What are cataracts?

A cataract is a clouding of the normally clear lens of your eye. For people who have cataracts, seeing through cloudy lenses is a bit like looking through a frosty or fogged-up window.

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Dr. Steven Schendel, MD, FRSC (C), Ophthalmologist, discusses the causes and symptoms of cataracts.

Quiz: Do You Understand Cataracts?

Test your knowledge by answering the following questions:

Questions
True
False
1

Cataracts always develop in both eyes at once.

Explanation:
Cataracts can affect both eyes or just one, and some patients experience mild symptoms, while others can barely see any shapes or movements.
2

Decreased night vision can be a symptom of cataracts.

Explanation:
Cataract symptoms include blurry vision, haloes, sensitivity to bright lights, decreased night vision, frequent changes in eyeglass prescriptions, and faded colours.
3

Cataracts don't develop as a result of diseases such as diabetes.

Explanation:
Cataracts can be caused by trauma, diseases such as diabetes or medications such as steroids.
4

An outpatient surgical procedure is the treatment for cataracts.

Explanation:
If you’re diagnosed with a cataract, your ophthalmologist will recommend an outpatient surgical procedure.
5

There are two types of intraocular lenses.

Explanation:
There are two types of IOLs: monovision (fixed-focus for a preset distance) or multifocal (focused vision at various distances).
(Answer all questions to activate)

Dr. Steven Schendel, MD, FRSC (C), Ophthalmologist, discusses cataract surgery.

Diagnosing and Treating Cataracts

Cataracts are probably the most common condition that we see as ophthalmologists. There’s a common misconception that it’s a growth inside the eye – it’s not. It’s a natural clouding of the lens that we’re born with said Dr. Baseer Khan.

It happens as a result of age, so if you live long enough, you’re going to get a cataract. You know, people who have diabetes, maybe have been on steroids or have chronic inflammation inside their eye may develop cataracts early in life, but everybody will at some point.

The only way cataracts can be treated is with surgery. There’s no drops, there’s no laser, there’s only surgery. Surgery involves removing the natural lens of the eye, which is now cloudy, and replacing it with an artificial lens said Dr. Baseer Khan.

The reason we have to put an artificial lens in is because the natural lens provided a certain amount of power to the eye in order to focus. If we didn’t put a new artificial lens in, you wouldn’t be able to see anything at all, except for with very high-powered glasses said Dr. Baseer Khan.

There are three reasons to do cataract surgery. The first is because it’s medically necessary, which means that there’s some reason, medically speaking, that we need to remove the cataract, either because the cataract is creating a problem, or it’s preventing us from seeing a problem in the back of the eye said Dr. Baseer Khan .

The second reason is because someone’s vision has fallen below the level required for driving, and if somebody wants to maintain their driver’s licence, they have to have their cataract removed. The third and the most common reason, really, is because someone’s not happy with their vision. So when someone says “I can no longer do the things that I enjoy doing”, whether it’s driving, golfing, watching TV, going to the movies, that’s probably the most of the time the reason we’re doing surgery said Dr. Baseer Khan .

There’s two ways that are commonly used in North America to remove a cataract, and that is using a manual method, meaning all the incisions are made inside and outside the eye by hand and with a blade. Or, a laser can be used to make those incisions as well. And that is called femtosecond-assisted cataract surgery. Both surgeries still require surgeons to be inside the eye and both surgeries still require an intraocular lens said Dr. Baseer Khan.

It’s important to know the risks of surgery that you’re thinking about, and cataract surgery has risks. It’s very safe overall, it’s one of the safest surgeries that medicine has available today, but there are still some risks. Overall, if you talk to most clinicians, they’ll tell you that 95% of patients will see better after surgery, 4% of patients will see the same, 1% of patients will see worse, and there’s a 1/1,000 chance that you might lose your vision to bleeding or infection said Dr. Baseer Khan.

The reality is though that the odds are probably much better than that, and unless you have any specific challenges with your surgery – and your surgeon will let you know, you have a very, very good chance of seeing better after surgery said Dr. Baseer Khan.

The best way to find out if you have a cataract and if that’s the problem that’s giving you a challenge with your vision is to visit your local optometrist, and they can refer you to a local surgeon who does cataract surgery. It’s really important to keep in mind that the lens that you choose and the surgery that you have is going to be permanent, and make sure that you educate yourself on all the different options that are available to you said Dr. Baseer Khan.

Presenter: Dr. Baseer Khan, Ophthalmologist, Vaughan, ON

Local Practitioners: Ophthalmologist

Cataract Causes and Symptoms

A cataract is an opacification of the lens that occurs over time as people age and just like a camera has a lens in it, the eye requires a lens in it to focus images on the back of the eye.

As we are young we have a nice clear lens in the eye, and then as we age it tends to get a little bit green or brown over time, and we call that development of a cataract.

Now most of the time this is a slow process, but occasionally it can happen more rapidly, and that can be if somebody’s had trauma in the eye, if they’ve inflammation inside of the eye, if they’ve had surgery in the eye, or sometimes if they have certain medical conditions they are required to take medication for a certain amount of time.

Although those scenarios are less common the vast majority of time as cataracts come on very gradually over months or even years. And patients might not perceive anything for a long time.

Usually they complain of decreased vision gradually. Sometimes they notice difficulty in different lighting situations particularly when it’s dark. They might have problems with glare or issues with driving, and those things will prompt them to see an eye care professional or their GP and get them sent in to see an ophthalmologist who can take a look at them.

When an eye care professional knows that you have cataracts or suspects you do or perhaps your GP suspect you do, they send you to an ophthalmologist. And there you have a full eye examination including dilation of the eyes where the doctor can ensure that the amount of cataract you have corresponds with your complaints, with the decreased level of vision that you have.

And then they might order some tests in the office to make sure you don’t have any other eye diseases present, and if that’s the case, they’ll go ahead and organize cataract surgery for you, which is how we treat this particular problem.

If you have been having decreased vision, or you’ve noticed some changes in your vision, and you suspect you might have cataracts, or were told that you had early cataracts developing, it’s reasonable to go see your GP or optometrist and get a referral to an ophthalmologist for a full eye assessment.

Presenter: Dr. Steven Schendel, Ophthalmologist, Vancouver, BC

Local Practitioners: Ophthalmologist

Dr. Baseer Khan, MD, FRCS(C), P.CEO, Ophthalmologist, discusses how cataracts are diagnosed and treated.

David Mitchell, OD, discusses the slit lamp and how it is used to test your eye health.

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