Everything You Need to Know About Cataracts and Cataract Surgery
Gulfcoast Eye Care is committed to improving vision and eye health for patients in the Tampa Bay and St. Petersburg area. Our board certified cataract surgeon, Dr. Michael Manning, specializes in diagnosing and treating cataracts and he is highly experienced in advanced cataract surgery techniques.
A cataract is a very common eye condition that affects over 24 million Americans. Cataracts occur when the eye’s natural lens hardens and becomes cloudy. This can reduce the ability of the lens to properly pass light to the retina and result in a range of visual symptoms. Cataracts frequently develop with age, but less commonly may affect younger people as a result of a congenital defect or an injury.
When cataracts first develop, symptoms may be very mild or not noticeable. However, cataracts can eventually cause blindness and vision loss if left untreated. As a cataract progresses, you will begin to notice symptoms such as:
Cataracts are typically caused by aging and are a result of the natural aging process. Some risk factors which may contribute to the development of cataracts include:
In the early stages of a cataract, symptoms are mild and you may be able to find improvement with glasses or brighter lighting. However, as symptoms inevitably progress surgery is the only option for the treatment of cataracts. Cataract removal is one of the most commonly performed surgical procedures in the United States and is widely regarded to be safe and effective. During cataract surgery your eye’s natural lens is replaced with an intraocular lens implant (IOL).
Intraocular lens implants, known as IOLs, are artificial lenses that serve as replacement for the eye’s natural lens once cataracts are removed. Traditional cataract surgery with a standard IOL will reverse the effects of cataracts and restore distance vision, but patients may still need glasses for reading vision or astigmatism. Our practice offers a full range of advanced IOLs that can allow patients to see more clearly at a variety of distances without heavy reliance on corrective eyewear. For patients who would like to experience LASIK-like results and reduce or eliminate their need for glasses, advanced IOLs can correct astigmatism, presbyopia, and vision at all distances!
Cataract surgery at Gulfcoast Eye Care is performed by Dr. Manning in an outpatient surgery center. Upon arrival at the center, your eye will be numbed with anesthetic eye drops and you will be given a mild sedative to prepare for surgery. Patients are generally quite comfortable during surgery and usually feel no pain but only a pressure sensation. Your cataract surgeon will make a tiny incision to remove the cataract and will replace the diseased natural lens with a new, artificial IOL. Surgery is performed one eye at a time. The other eye may be treated as soon as 1-2 weeks later. The cataract surgery incision is self-healing and typically require no sutures.
You will need to have a friend or family member drive you home after surgery and you should plan to rest the remainder of the day. Recovery after cataract surgery typically requires minimal downtime. You will typically be advised to avoid strenuous activity and exercise for one week and avoid swimming for 2 weeks. You will be given detailed instructions for antibiotic and anti-inflammatory eye drops, which should be used for several weeks after surgery to ensure proper healing. It is important to attend post-op appointments after surgery, the first of which will be scheduled the day after surgery, and check in with Dr. Manning with any questions. Patients often return to work after their initial post-op visit.
Research shows that over 95 percent of the more than 3 million cataract surgeries performed in the U.S. each year result in improved vision without complications. Many patients feel that their overall quality of life improves greatly after cataract surgery. However, other conditions of the eye may affect your visual outcome after surgery. For example, if you have significant glaucoma, macular degeneration, or other eye disease, then you might still have some limitation in your vision owing to these diseases. In order to understand the appropriate timing of surgery and to get a sense of the potential benefits and outcome of surgery, a comprehensive eye examination is required.
Did you know that many of the costs associated with standard cataract surgery are covered by medical insurance? Health plans vary, so check with your insurance provider to see if your plan covers a portion of cataract surgery, and to verify that Dr. Manning at Gulfcoast Eye Care is in network with your plan. Many patients opt for an advanced IOL, also known as a Lifestyle Lens, because it can offer a more significant improvement in overall vision by reducing or eliminating your need for corrective eyewear after surgery. Lifestyle Lenses are not covered by insurance, but we do offer financing options that can help you fit advanced cataract surgery in your budget. Learn more about financing for cataract surgery.
If you have noticed any cataract symptoms, it is important to be evaluated by an experienced ophthalmologist. People often delay having cataract surgery until symptoms significantly interfere with day-to-day life, but it is beneficial to have a treatment plan in place. Once your vision changes, daily tasks such as driving can become dangerous. If cataracts are beginning to make everyday activities more difficult, it may be time for cataract removal surgery. To learn if you are a candidate for cataract surgery, please contact us at Gulfcoast Eye Care to schedule a cataract consultation.
What is a cataract? What causes a cataract? What are symptoms of a cataract?
Does cataract and lens replacement surgery hurt?
Thanks to numbing drops and medications to help you relax, this procedure involves minimal discomfort. It is normal to experience some scratchiness, foreign body sensation, or a mild headache during the first 24 hours after surgery, but severe pain is rare and should be reported to your doctor right away.
Will I be asleep for the surgery?
Since this procedure does not take very long, it is unnecessary to put you to sleep with general anesthesia. Fortunately, this makes your surgery even safer. Instead, we will use topical/local anesthesia to numb the eye and you will remain awake during surgery.
Who performs the procedure?
I have cataracts in both eyes. Will Dr. Manning do surgery on both at the same time?
No, only one eye will be operated on at a time. Typically, we will perform surgery on the fellow eye as soon as 1 to 2 weeks after the first eye. All patients are different and heal at different rates, so speak with us further to learn what is appropriate for you.
How long will I be in surgery?
The surgery itself is very quick and usually lasts less than 15 minutes. However, due to pre-operative preparation and brief post-op recovery, your entire stay in the surgical center will be about 1 1/2 to 2 hours.
Can I drive myself to and from the surgical center on the day of surgery?
No. Even if you elect not to have relaxing medication administered before surgery, your vision will be blurry in the operative eye (due to dilation and anesthesia) and not suitable for driving. You must arrange for transportation to and from the surgical center.
Will I have stitches or have to wear a patch?
At Gulfcoast Eye Care we use the most modern technique for cataract and lens replacement surgery that involves creating a tiny incision with either a laser or a blade that self-seals and does not require stitches. Because we use topical anesthesia that numbs the surface of the eye only, it is not necessary to wear a patch on the operative eye to keep it closed. You will have the ability to blink and close your eyelids. We will provide you with an eye shield to wear while sleeping during the first week. This is used to protect your eye so that you don’t rub it or put pressure on it while sleeping.
How long before I can see after surgery?
Every patient and eye is different, but many patients see well enough to drive the day after surgery.
What are the risks of cataract surgery? Could I go blind?
Just like any surgical procedure, cataract surgery does have risks that can even include blindness. Fortunately, our surgeon Dr. Manning takes every precaution to minimize those risks, and has an extraordinary success rate with this procedure.
When can I resume normal activities? When can I play golf, tennis, etc?
Most patients can return to normal basic activities like reading and watching TV by the next day, and return to work within one to seven days. However, results vary for different patients, so you should ask your doctor if you have questions about specific activities. We usually recommend that you avoid touching or rubbing the eye, engaging in activities like sports where an object could hit the eye, and getting dust, dirt or sand into the eye. We also advise you to avoid swimming for two weeks after surgery. You may exercise if you avoid high impact activity during the first week. Most patients resume golf, tennis, and other active sports or hobbies within one week.
When can I go to the hair salon?
You may go as soon as the next day however be sure to advise your stylist of your recent eye surgery and to take precautions to prevent any chemicals, water or hairspray from getting into your eyes.
After surgery, will I be able to drive at night?
You should find that your ability to drive at night is improved once your cataract is removed. Once a lens has been implanted, you might notice rings, haloes, or starbursts around point sources of light such as headlights or streetlights. This effect may be more noticeable with certain types of multifocal lens implants. Fortunately, these visual effects are typical mild, rarely bothersome, and tend to diminish with time.
Will I need glasses after cataract and lens replacement surgery?
This depends much on what type of intraocular lens you choose to have implanted as well as unique aspects to your eyes such as the presence and amount of astigmatism. Many people mistakenly believe that simply having cataract surgery will enable them to see perfectly without glasses. While having cataract surgery can improve the vision, the conventional lens implant is a single, fixed focus lens. It cannot give distance vision one moment and near vision the next (like the eye’s natural lens does in a young person). Learn more about which intraocular lens implants can decrease your dependence on glasses.
What is the best type of intraocular lens implant?
There is no one best intraocular lens implant. Selection of a lens implant is a very personal choice based on your visual needs, eye conditions, and postoperative expectations. This decision should be made in close discussion between you and your eye surgeon. What might be a good choice for a friend, family member, or neighbor, may not be the best choice for you.
If I need glasses after cataract and lens replacement surgery, how soon can I get a prescription?
The eye typically takes 3-4 weeks to stabilize after cataract surgery. It is recommended that you wait until then to have a prescription made so as to allow for the most stable result.
If I elect to have surgery with a monofocal lens implant, will I be able to use the same pair of glasses for the rest of my life?
The natural lens is a major factor that causes us to need eyeglass prescription changes during our adult life. When you go through cataract surgery, the implantation of a synthetic lens creates added stability in your eyeglass prescription. While your prescription will be more stable, the average lifespan of a pair of eyeglasses is approximately two years due to scratching, breakdown of lens coatings, and other wear and tear. For this reason, if you have opted for a lens implant still requiring you to wear eyeglasses, then you will still find a need to change your eyeglasses approximately every two years.
If I elect to have surgery with a multifocal or accommodating Lifestyle Lens implant, what happens if my prescription were to ever change but I want to continue with minimal need for glasses?
If you should experience changes whereby you develop nearsightedness, farsightedness, or astigmatism, then you may be a candidate for a vision correction procedure or “enhancement” such as PhotoRefractive Keratectomy.
Who might need laser vision correction “enhancement” after a Lifestyle Lens implant?
Like eyeglasses or contact lenses, every artificial lens implant model (both monofocal and multifocal) is manufactured in more than 60 different “powers” so as to match the appropriate power to your eye. When “refracting” or measuring you for eyeglass or contact lens prescription, we use a trial and error method to preview various lens powers in front of your eye. You are asked, “which is better, lens one or two?” as a way for you to select the lens power that you see best with. However, because the artificial lens implant is inserted inside the eye, and only after your natural lens (cataract) has been removed, it is impossible for you to preview or “try out” different lens powers before surgery. There is not a way to simply insert more than one lens implant and then let you select which one gives you the best distance focus. Lastly, once it is implanted, we cannot easily exchange the lens implant the way we could with eyeglasses or contact lenses. Fortunately, the appropriate power of the lens implant can be estimated using mathematical formulas that utilize preoperative measurements of your eye’s dimensions. Although the measurements are very accurate, a number of variables prevent this process from being 100% perfect. One variable is the final precise position where the implant will end up inside your eye. Another variable is your amount of astigmatism, the naturally occurring imperfection in the optical shape of your cornea. Astigmatism generally is not corrected by the lens implant placed inside the eye and is another variable that may reduce your ability to see without glasses. The entire process is accurate enough so that most patients will see quite well without glasses in the distance when that was the planned goal. However, that distance vision might not be “perfect” and you might choose to wear glasses with a mild prescription for those times when a sharper distance focus is required. For a multifocal lens implant to work well, it is very important for the selected lens power to match your individual eye. Despite flawless surgery, some patients with multifocal lens implants are still not able to see as well without glasses as they would like. If this is due to the lens power being “off”, then there are different options available. One option would be to wear glasses or contact lenses. A theoretical solution might be to exchange the multifocal lens implant for another with a different power. However, because of the risks involved with removing a lens implant, it is usually safer to “enhance” or fine-tune any residual prescription with an external laser vision correction procedure such as PRK on the cornea instead. PRK can also correct any remaining astigmatism of your cornea. Every type of eye procedure intending to reduce a person’s need for eyeglasses may need to be “enhanced” with additional surgery. For example, nearsighted or farsighted people choosing to have laser vision correction such as LASIK or PRK may need a second treatment if the first one does not fully correct their prescription. This unpredictability is understandable because we are not machining plastic or metal, but are working instead with human tissue. At the same time, it is possible that either the standard or multifocal lens implant that has been selected may not adequately correct your distance prescription. Depending upon how far off your prescription is from our intended goal, laser enhancement may be a good option. The odds that this would need to be done with a multifocal lens are usually less than 10%. The chances are greater in patients with high astigmatism or those requiring very strong prescription glasses to begin with. The need will also depend upon how much better one wants to see without glasses. Unlike some doctors who specialize in only cataract surgery, at Gulfcoast Eye Care we are able to offer laser vision correction enhancements when they may be needed. Owing to the fact that an additional procedure is involved, there may be added cost implications should you need a laser vision correction.
Will my medical insurance cover a multifocal Lifestyle Lens?
Not surprisingly, the additional charge for implanting these special lenses is not covered and must be paid out-of-pocket by the patient. Because these lenses have nothing to do with improving the health of your eye, insurance companies and Medicare do not view them as “medically necessary.”
Will my medical insurance cover cataract surgery?
Generally, some portion is covered by insurance and/or Medicare and some is out-of-pocket cost that will be the patient's responsibility. Certain insurance companies may set higher restrictions as to who would qualify for cataract surgery. We advise you to check with your insurance representative as to the specific qualifications of your plan. Once you are a patient of our practice, our doctors and insurance experts can assist in this process to help determine whether you qualify for cataract surgery and determine what your costs might be.
If I elect to have LASIK/PRK/Laser Vision Correction after cataract surgery, how soon can I have it?
Typically, we wait a minimum of 3 months after cataract and lens replacement surgery to give your eye adequate time to heal before performing any additional surgery on it. Your eye doctor will be able to determine when you are ready for Laser Vision Correction.
Can my cataract come back or can I develop a cataract after I have had a lens implant?
No, once a cataract has been removed, a new cataract cannot develop. Lens implants do not cloud over like human lenses do. However, over time many patients may notice that their vision has once again become cloudy. This fairly common condition, which may occur with any type of lens implant, is known as posterior capsular opacification or “PCO.” Some doctors refer to it as a “secondary cataract” because the visual symptoms are similar to those of a cataract. If the PCO becomes bothersome, your surgeon can clear it away with a relatively simple laser procedure, known as a Yag Laser Capsulotomy.
What might I notice immediately after surgery and in the first couple days or weeks while my eye is healing?
Your eye may be very sensitive to light and wind and may have some watering and tearing for a couple weeks following surgery. It is also normal to experience a slight aching or tenderness to the eye as well as irritation, scratchiness, and dryness. You will likely notice fluctuations in your vision that might include the appearance of a shimmering or flickering to your vision and will gradually improve over the first couple weeks following surgery. These changes generally should not be severe enough to interfere with your day-to-day activities.
Are there any common side effects that may last more than a couple weeks?
One of the most common side effects of cataract surgery is the temporary development or worsening of dry eye syndrome. These symptoms most often improve or subside within the first 3 months after surgery however in some cases they may last up to one year or beyond. Fortunately, we have a number of treatments to improve or alleviate your dry eye symptoms. Learn more about dry eye symptoms and treatment.
Are there any side effects to Lifestyle/ multifocal lenses? Anything that I won’t like?
Most patients will notice some amount of a ring or halo effect around point sources of light at night, especially in the first few days after surgery while the pupil is dilated. These are different from and less problematic than halos caused by cataracts. Fortunately, this effect is usually mild, generally does not interfere with your visual function, and tends to decrease with time. The process through which these halos become less noticeable by the brain selectively ignoring them is known as neuroadaptation. It is the same process that allows us to ignore background noise such as traffic noise or the sound of an air conditioner or to become less aware of certain stimulation such as the feeling of wearing jewelry or a seatbelt. How quickly this adjustment happens will vary for different individuals. Experience has shown this to continue to improve throughout the course of the first year. Earlier generations of multifocal lenses had a more pronounced effect that was more difficult to adapt. Fortunately, subsequent design changes have enabled subsequent generations of multifocal lenses to be re-engineered so as to significantly reduce the halo effect compared to the earlier model. During the first couple weeks after surgery, some patients describe differences in the crispness of their near or intermediate vision when compared with their distance vision. With time, healing, and adaptation to the lens implant optics, the crispness of each of these zones of vision tends to become more equal.
Will cataract surgery get rid of my floaters?
No. Though it is possible for patients to notice some changes to their floaters when they have gone through cataract surgery, you should not expect for cataract surgery to get rid of your floaters. Learn more about floaters.
What are negative dysphotopsias?
Negative dysphotopsias are the appearance of a dark line or crescent-shaped shadow out of the corner of your peripheral vision that may described as a dark shadow. Others describe this as what a horse might see with blinders over the sides of its vision. This visual effect may occur in patients who have had otherwise perfect surgery with any type of intraocular lens implant. Though it is not well understood why this phenomenon occurs, it is believed to be related to changes in the optical system of the eye with the introduction of the lens implant. This temporarily creates an arc-shaped shadow over the peripheral retina when light enters and reflects within the lens implant. Fortunately, this effect generally goes away over 6 to 12 months after cataract surgery in most patients.
Can the lens be replaced if it doesn’t work? Does it ever need to be replaced?
Although this would be considerably unlikely for it not to work, the lens implant or IOL can be replaced with a different one, if needed. Overall, lens implants are intended to be permanent and never need to be replaced under normal circumstances. The first lens implants were used starting shortly after World War II, so there is considerable data supporting the long-term safety of lens implants.
Are there any precautions after surgery?
See the answer above regarding resuming normal activities.
Who do I call if I have a problem?
Contact one of our offices immediately if you have any problem, especially if you experience decreased vision or pain. (727) 346-8696 It is not necessary to call the office in which you had surgery; the staff and doctors in any of our offices can help you. In addition, we have a doctor on call after regular business hours. Call any office and our answering service will be happy to page the doctor on-call for you. The doctor will return your page as soon as possible.
We know that patients may be nervous to seek out cataract treatment, but your vision is precious and we want to help you live life with healthy eyes and clearer vision. Dr. Michael Manning is a renowned cataract surgeon and the entire team at Gulfcoast Eye Care is dedicated to compassionate care. Contact us with any questions or to schedule a consultation appointment in Pinellas Park, Palm Harbor, or St. Petersburg, Florida.