A cataract forms when the natural crystalline lens of the eye becomes cloudy. The lens is an onion-like structure behind the pupil with a skin (capsule), concentric layer of pulp (cortex), and a more compact or firm inner portion (nucleus). Normally it is optically clear and focuses light on the back of the eye to provide clear vision. When any part of this lens becomes cloudy we call it a cataract.
Its thought, if we live to be old enough, everyone will develop a cataract as a normal part of the aging process. The age at which the cloudiness interferes significantly with vision is, however, variable. The genes we get from parents play some role. There is also evidence that ultraviolet rays, a lack of adequate vitamin intake, severe dehydration, smoking, diabetes, inflammatory eye disease, the chronic use of certain drugs (primarily steroids), direct trauma to the eye, and other chemical imbalances can promote cataracts at an early age.
Surgery, the only treatment to clear the clouded visual pathway, is appropriate when poor vision interferes with lifestyle sufficiently to warrant the small statistical risk of surgery.
A manmade intraocular lens (IOL) is used to replace the cloudy cataract. If you are over the age of 65, Medicare will typically cover the cost of cataract surgery along with a conventional monofocal IOL. Monofocal IOLs typically have both eyes corrected for clear distance vision, so you may have to rely on readers or bifocal glasses for intermediate and near vision. Blended monofocal vision, where one eye sees better in the distance without glasses and one eye sees better at arm's length, involves implanting an IOL in one eye that provides near vision and an IOL in the other eye that provides distance vision. Usually people can adjust to this, but if you can't, your vision may be blurred at both near and far. Another problem is that depth perception may decrease because there is less binocular vision - your eyes aren't working together as they once did.
Beyond the monofocal implants, fully covered by insurance, there are premium lenses which are designed to offer more solutions for patients who want to reduce their dependence on glasses. Eye Surgeons was among the first to practice refractive surgery to reduce dependence on glasses and contacts both after cataract surgery and as a refractive technique for older patients without cataracts. Patients are now given the choice of driving without glasses, reading without them and even, with the advent of presbyopia correcting IOL's, both. Payment plans available through ESA can make these premium lenses an affordable option.
A premium monofocal implant, the Toric lens, corrects astigmatism for most people. A Toric implant allows a person with astigmatism to achieve good uncorrected vision for distance or near without glasses. This is the only lens that will allow people with astigmatism to see clearly at one distance without glasses or contacts. Toric lenses can also be used for blended vision to give those with astigmatism more range of focus.
Multifocal and accommodating IOL's provide distance, intermediate and near vision potentially eliminating one's dependence on glasses for most activities. There are a number of premium IOLs available, each having some advantages and disadvantages.
A Multifocal lens presents visual information differently than your natural lens. It divides the light energy into more than one image. Your brain will need to learn to tune out the blur and focus on the image you're looking at. This learning process is called neuroadaptation. Because light is divided between images there is lower contrast and more light is required for good vision. During this time most people will achieve relative independence of glasses, although you may need them for certain tasks. Anything that reduces the contrast of the visual system, even a dry eye, can reduce satisfaction with this technology.
The accommodative lens closely mimics the function of the young natural human lens by changing its shape and position within the eye to provide a broader range of focus. The accommodative lens has hinges which allows it to move forward with contraction of the muscle inside the eye causing the effective power to increase. It often requires some effort on your part for best results. Similar to gaining improved arm muscle strength by doing pushups, the accommodative lens patient will be encouraged to "exercise" by progressively looking at smaller and closer objects over time without glasses after the first week of surgery. Almost all patients will succeed in reading moderate size print without help though many may still need low powered "cheaters" reading glasses for fine print up close. Focusing speed and ability may continue to improve for 3 months or more after surgery.
Which IOL is right for you? That will depend on your lifestyle needs and the unique characteristics of your eye, which your doctor should discuss with you. But, the only reason to consider paying more for embracing the newer technology of premium implants is to satisfy a desire to be less dependant on glasses or contact lenses.
A co-founder of Eye Surgeons Associates, Dr. Arbisser, teaches cataract and anterior segment ophthalmic surgery worldwide. Following medical school in New Orleans and Houston she pursued an NIH neurobiology fellowship. She completed her ophthalmology residency at the University of Iowa Hospitals and Clinics. She is a diplomat of the American Board of Ophthalmology and certified in cataract and implant surgery by the American Board of Eye Surgery. She is a clinical adjunct associate professor at the University of Utah John A. Moran Eye Center and a former president of the American College of Eye Surgeons.
Eye Surgeons Associates provides comprehensive eye care for the entire family, for a lifetime. Established in 1983, they serve the eye care needs of the Quad Cities and surrounding communities from their offices in Bettendorf and Muscatine, Iowa; Rock Island, Silvis and Geneseo, Illinois. For more information visit www.eyesurgeonspc.com/. Eye Surgeons Associates provides comprehensive eye care for the entire family, for a lifetime. Our medical doctors are fully fellowship trained in their specialties and board certified. For more information visit us online at www.esaeyecare.com or call for an appointment at one of our convenient locations in Silvis, Rock Island, Geneseo, Bettendorf, and Muscatine.
Its thought, if we live to be old enough, everyone will develop a cataract as a normal part of the aging process. The age at which the cloudiness interferes significantly with vision is, however, variable. The genes we get from parents play some role. There is also evidence that ultraviolet rays, a lack of adequate vitamin intake, severe dehydration, smoking, diabetes, inflammatory eye disease, the chronic use of certain drugs (primarily steroids), direct trauma to the eye, and other chemical imbalances can promote cataracts at an early age.
Surgery, the only treatment to clear the clouded visual pathway, is appropriate when poor vision interferes with lifestyle sufficiently to warrant the small statistical risk of surgery.
A manmade intraocular lens (IOL) is used to replace the cloudy cataract. If you are over the age of 65, Medicare will typically cover the cost of cataract surgery along with a conventional monofocal IOL. Monofocal IOLs typically have both eyes corrected for clear distance vision, so you may have to rely on readers or bifocal glasses for intermediate and near vision. Blended monofocal vision, where one eye sees better in the distance without glasses and one eye sees better at arm's length, involves implanting an IOL in one eye that provides near vision and an IOL in the other eye that provides distance vision. Usually people can adjust to this, but if you can't, your vision may be blurred at both near and far. Another problem is that depth perception may decrease because there is less binocular vision - your eyes aren't working together as they once did.
Beyond the monofocal implants, fully covered by insurance, there are premium lenses which are designed to offer more solutions for patients who want to reduce their dependence on glasses. Eye Surgeons was among the first to practice refractive surgery to reduce dependence on glasses and contacts both after cataract surgery and as a refractive technique for older patients without cataracts. Patients are now given the choice of driving without glasses, reading without them and even, with the advent of presbyopia correcting IOL's, both. Payment plans available through ESA can make these premium lenses an affordable option.
A premium monofocal implant, the Toric lens, corrects astigmatism for most people. A Toric implant allows a person with astigmatism to achieve good uncorrected vision for distance or near without glasses. This is the only lens that will allow people with astigmatism to see clearly at one distance without glasses or contacts. Toric lenses can also be used for blended vision to give those with astigmatism more range of focus.
Multifocal and accommodating IOL's provide distance, intermediate and near vision potentially eliminating one's dependence on glasses for most activities. There are a number of premium IOLs available, each having some advantages and disadvantages.
A Multifocal lens presents visual information differently than your natural lens. It divides the light energy into more than one image. Your brain will need to learn to tune out the blur and focus on the image you're looking at. This learning process is called neuroadaptation. Because light is divided between images there is lower contrast and more light is required for good vision. During this time most people will achieve relative independence of glasses, although you may need them for certain tasks. Anything that reduces the contrast of the visual system, even a dry eye, can reduce satisfaction with this technology.
The accommodative lens closely mimics the function of the young natural human lens by changing its shape and position within the eye to provide a broader range of focus. The accommodative lens has hinges which allows it to move forward with contraction of the muscle inside the eye causing the effective power to increase. It often requires some effort on your part for best results. Similar to gaining improved arm muscle strength by doing pushups, the accommodative lens patient will be encouraged to "exercise" by progressively looking at smaller and closer objects over time without glasses after the first week of surgery. Almost all patients will succeed in reading moderate size print without help though many may still need low powered "cheaters" reading glasses for fine print up close. Focusing speed and ability may continue to improve for 3 months or more after surgery.
Which IOL is right for you? That will depend on your lifestyle needs and the unique characteristics of your eye, which your doctor should discuss with you. But, the only reason to consider paying more for embracing the newer technology of premium implants is to satisfy a desire to be less dependant on glasses or contact lenses.
A co-founder of Eye Surgeons Associates, Dr. Arbisser, teaches cataract and anterior segment ophthalmic surgery worldwide. Following medical school in New Orleans and Houston she pursued an NIH neurobiology fellowship. She completed her ophthalmology residency at the University of Iowa Hospitals and Clinics. She is a diplomat of the American Board of Ophthalmology and certified in cataract and implant surgery by the American Board of Eye Surgery. She is a clinical adjunct associate professor at the University of Utah John A. Moran Eye Center and a former president of the American College of Eye Surgeons.
Eye Surgeons Associates provides comprehensive eye care for the entire family, for a lifetime. Established in 1983, they serve the eye care needs of the Quad Cities and surrounding communities from their offices in Bettendorf and Muscatine, Iowa; Rock Island, Silvis and Geneseo, Illinois. For more information visit www.eyesurgeonspc.com/. Eye Surgeons Associates provides comprehensive eye care for the entire family, for a lifetime. Our medical doctors are fully fellowship trained in their specialties and board certified. For more information visit us online at www.esaeyecare.com or call for an appointment at one of our convenient locations in Silvis, Rock Island, Geneseo, Bettendorf, and Muscatine.
