Cataracts and Surgery

by John B. Lyon, MD, Lindstrom Eye Clinic

Cataracts, put simply, are a clouding of the lens of the eye. The lens is just behind the iris, the colored portion of your eye, which is blue, brown, or green. The lens serves to focus light, like the lens of a camera, so that the eye can be in focus whether you are looking far away or near.

People often want to know what causes a cataract. The most common type is caused by age. The lens is composed of thousands of cells that originate from the clear bag or “capsule” that holds the lens in place in our eyes. The bag continues to make new lens cells throughout life, but there is a catch. The old cells are never removed, and the eye is unable to otherwise process them. Old lens cells are crammed more tightly into the center of the lens. This leads to hardening of the lens as well as clouding.

When a person gets to be about the age of 40, they often need reading glasses or a bifocal to be added to their glasses. This is the first sign of the hardening of the lens. Thirty years later or so, the center of the lens is not just hard but also discolored and cloudy. At some point, glasses alone will not improve vision, and the cataract will need to be removed with surgery.

Modern cataract surgery, like that done by the physicians at the Lindstrom Eye Clinic, removes cataracts from the eye by breaking them into very small pieces with a special instrument called a phacoemulsifier. The tip of this small instrument vibrates very rapidly to dissolve the lens. A laser is not used for this, as is commonly supposed. The bag that produces the lens fibers is left intact, except for an opening made on top to get to the lens. This leaves a place to put the artificial lens inside the eye.

People also want to know when a cataract is ready to be removed. There are two main considerations: The first is that a person’s vision must be reduced to a certain point on the eye chart, usually the 20/50 line or worse. Second, the person must be affected by the cataract, meaning they must have difficulty driving, reading, or doing activities that they enjoy. As long as a person is happy with their vision, there is no pressing need to remove the cataract, even if the vision qualifies on the eye chart.

If the person wants to know why they are not seeing well, they should have a thorough exam by their eye doctor. A complete exam is necessary to make sure that no other eye diseases are present, such as glaucoma and macular degeneration. For more information, call Lindstrom Eye Clinic at 426-9454.

Over the years, exposure to harmful UV-B rays from the sun can cause cataracts. In a study of 2,520 people ages 65 to 84, researchers found that even spending a moderate amount of time outside—less than two hours a day in the summer months—increased participants’ risk of developing cataracts.

The best prevention? Sunglasses offer excellent protection. Wearing a hat with a brim also decreases exposure by 30 to 50%.

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