The best treatment for cataract depends on the type of cataract and the vision loss that is causing it. If the cataract is causing vision problems, surgery is usually recommended.
A slit-lamp exam and a retinal exam help your doctor determine what kind of cataract you have. Your doctor will also check your eyes for other signs of eye health issues.
Small-incision surgery
When you’re having cataract surgery, your doctor will remove the cloudy lens that is causing problems with your vision and replace it with an artificial lens. This procedure is a very common surgery that’s safe and effective for most people.
In small-incision cataract surgery, also called phacoemulsification, your eye surgeon makes a tiny cut in your eye and uses a device to give off ultrasound waves. These waves break up the hard part of your cloudy lens, allowing it to be removed carefully.
Then, the remaining cataract material is sucked out with another probe. You will have an eye patch for a few days following the surgery to protect your eye from injury, and you may need medication to help with any discomfort or pain.
This type of surgery is the most common and has a high success rate. About 95% of patients who have it can see better afterward, even if they have other eye conditions or had vision problems in the past.
During this surgery, your doctor will make a very small incision on the side of your eye, next to the outer corner. They will put a very thin, flat-bottomed probe in your eye that gives off ultrasound waves.
It’s important to remember that the operation is only necessary if your cataract is interfering with your ability to see, or it can’t be fixed with glasses or contact lenses. Your doctor will be able to tell whether you need this kind of surgery or not.
Cataracts are one of the most common and serious vision problems affecting older adults. They cause blurry vision, a hazy appearance, and difficulty reading in dim light. These symptoms can be frustrating and disruptive to your daily life. They may even lead to blindness if left untreated.
Large-incision surgery
Most cataracts can be treated with a surgical procedure that removes the cloudy lens and replaces it with an artificial lens (intraocular lens or IOL). Several types of IOLs are available to improve vision and reduce your need for glasses. The type of IOL that you choose depends on your lifestyle and budget.
The most common surgery used to remove cataracts is called phacoemulsification, or phaco. It is minimally invasive and uses a tiny incision to break up the cataract and remove the particles. This procedure has a lower risk of infection than larger incision surgery. It is also faster and more accurate, so you recover better.
Phacoemulsification uses ultrasound waves to soften the cataract and break it into smaller pieces that can be easily removed with a suction device. A surgeon makes a small incision in the cornea and inserts a special device to emit ultrasound waves.
A laser, or a light beam, is used to make the incisions. Using a laser may speed recovery and be more precise. Compared to traditional cataract surgery, phaco is less invasive and more effective.
Large-incision surgery is sometimes used when cataracts are bigger and more complicated than a small or medium-sized cataract. It can be more difficult to remove a large cataract with phacoemulsification. A doctor may use a tool known as an extracapsular cataract extraction, or ECCE, to remove the cataract in one piece and then implant a new artificial lens.
During this surgery, the surgeon makes a large incision on the top part of the eye. The doctor then breaks up the cataract material with a specialized instrument and pulls it out of the eye. The lens material is then removed by suction and the IOL is placed in place.
The type of IOL you get after surgery can have a dramatic impact on your vision. Some lenses allow you to see well at all distances, while others improve vision only at certain distances. There are also monofocal lenses that only let you see at a single focus, such as reading or driving. These lenses are less likely to interfere with your daily activities than bifocal lenses, which allow you to see at multiple distances.
Monofocal lenses
Monofocal lenses are the most common type of intraocular lens (IOL) used for cataract surgery. They are a good choice for patients who do not have astigmatism, and also for those who are comfortable wearing glasses after their procedure.
The most important factor to consider when choosing an IOL is your vision needs. Your ophthalmologist will help you decide which IOL is best for you.
Most people choose monofocal lenses for their cataract treatment because they provide excellent distance and up-close vision. They also don’t have any glare or halos that can cause trouble when driving at night.
However, you should be aware that monofocal IOLs are not ideal for people who have moderate to high astigmatism. Astigmatism is caused by one curve in the cornea that is longer than the other, causing it to distort near and distant objects.
If you have astigmatism, your doctor may recommend toric IOLs instead of monofocal lenses. Toric IOLs have a larger surface area and are more durable than their counterparts, so they can last longer.
When you’re choosing an IOL for your cataract treatment, your ophthalmologist will recommend the most appropriate lens based on your specific visual needs. Your ophthalmologist will also be happy to discuss the cost of different lens options and how they might be covered by your health insurance plan.
Some health plans, such as Medicare, consider cataract surgery a medically necessary treatment and cover the cost of a standard monofocal IOL. Other types of premium IOLs, such as multifocal and extended depth-of-focus (EDOF) lenses, are not covered by most insurance plans.
Multifocal IOLs have corrective zones built into the lens, much like bifocal eyeglasses. Some multifocal IOLs also have an accommodative zone, which allows you to see at all distances.
Accommodative IOLs use your natural movements of the eye to change focus. They can also be a good option for people who have presbyopia, which is a condition that causes the eyes to become less flexible.
If you have moderate to high astigmatism, your ophthalmologist will likely suggest toric IOLs or other types of specialty lenses for your cataract treatment. These specialty lenses will improve your near and intermediate vision as well.
Contact lenses
Contact lenses can be a good treatment option for cataract, as long as you get them fitted properly by an eye care professional. You’ll also need to have regular eye exams and follow-up appointments to keep your contacts safe, healthy and working well.
There are several types of contact lenses, including soft (also called hydrogel) and rigid gas permeable (RGP). Both are available in various strengths for different vision problems.
Soft contact lenses are the most common type of lens, and many people wear them daily to correct refractive errors such as nearsightedness or farsightedness. They are also a good choice for patients who have dry eyes, severe astigmatism or other vision issues caused by corneal irregularities.
Rigid gas permeable lenses are a more advanced option that can offer crisper vision correction than soft contacts. However, they may be more difficult to get used to than soft lenses at first and require more frequent cleaning and disinfection.
They can also be more expensive than soft lenses, but they tend to last longer with good care. You may also want to consider hybrid contacts, which combine the benefits of both soft and RGP lenses.
A doctor of optometry will fit you with the right type of contact lens for your eye’s unique needs. This is often determined by your prescription, lifestyle, and personal preferences.
Unlike glasses, contact lenses need to be worn on a schedule, so you’ll need to keep track of them and get regular eye exams. This requires more time and attention than wearing glasses, but it’s worth the investment in improved vision and comfort.
You should only wear your prescribed lenses and not substitute them with other types of contact lenses or eyeglasses, as this can cause serious eye disease. If you’re not comfortable with your prescription, ask your doctor to try another type of contact lens or explore other options, like corrective surgery.
Some decorative (cosmetic) contact lenses are sold without a prescription at cosmetic shops, tattoo parlors or other nonprofessional retailers. These include colored contacts, lenses that make your eyes look like vampires or other characters, and lenses that hide certain eye conditions.