breakthrough in the treatment of cataracts, but it’s still far too early to consider them a viable alternative.
7. Cataracts Don’t Grow Back. However…
Once you’ve had a cataract removed it will not grow back. However, there is a relatively common complication that can result in what some people call a “secondary cataract.” Your surgeon will attempt to leave the lens capsule (membrane surrounding the lens) intact during and after surgery. Occasionally clouding can develop on the back of this capsule, a complication referred to as posterior capsule opacity (PCO).
The reality is it’s not really a cataract at all, and it can be easily treated through a procedure called YAG laser capsulotomy. This simple, painless laser treatment can be performed in a few minutes and does not require any incisions or contact with the eye whatsoever.
8. Cost of Cataract Surgery
The per-eye cost of cataract surgery can be as little as $1,000 or more than $5,000. This cost range reflects a variety of factors that include things like the type of IOL you have implanted in your eye, the location of the practice in which the procedure is performed (many urban offices have more overhead and therefore higher costs), and whether or not you have insurance coverage.
Insurance coverage such as Medicare can help to limit your out-of-pocket costs for the basic surgery. For example, if you have a standard monofocal IOL implanted, the majority of your treatment should be covered. If you opt for a more advanced IOL option such as a presbyopia-correcting IOL, you may have increased out-of-pocket expenses.
Your ophthalmologist will work with you to determine the best cataract surgery option for your eye health, lifestyle and budget.