Our cataract surgeons at UC Irvine’s Gavin
Herbert Eye Institute are certified by the American
Board of Ophthalmology. Additionally, all of our cataract surgeons
have had advanced fellowship training and have been distinguished
as top doctors in Orange County and the nation.
Our
relationship with you as a patient is focused on fulfilling the
needs and priorities of your eye condition, applying state-of-the-art
diagnosis and surgical procedures, and supplying experienced advice
for achieving your best possible visual results.
What are cataracts?
More than 50 percent of people over the age of 60 (and quite a few younger
than that) suffer from cataracts. Almost everyone develops cataracts as they
grow older. Cataract formations occur at different rates and can affect one
or both eyes.
A cataract is a progressive clouding of the eye's
natural lens. It interferes with light passing through the eye
to the retina. Aging and other factors cause proteins in the eye's
lens to clump together forming these cloudy areas. Early changes
may not disturb vision, but over time cataracts typically result
in blurred or fuzzy vision and sensitivity to light. People with
progressed cataracts often say they feel as if they're looking
through a waterfall or a piece of wax paper.
In fact, eye cataracts are the leading cause of vision
loss among people over age 55, and cataract surgery with an intraocular
lens implant (IOL) is one of the most frequently performed operations.
This may be a reflection of the changing demographics of our population.
In 2006, 80 million “baby boomers” began turning 60
and it is estimated that by 2011 there will be 40 million people
over age 65 in our population and by 2020 there will be close to
55 million! In the United States, the incidence of senile cataract
has been reported to be about 42 percent in people age 52 to 64,
60 percent in those age 65 to 74 and 91 percent in those age 75
to 85.
Diagnosing cataracts:
Regular eye exams help your doctor determine if cataracts are affecting your
vision. If you have experienced a gradual drop in vision, with the symptoms
described above, you may have cataracts and should schedule an appointment
with one of our comprehensive ophthalmologists or cataract specialists.
Treating cataracts:
Currently there is no medical treatment to reverse or prevent the development
of cataracts. Once they form, the only one way to achieve clear vision again
is through cataract surgery.
In your parents' or grandparents' day, cataract surgery was considered
risky, required a lengthy hospital stay and was usually postponed
for as long as possible. Today, cataract surgery is performed on
an outpatient basis and takes only a few minutes. It is now one
of the most common and successful medical procedures performed.
In fact, after cataract surgery, many patients’ vision is
better than before they developed cataracts.
During surgery your clouded lens is removed and replaced with
an intraocular lens (IOL). Your doctor will help you choose the
correct IOL for you. Depending on the health of your eye and your
needs, there are multiple IOL options that may be available to
you.
Monofocal IOL – These
are single focus lenses that allow for vision at distance
or near. Glasses are generally needed after surgery.
Toric IOL* – These
IOLs correct for astigmatism in addition to correcting
for either distance or near. Toric IOLs allow for clearer
vision as a result of astigmatism correction.
Multifocal IOL* – These
IOLs give a wider range of vision without glasses. In most
cases, glasses will not be needed either for driving or
TV and also close up vision, such as computers or reading.
These lenses function somewhat like built-in bifocals,
splitting the focused light between distance and near.
Accommodating IOL* – Like
multifocal IOLs, accommodating IOLs are also designed to
increase range of vision without glasses for most daily
activities. These lenses work by flexing, mimicking the
natural focusing action of the eye.
Traditionally, cataract patients received monofocal lens implants
that had only a single power. This meant you had a choice of correction
for either far or near vision. If you suffer from presbyopia like
many people over age 40, this would mean that you still need glasses
for either reading or for distance vision. Over the last 10 years,
the FDA has approved several lifestyle intraocular lens implants
for use by certified ophthalmologists. These lenses can increase
your chances for a life free of dependence on glasses or contacts
after cataract surgery for near, far and intermediate vision. If
you have worn glasses for 30 years, this might be an opportunity
to eliminate them altogether.
The implantation procedure is the same for lifestyle IOLs and
monofocal IOLs. The main point of differentiation between the IOLs
is in the type of vision they provide.
All patients should know that one approach or IOL is not better than another,
they are just different. Our goal is to provide the safest and most effective
cataract surgery for each one of our patients. All efforts will be made to
personalize the cataract surgery approach and IOL choice for you so that you
will be able to enjoy improved vision for years to come.
What exactly is a cataract?
A cataract is a cloudiness of the eye's natural lens, which lies between the
front and back areas of the eye.
Are cataracts found only in older people?
About half of the population develops a cataract by age 65, and nearly everyone
over age 75 has at least one. But in rare cases, infants can have congenital
cataracts. These are usually related to the mother having German measles,
chickenpox, or another infectious disease during pregnancy, but sometimes
they are inherited.
My doctor says I have a cataract, but he wants to wait
awhile before removing it. Why?
A cataract usually starts very small and is practically unnoticeable until
it grows gradually larger and cloudier. Your doctor is probably waiting until
the cataract interferes significantly with your vision and your lifestyle.
Continue to visit your eye doctor regularly so the cataract's
progress is monitored. Some cataracts never reach the stage where
they should be removed. If your cataract is interfering with your
vision to the point that it is unsafe to drive or makes doing everyday
tasks difficult, it's time to discuss surgery with your doctor.
Is cataract surgery serious?
All surgery involves some risk, so yes, it is serious. However, cataract surgery
is the most commonly performed type of surgery in the United States.
What is the right lens for me?
Determining the right IOL for you can be based on many factors, including the
health of your eye, your lifestyle and the fact that lifestyle IOLs incur out-of-pocket
expenses. If you are interested in correcting presbyopia, which all people
develop beginning at about age 40, you potentially could decrease your dependence
on eyeglasses and restore your ability to see at all distances with a multifocal
IOL or accommodating IOL.
However, you must consider that additional cataract surgery costs
do occur with "lifestyle" IOLs, even though they may
reduce or eliminate dependency on eyeglasses.
Before cataract surgery, your eye will be thoroughly measured
in a preliminary examination to determine the proper power of the
intraocular lens that will be placed in your eye. If you choose
a lifestyle IOL, you may need extra tests to make sure measurements
are exact and that you don't have other vision problems that might
hamper the performance of the IOL.
Before Your Cataract Surgery
Should someone accompany me on the day of surgery?
We request that you bring someone with you on the day of cataract removal surgery.
Where does the surgery take place?
The Argyros surgery center is located in the garden level of the Gavin Herbert Eye Institute Building on the main campus of UC Irvine.
How long will I be at the surgery center the
day of my surgery?
Most patients should plan to be at the surgery center between
2-3 hours from the registration to discharge.
What should I bring with me the day of surgery?
We recommend that you bring the following to the surgery center:
Friend or family member (someone to help with paperwork, driving
home, etc.)
Medicare or insurance cards
Medication – enough for the time you will be away from
home
List of prescription medication including dosage and strength
Sweater or jacket
Reading material or busy work
I take several prescription medications, including a blood
thinner. Should I continue these before surgery?
Yes. Take all prescription medications as you normally would with a sip of
water (unless specifically instructed by your doctor).
I wear contact lenses. May I wear my contacts until the
day of surgery?
Please stop wearing soft contact lenses at least one week prior to your evaluation for surgery. Hard contact lenses may change the shape of your cornea and you may need to be out of them for several weeks prior to surgery. Please let your doctor know that you wear contact lenses.
May I eat before surgery?
No. Please ensure that you have nothing to eat or drink at least eight hours
prior to surgery.
May I wear makeup?
Please do not wear any makeup on the day of surgery.
I’m on oxygen. Should I bring it with me?
Yes, bring more than enough oxygen for a 3 hour stay. While under our care,
we will have oxygen available for you.
During Your Cataract Surgery
Will I feel anything during surgery?
Most patients feel only gentle pressure during cataract removal surgery.
What do I see during surgery?
Most patients only see the bright lights of the microscope.
May I have medication for my nerves?
Generally our anesthesia staff is present. A mild anti-anxiety medication will
be administered as needed.
I was told to take antibiotics before receiving dental
work. Should I take them before eye surgery also?
Unlike the mouth, the eyes are very clean. You will not need to take antibiotics
unless instructed by your doctor before the operation.
How soon may I leave after having cataract removal surgery?
Most patients are able to leave within an hour of having cataract surgery.
I was told I need surgery on both eyes. When may I receive
treatment for my second eye?
You may have your surgeries one to two weeks apart (unless there is a
reason to wait longer.) If applicable, your doctor will discuss this
with you.
Will I be able to see immediately after the operation?
Most patients’ vision is quite blurred after the surgery from the dilating
drops and bright microscope lights.
What will happen before I’m discharged?
After the surgery, you will be taken to the recovery room where we will assess
your vital signs (pulse, blood pressure etc.). At this time, we will also
explain your postoperative instructions and medications to you and a friend
or family member.
My back keeps me from lying flat. What position must I
be in for the surgery?
We will need you to lie down for surgery; however, our experienced OR team
has worked with virtually every medical condition that presents special needs.
We will be able to work with you to make your experience as comfortable as
possible.
Does every patient need an implant?
The vast majority of patients require an implant to replace the natural lens
or cataract. Only in very rare cases of extreme nearsightedness is an implant
not required.
May I drive myself home?
No, we require patients bring a friend or family member to drive them home
due to the medications given.
Sometimes my blood pressure gets high when I’m nervous.
What happens if it’s too high?
If we are unable to manage your blood pressure with medication, your surgery
may be postponed until you consult with your primary physician.
Do I need a physical before surgery?
Yes, you will be asked to get a medical clearance prior to surgery. Our nurse
practitioner can perform routine clearances. If you have a complicated medical
history, we may ask you to be cleared by one of our Hospitalists.
After Your Surgery
Did I receive a lens implant during surgery?
Intraocular lenses are required except in very rare cases of extreme nearsightedness.
What material is my implant made of?
Most of the implants used are made of either acrylic, silicone or PMMA (plastic).
Will the implant need to be replaced in the future?
The intraocular lens implant will remain in your eye permanently and will not “wear
out.”
Can my eye reject the lens implant?
No, since the intraocular lens is not made up of human tissue, your body cannot
reject it.
Was a laser used to remove my cataract?
Cataracts are removed by ultrasound, not a laser. In a process called phacoemulsification,
sound waves are used to gently break up the cataract before it is removed
from the eye. Lasers are currently being developed to remove cataracts.
Should I wear my old glasses after surgery?
Wearing your old glasses will not harm your eyes, but they will probably not
give you optimal vision either. Most patients find it best to wear glasses
only for reading.
Why isn’t my close-up vision as good as my distance
vision?
Your ability to see well at close range depends on the type of intraocular
lens you received. For most IOLs, it is normal to require reading glasses after
cataract surgery.
During at least the first week after surgery, it is essential
that you avoid:
Strenuous activity and heavy lifting (nothing over 10 to 15
pounds).
Bending, exercising and similar activities that might stress
your eye while it is healing.
Water that might splash into your eye and cause infection.
Keep your eye closed while showering or bathing. Also, avoid
swimming or hot tubs for at least two weeks.
Any activity (such as changing cat litter boxes) that would
expose your healing eye to dust, grime or other infection-causing
contaminants.
How soon may I resume driving after surgery?
For most cataract surgery patients, vision improves significantly in the first
24 hours after surgery. You may drive as soon as you feel comfortable doing
so.
Is it safe to fly after cataract surgery?
Flying after cataract removal surgery will not harm your eye.
When may I wear make-up again?
You may wear lipstick and powder immediately after surgery. However, you should
avoid eye make-up for two weeks after surgery.
Is it safe to have my hair done or get a permanent?
Yes, as long as you take sensible precautions to avoid chemical contact with
your eyes.
Why does it feel like there is something in my eye after
my surgery?
During cataract surgery, a microscopic incision was made on the surface of
your eye. When you blink, you may feel a slightly scratchy sensation until
the incision heals. After surgery, many patients find that using artificial
tears helps to alleviate discomfort.
The eye drops that I was instructed to use after surgery
sting my eye. Is this normal?
It is common for some eyedrops to burn or sting. You should continue to use
your eyedrops as prescribed. However, if your discomfort seems to be worsening,
or you experience a decrease in vision, call us immediately. Some patients
find that using “artificial tears” five minutes before placing
medicated drops in the eye decreases irritation.
After surgery, I noticed a spot of blood on the white
of my eye. Should I be concerned?
The white part of the eye (sclera) is covered by a clear layer of tissue (conjunctiva).
When a tiny blood vessel breaks, the blood becomes trapped below the conjunctiva.
Since the tissue is clear, the blood is clearly visible. If this were to happen
on your arm, you would have a blue or purple bruise because the skin is not
transparent. This will not affect your vision and will gradually resolve on
its own.
On the way home from surgery I saw huge halos around all
the lights. What causes this?
This dramatic glare was due to the fact that your pupil was still dilated from
the surgery. After dilation wears off, vision should return to normal.
My glare problem has improved dramatically since the surgery,
but I still occasionally notice halos or streaks on lights at
night. What causes this?
There are many factors that can cause glare. A slight need for glasses (refractive
error) is one of the most common reasons you may notice slight glare at night.
Also, some patients experience minor corneal swelling after surgery that may
cause temporary glare.
Since my surgery a few weeks ago, everything has a pink
tint. What causes this?
This pink tint is due to slight swelling in the retina and is not uncommon
after surgery. It will gradually go away as you use your postoperative eye
drops. However, always contact your eye doctor if you notice a change in your
vision. Since sun exposure can aggravate this problem, it is also important
to protect your eyes with sunglasses when outdoors
After surgery, why does everything appear to have a blue
tint??
Patients with cataracts see their world through a yellow tint. It’s just
like wearing yellow-tinted (”blue-blocker”) sunglasses, which block
colors from the lower end of the color spectrum (blues and violets). When the
cataract is removed and replaced with a clear implant, you will see these unfamiliar
colors again. This is much more dramatic for some patients than others.
If you have additional questions about cataract removal surgery
please ask your doctor.
Our
relationship with you as a patient is focused on fulfilling the
needs and priorities of your eye condition, applying state-of-the-art
diagnosis and surgical procedures, and supplying experienced advice
for achieving your best possible visual results.
