Treatments for Cataracts

How is a cataract treated?

The symptoms of early cataract may be improved with new eyeglasses, brighter lighting, anti-glare sunglasses, or magnifying lenses. If these measures do not help, surgery is the only effective treatment. Surgery involves removing the cloudy lens and replacing it with an artificial lens.

A cataract needs to be removed only when vision loss interferes with your everyday activities, such as driving, reading, or watching TV. You and your eye care professional can make this decision together. Once you understand the benefits and risks of surgery, you can make an informed decision about whether cataract surgery is right for you. In most cases, delaying cataract surgery will not cause long-term damage to your eye or make the surgery more difficult. You do not have to rush into surgery.

Sometimes a cataract should be removed even if it does not cause problems with your vision. For example, a cataract should be removed if it prevents examination or treatment of another eye problem, such as age-related macular degeneration or diabetic retinopathy.

If you choose surgery, your eye care professional may refer you to a specialist to remove the cataract.

If you have cataracts in both eyes that require surgery, the surgery will be performed on each eye at separate times, usually four weeks apart.

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Back to: « Cataracts

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Early symptoms of cataract can be improved with eyeglasses, brighter lighting, anti-glare sunglasses or magnifying lenses. If these steps don’t help, surgery is the only effective option for treatment. Surgery involves removing the cloudy lens and replacing it with a plastic lens.

Cataract procedures are among the most common surgeries performed in the United States. Most patients recover in just a few weeks, and many have improved eyesight after a few days. Recent advances have allowed doctors to tailor new lenses to patients and help reduce the need for eyeglasses after surgery.

The decision to have cataract surgery is a personal one that should be made between you and your doctor. Some experts advise that cataracts be removed only when vision loss interferes with your everyday activities, such as driving, reading or watching TV.

Source: NIH News in Health (NIH)1

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You need surgery to remove a cataract. During surgery, the ophthalmologist takes the lens out and puts in a plastic lens that is similar to a contact lens. The plastic lens stays in your eye permanently.

Source: NIDDK (NIH)2

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The only treatment for cataract is removal of the cloudy lens of the eye with surgery. After the cloudy lens is removed, it is replaced with an intraocular lens implant to restore the focusing power of the eye.

Most surgeries are done as day procedures and do not require an overnight stay in hospital.

Source: Queensland Health3

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How is a cataract treated?

The symptoms of an early cataract may improve with new eyeglasses, brighter lighting, anti-glare sunglasses, or magnifying lenses. If these measures do not help, surgery is the only effective treatment. Surgery involves removing the cloudy lens and replacing it with an artificial lens.

Source: MedLinePlus Magazine (NIH)4

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Cataracts usually develop slowly. New glasses, brighter lighting, anti-glare sunglasses, or magnifying lenses can help at first.

Surgery is an option. It involves removing the cloudy lens and replacing it with an artificial lens.

Source: MedLinePlus Magazine (NIH)5

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Were you worried about having surgery?

Yes. Having never had eye surgery, my major concerns were how painful it would be and how long it would take to recover.

Where did you go for information about cataracts and surgery?

I used MedlinePlus (medlineplus.gov) to check on the procedure and any drawbacks. Also, the New York City cataract specialists that my local surgeon referred me to (a father-and-son team) gave me lots of helpful information in advance.

Did the procedure take long?

No. I had both eyes done two weeks apart. The procedures were completely painless and took about 15 minutes each, with brief follow-up visits the next morning.

What kind of lenses did you have implanted?

Because of the iritis, I could not have them implant multifocal lenses, which would allow me to see both near and far. So I chose lenses for clear distance sight, and I wear reading glasses to see up close.

What was the result?

Immediately, I could read the signs across the street from the clinic. There weren't any complications either, although I did have to use a lot of drops for several months after to control the iritis.

Today, when I'm driving, I see every leaf on every tree. It's great!

Source: MedLinePlus Magazine (NIH)6

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Treatment with new glasses, brighter lighting, anti-glare sunglasses, or magnifying lenses can help at first. Surgery is also an option. It involves removing the cloudy lens and replacing it with an artificial lens. Wearing sunglasses and a hat with a brim to block ultraviolet sunlight may help to delay cataracts.

Source: MedLinePlus Magazine (NIH)7

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The symptoms of early cataracts may be improved with new prescription glasses, better lighting or effective sunglasses. However, once cataracts affect your ability to do your daily activities, surgery is the only treatment that will help.

Cataract surgery

Cataract surgery is most commonly performed as a day-stay procedure.

The surgery is usually carried out under a local anaesthetic with a light sedation. Surgery involves making a small incision in the front of your eye, through which the old lens is removed and a new intraocular lens is inserted.

The surgery is generally straightforward and recovery is quick and rarely painful.

Source: New Zealand Health8

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Treating age-related cataracts

If your cataracts aren't too bad, stronger glasses and brighter reading lights may help for a while.

But cataracts get worse over time, so you'll eventually need surgery to remove and replace the affected lens.

Surgery is the only treatment that's proven to be effective for cataracts.

Read about cataract surgery.

Source: NHS Choices UK9

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How childhood cataracts are treated

Cataracts in children are often not too bad and have little or no effect on their vision.

However, if cataracts are affecting your child's vision, they can slow down or stop their normal sight development. In these cases, surgery to remove the affected lens (or lenses) will usually be recommended as soon as possible.

Replacing the focusing power of the lens is as important as the surgery to remove it. The affected lens may sometimes be replaced with an artificial lens during surgery, although it's more common for the child to wear contact lenses or glasses after surgery to compensate for the lens that was removed.

It can be difficult to predict exactly how much better your child's vision will be after treatment, although it's likely there will always be a degree of reduced vision in the affected eye (or eyes). However, many children with childhood cataracts are able to live a full and normal life.

Read more about treating childhood cataracts.

Source: NHS Choices UK10

Treatments for Cataracts

Cataract surgery: Cataract surgery is a safe and common treatment that can restore good vision.

Source: NIH News in Health (NIH)11

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Intraocular lens: Lenses After Cataract Surgery

After your eye's natural lens has been removed, it is usually replaced by an artificial lens, called an intraocular lens (IOL). An IOL is a clear, plastic lens that requires no care and becomes a permanent part of your eye. Light is focused clearly by the IOL onto the retina, improving your vision. You will not feel or see the new lens.

IOL Types

  • Monofocal—This common IOL type has been used for several decades. Monofocals are set to provide best-corrected vision at near, intermediate, or far distances. Most people who choose monofocals have their IOLs set for distance vision and use reading glasses for near activities. On the other hand, a person whose IOLs were set to correct near vision would need glasses to see distant objects clearly. Some decide to have the IOL for one eye set for distance vision, and the other set for near vision, called "monovision."
  • Multifocal—These newer IOL types reduce or eliminate the need for glasses or contact lenses. In the multifocal type, a series of focal zones or rings is designed into the IOL. Depending on where incoming light focuses through the zones, the person may be able to see both near and distant objects clearly.

Discuss your lens options with your eye doctor to determine the IOL that best suits your vision needs and lifestyle.

  • Source: American Academy of Ophthalmology (AAO)

Source: MedLinePlus Magazine (NIH)12

Drugs for Cataracts

Surgery is the only treatment for cataracts—there are no approved medications at this time.

Source: MedLinePlus Magazine (NIH)13

Surgery for Cataracts

Is cataract surgery effective?

Cataract removal is one of the most common operations performed in the United States. It also is one of the safest and most effective types of surgery. In about 90 percent of cases, people who have cataract surgery have better vision afterward.

What are the risks of cataract surgery?

As with any surgery, cataract surgery poses risks, such as infection and bleeding. Before cataract surgery, your doctor may ask you to temporarily stop taking certain medications that increase the risk of bleeding during surgery. After surgery, you must keep your eye clean, wash your hands before touching your eye, and use the prescribed medications to help minimize the risk of infection. Serious infection can result in loss of vision.

Cataract surgery slightly increases your risk of retinal detachment. Other eye disorders, such as high myopia (nearsightedness), can further increase your risk of retinal detachment after cataract surgery. One sign of a retinal detachment is a sudden increase in flashes or floaters. Floaters are little “cobwebs” or specks that seem to float about in your field of vision. If you notice a sudden increase in floaters or flashes, see an eye care professional immediately. A retinal detachment is a medical emergency. If necessary, go to an emergency service or hospital. Your eye must be examined by an eye surgeon as soon as possible. A retinal detachment causes no pain. Early treatment for retinal detachment often can prevent permanent loss of vision. The sooner you get treatment, the more likely you will regain good vision. Even if you are treated promptly, some vision may be lost.

Talk to your eye care professional about these risks. Make sure cataract surgery is right for you.

What if I have other eye conditions and need cataract surgery?

Many people who need cataract surgery also have other eye conditions, such as age-related macular degeneration or glaucoma. If you have other eye conditions in addition to cataract, talk with your doctor. Learn about the risks, benefits, alternatives, and expected results of cataract surgery.

What happens before surgery?

A week or two before surgery, your doctor will do some tests. These tests may include measuring the curve of the cornea and the size and shape of your eye. This information helps your doctor choose the right type of intraocular lens (IOL).

You may be asked not to eat or drink anything 12 hours before your surgery.

What happens during surgery?

At the hospital or eye clinic, drops will be put into your eye to dilate the pupil. The area around your eye will be washed and cleansed.

The operation usually lasts less than one hour and is almost painless. Many people choose to stay awake during surgery. Others may need to be put to sleep for a short time. If you are awake, you will have an anesthetic to numb the nerves in and around your eye.

After the operation, a patch may be placed over your eye. You will rest for a while. Your medical team will watch for any problems, such as bleeding. Most people who have cataract surgery can go home the same day. You will need someone to drive you home.

What happens after surgery?

Itching and mild discomfort are normal after cataract surgery. Some fluid discharge is also common. Your eye may be sensitive to light and touch. If you have discomfort, your doctor can suggest treatment. After one or two days, moderate discomfort should disappear.

For a few weeks after surgery, your doctor may ask you to use eyedrops to help healing and decrease the risk of infection. Ask your doctor about how to use your eyedrops, how often to use them, and what effects they can have. You will need to wear an eye shield or eyeglasses to help protect your eye. Avoid rubbing or pressing on your eye.

When you are home, try not to bend from the waist to pick up objects on the floor. Do not lift any heavy objects. You can walk, climb stairs, and do light household chores.

In most cases, healing will be complete within eight weeks. Your doctor will schedule exams to check on your progress.

Can problems develop after surgery?

Problems after surgery are rare, but they can occur. These problems can include infection, bleeding, inflammation (pain, redness, swelling), loss of vision, double vision, and high or low eye pressure. With prompt medical attention, these problems can usually be treated successfully.

Sometimes the eye tissue that encloses the IOL becomes cloudy and may blur your vision. This condition is called an after-cataract. An after-cataract can develop months or years after cataract surgery.

An after-cataract is treated with a laser. Your doctor uses a laser to make a tiny hole in the eye tissue behind the lens to let light pass through. This outpatient procedure is called a YAG laser capsulotomy. It is painless and rarely results in increased eye pressure or other eye problems. As a precaution, your doctor may give you eyedrops to lower your eye pressure before or after the procedure.

When will my vision be normal again?

You can return quickly to many everyday activities, but your vision may be blurry. The healing eye needs time to adjust so that it can focus properly with the other eye, especially if the other eye has a cataract. Ask your doctor when you can resume driving.

If you received an IOL, you may notice that colors are very bright. The IOL is clear, unlike your natural lens that may have had a yellowish/brownish tint. Within a few months after receiving an IOL, you will become used to improved color vision. Also, when your eye heals, you may need new glasses or contact lenses.

What can I do if I already have lost some vision from cataract?

If you have lost some vision, speak with your surgeon about options that may help you make the most of your remaining vision.

Source: NEI (NIH)14

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References

  1. Source: NIH News in Health (NIH): newsinhealth.nih.gov/ issue/ aug2013/ feature2
  2. Source: NIDDK (NIH): niddk.nih.gov/ health-information/ diabetes/ overview/ preventing-problems/ diabetic-eye-disease
  3. Source: Queensland Health: conditions.health.qld.gov.au/ HealthCondition/ condition/ 11/ 61/ 244/ cataract-surgery
  4. Source: MedLinePlus Magazine (NIH): medlineplus.gov/ magazine/ issues/ summer17/ articles/ summer17pg4-5.html
  5. Source: MedLinePlus Magazine (NIH): medlineplus.gov/ magazine/ issues/ summer14/ articles/ summer14pg6-7.html
  6. ibid.
  7. Source: MedLinePlus Magazine (NIH): medlineplus.gov/ magazine/ issues/ winter12/ articles/ winter12pg12-13.html
  8. Source: New Zealand Health: health.govt.nz/ your-health/ conditions-and-treatments/ diseases-and-illnesses/ eye-and-vision-problems/ cataracts
  9. Source: NHS Choices UK: nhs.uk/ conditions/ cataracts/ 
  10. Source: NHS Choices UK: nhs.uk/ conditions/ childhood-cataracts/ 
  11. Source: NIH News in Health (NIH): newsinhealth.nih.gov/ issue/ jan2011/ feature1
  12. Source: MedLinePlus Magazine (NIH): medlineplus.gov/ magazine/ issues/ summer14/ articles/ summer14pg8-9.html
  13. ibid.
  14. Source: NEI (NIH): nei.nih.gov/ health/ cataract/ cataract_facts

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Note: This site is for informational purposes only and is not medical advice. See your doctor or other qualified medical professional for all your medical needs.