A cataract is a gradual, painless clouding of the crystalline lens of the eye. Most people develop cataracts later in life. Risk factors for developing cataracts are medical conditions such as diabetes mellitus, medications such as steroids, and significant trauma to the eye.
Ophthalmologists and Optometrists
Both ophthalmologists and optometrists can diagnose cataracts. Ophthalmologists are the only doctors who can perform cataract surgery. The diagnosis is made during an exam where your eye doctor puts drops in your eyes that dilate your pupils. The purpose of this is to thoroughly examine the eye and to grade the "hardness" of the crystalline lens.
Pre-surgery Preparations
Intraocular lens implant calculations allow your surgeon to select an implant based on your personal specifications. Implants may be monofocal or one focus distance or multifocal, multiple focus distances. The monofocal implant is covered by most medical insurance plans and the multifocal implant is not. These implants are made of either acrylic or silicone and are implanted inside your eye. On this same visit, you may also view a video describing the risks, benefits and alternatives to cataract surgery, and you will be asked to sign a consent for surgery.
Surgery
Cataract surgery is an outpatient procedure. You are not allowed to eat or drink anything after midnight the night before surgery. Depending on the experience of the surgeon and the difficulty of your cataract, the procedure on average takes 15 to 30 minutes per eye. Because of the potential risk of infection, it is recommended that only one eye at a time be done. Most patients receive mild intravenous sedation in addition to topical anesthesia. During the surgery your surgeon makes a small incision through the clear part of your eye called the cornea, and your cataract is emulsified and aspirated in a process called phacoemulsification. Once the cataract is removed, the artificial implant is implanted inside your eye. The surgery is done using a high magnification microscope. You may or may not have an eye patch when you leave the operating room.
Postoperative Procedure
After your surgery is completed, you are instructed to continue drops in the eye that had surgery. The drops are an antibiotic drop, a steroid drop and a nonsteroidal drop. Avoid rubbing your eye and getting water in the eye. Every person heals differently, and therefore the outcome of your surgery depends largely on you as a patient following the instructions you are given. You must wear a shield at bedtime to prevent rubbing your eye while you sleep.
The day after surgery you see your doctor. During this visit your doctor checks your eye's vision, intraocular pressure, grade of inflammation, placement of the lens and integrity of the wound. The vision can be blurry the first few days after surgery depending on the difficulty of your cataract. This is expected to clear within the first week after surgery. If all goes well and your surgeon is comfortable with your results, you continue your medications as directed and follow up in one week.
Resuming Regular Activities
Most patients return to work within a few days after cataract surgery. Refrain from any type of rigorous activity for at least a week. Patients were once told to refrain from heavy lifting and to avoid bending over. With advances in technology, the wounds are much smaller and watertight. You can bend over, but avoid lifting more than 25 pounds the first week after surgery.
