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A cataract is disturbance of vision caused by a decrease in the transparency of the lens in the eye. Cataracts commonly involve both eyes and can cause a variety of symptoms, with the most common being the impression that the patient is looking at the world through a foggy window, difficulty seeing at night, and “star-bursts” or “halos” around bright lights. Cataracts usually involve both eyes, although one eye may be affected more than the other. The only proven treatment for cataracts is to surgically remove them and insert an artificial lens in their place. Cataracts are usually diagnosed after an examination by an ophthalmologist, a physician with special training in diseases of the eye and their treatment. If cataracts are detected, a series of special eye examinations will reveal the extent of their impact on vision and determine the proper size of artificial lens that will allow the best return to near-normal vision. The physician will discuss the procedure with the patient and, if the patient agrees, surgery is scheduled for some time in the future. If both eyes are affected by cataracts, the eye with the more compromised vision is usually operated on first. Despite the seeming complexity of an operation on the human eye, cataract surgery is actually very straightforward. Using specially-designed instruments, a small incision is placed at the edge of the colored part of the eye. Another small instrument is placed into the lens through this incision and the cataract is removed. An artificial lens in then inserted in the space formerly occupied by the cataract and, once its position is verified, the incision is closed with a special adhesive. A dressing is then placed over the eye and the patient is observed for about an hour before being discharged. Cataract surgery is done on an outpatient basis and under local anesthesia in the form of drops that are placed on the eye. Including preparation time, the surgery itself, and a period of observation after the operation, the procedure takes about three hours and the patient is then allowed to go home. Most patients are seen in the ophthalmologist’s office the day after surgery and medications in the form of eye drops are administered for several weeks following surgery. With modern surgical techniques, the incidence of complications following cataract surgery is very low. Most frequently, complications are related to a temporary blurring of vision in the eye or possible “double vision” when only one eye is operated on. Thanks to the effectiveness of antibiotic eye drops, infection is not usually seen after cataract surgery. Rarely, the artificial lens will slip out of position. This complication is easily corrected by a second surgical procedure. In general, cataract surgery with lens replacement is covered by Medicare, all state medical assistance programs, and practically all private insurance carriers and Health Maintenance Organizations. In addition, many ophthalmic physicians offer affordable payment schedules for those without insurance coverage.
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