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What to know before you have cataract surgery

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You and the LawA normal part of aging, a cataract is a medical condition in which the eye’s lens becomes clouded, eventually affecting vision. The first sign of cataracts may be nearsightedness, which glasses can correct. Over time, however, night vision worsens and colors appear duller.

According to the American Academy of Ophthalmology, the only effective treatment for cataracts is surgery to remove the clouded lens and replace it with a clear, synthetic one. This surgery is a commonly performed procedure with a very high success rate.

Cataract surgery is done under a local anesthetic on an outpatient basis. The procedure usually takes about 15 minutes to perform, with about an hour in recovery for the anesthesia to wear off. You should be back to a normal routine in just a few days.

If you have cataracts in both eyes, the doctor may recommend operating on one eye first. Depending on the improvement in your vision, you may even forego surgery on the other eye.

Your physician may offer you a choice between traditional cataract surgery using a scalpel to remove the lens and laser-assisted surgery. Laser surgery costs more than traditional surgery and most insurance plans don’t cover it. Traditional surgery is the most common type of procedure and is just as safe and effective as laser surgery.

Lens types

Several replacement lens options are available. A clear, fixed-focus, monofocal implant works for many people even though glasses may still be required for reading. Another option is to have one lens that provides far vision and another that provides near vision.

Accommodating monofocal lenses can shift from near to far vision based on movements of your eye muscle, but aren’t always ideal for close work. Toric lenses correct astigmatism.

Multifocal lenses are like bifocal or progressive lenses, requiring the brain and eye to sort out which part of the lens to use.

There are benefits and drawbacks to each choice. Insurance typically covers the cost of clear, monofocal lenses. Expect to pay out-of-pocket for specialty lenses.

Best practices

Cataracts develop gradually and are not life threatening. If they are not bothering you, you don’t need to remove them. The time to have surgery is when cataracts begin to interfere with daily life.

A comprehensive eye exam by your ophthalmologist every two years beginning at age 40, then every year beginning at age 65 is recommended to monitor for cataracts.

The American Academy of Ophthalmology suggests these steps to delay development of cataracts and the need for surgery:

  • When outdoors, wear a hat and sunglasses that block at least 99 percent of UV rays.
  • If you smoke, quit. Smoking is a key risk factor for cataracts.
  • Use brighter lights for reading and other activities.
  • Limit night driving once night vision or glare becomes a problem.
  • Address other health problems, especially diabetes.
  • Get eyeglasses or contact lenses to correct your vision.

To learn more about cataracts, visit the National Eye Institute’s website at cataract/cataract_facts.

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