Cataract Surgery
What are Cataracts?
Cataract is a normal aging process where the clear lens in the eye slowly becomes cloudy. The inside of your eye contains a natural inner lens- it’s located behind your iris (the coloured part of your eye). This clear lens bends (or refracts) the light rays that enter our eyes onto our retina, allowing us to see clear, well-defined images every day.
A cataract forms once the proteins in the eye start to break down and clump together around the inner lens. The formerly clear inner lens is clouded, thus causing the light rays entering our eyes to be scattered or blocked. Think of it as a cloudy or murky window- it is more difficult both for light to enter and to see out of.
Cataracts generally develop slowly, and can affect one or both eyes. They are the most common cause of vision loss globally. Finding cataracts requires a thorough eye exam, and once detected, surgery is required to remove the cataract (although surgery may not be necessary right away).
Causes of Cataracts
The most common cause of cataracts is aging. More than 75% of Canadians who report cataracts are above the age of 60.
However, you have a higher risk of developing cataracts at a younger age if you have diabetes, a history of high UV exposure, previous eye trauma, take certain medications, or have a family history of cataracts. If you’re above 50 or have any of the prespecified risks, ensure you’re getting your eyes checked once a year.
Common Symptoms Include…
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Cloudy or blurry vision
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Difficulties seeing at night or in the rain
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Light or glare sensitivity
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Seeing “halos” around lights
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Double vision
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Inability to see bright colours
Treatment Options
In the early stages of cataracts, immediate surgery isn’t usually necessary. Wearing sunglasses to block UV rays is the best way to slow down the development of cataracts, and if your symptoms aren’t bothering you very much, you may just look into a new eyeglass prescription. However, once cataracts have begun to actively interfere with your life, it is time to consider surgery.
Surgery
Cataract surgery is one of the most frequently performed surgical operations in Canada. The clouded, natural inner lens is removed and replaced with a clear replacement lens called an intraocular lens implant (IOL). To prepare, our skilled technicians will use machines to measure the natural inner lens so that Dr. Zack can choose an implant specific to your eye.
There are several different types of IOLs; choosing one depends on your vision (e.g. if you’re nearsighted or farsighted) and your insurance coverage. While MSP covers basic cataract surgery, choosing a premium lens may involve extra costs.
Cataract surgery is an outpatient procedure- meaning you’ll go to one of the hospitals Dr. Zack operates out of to get your surgery done.
Dr. Zack works with state-of-the-art equipment, using surgical techniques that require no stitches or needles. For most patients, no IV sedation is needed to perform the surgery, and while you will be awake, your eyes will feel little to no discomfort during the procedure. The surgery itself is relatively quick (15-60 minutes). Make sure to arrange a ride home from the hospital with a friend or relative.
Over 95% of cataract surgery cases result in improved vision. Cataract surgery is one of the safest and most effective types of surgery, and most patients report improved vision within a few days of surgery.
You’ll receive a prescription for eye drops. Start using them on the date of your surgery, after you get home (approximately 2 - 3 hours after the surgery). Use a drop from each bottle, leaving at least a minute between each one. Repeat three times a day, approximately 6-8 hours apart. Within 24 hours of surgery, you’ll also go to Dr. Zack’s office for a follow-up eye examination.
In the weeks, months, or years after your initial surgery, your vision may become hazy again. This is because your natural lens capsule (the part of your eye that holds the IOL in place) has become cloudy. To restore your vision again, Dr Zack will use a laser to open the cloudy capsule. This outpatient procedure is called a Laser Capsulotomy.
After Surgery
First Few Days
Following surgery, your vision for the first few days may be cloudy and smokey as the eye is healing. Many patients (though not all) may report watery eyes/excessive tearing, and others report a scratchy or sandy feeling in the eye which is known as “foreign-body sensation” as some describe feeling as though something like an eyelash is in the eye. This occurs most frequently and is more bothersome for some patients especially those with dry eyes and dry skin, and certain medical conditions such as thyroid and Rheumatoid Arthritis. Avoid bending, lifting, or straining in the first 24 hours following surgery. Ensure you’re using your prescribed eye drops. Take it easy for the first few days- watching TV and reading is fine. In some cases, especially after the removal of a particularly dense/thick cataract, corneal swelling may occur- when vision is particularly unclear/foggy/blurry, or is initially pretty clear but becomes blurred later in the day or the following morning. While rare, this is completely normal. Swelling can take a week or two (in some cases, even a month or two) to improve and vision to clear up.
First Few Weeks
In the first few weeks, many patients report that one eye feels fine and one eye has uncomfortable symptoms, or that it is more bothersome in one eye than in the other. It is actually less common for patients to report that both eyes feel identical. All these experiences are normal, and usually resolve over time and with dry eye drops. Avoid strenuous activity and heavy lifting for the first week after surgery. Avoid getting water in your eyes for the first week after surgery. Avoid wearing eye makeup for the first few weeks. Wait until 2 weeks post-surgery before swimming.