Understanding Cataracts
Because cataracts are so common and because cataract surgery is my specialty, I have written this booklet for patients to answer commonly asked questions about cataracts. Although each individual’s condition may differ, advances in cataract surgery continue to benefit more patients than ever before.
I hope that this information will help you to understand cataract better and to view potential cataract surgery
with less apprehension.
Cataract FAQ
What causes blurred vision?
Just as defective film will spoil photographs, a weak retina or nerve (e.g., conditions such as macular degeneration, epiretinal membrane, or glaucoma) will cause blurred vision in eyes despite a clear lens and proper focus (glasses). Good vision always requires (1) optimal focus – usually with glasses, (2) a clear lens, and (3) a healthy retina and nerve.
What causes cataracts?
What is a “lens implant”?
The “prescription” or power of each patient’s implant is selected based on computer calculations that use a series of precise eye measurements performed in the office prior to surgery. The distance between the front of the eye and the retina can be measured precisely using optical methods. This painless test is called biometry.
Recently, newer implant designs that can decrease your dependence upon glasses have become very popular. However, they are not appropriate for all individuals, and the additional cost is not covered by insurance.
What is “small incision” cataract surgery?
What are the symptoms?
When should cataracts be removed?
With the success of the modern implant, waiting for cataracts to “ripen” is no longer necessary. Because cataracts will not improve and will eventually worsen, there is no advantage in delaying treatment if vision is sufficiently affected and the prognosis of surgery is good. You are never “too old” to have cataract surgery, just as you are never “too old” to enjoy better vision.
How is surgery performed?
What are the risks of cataract surgery?
What is a cataract?
A cataract is a clouding of the normally transparent lens within the eye. It is not a growth or a film that can be peeled off. Located inside the eye, most cataracts cannot be seen without a special microscope. Thus, they do not change the appearance of the eye; they do not cause discomfort. Changes may be so gradual that you are not aware of a cataract’s effect at first.
Cataracts are the most common cause of blurred vision over the age of 50. Although there is no medicine or diet to cure cataracts, surgical removal of the cataract and replacement with a permanent artificial lens implant can restore lost vision.
How does the eye work?
The eye functions very much like a camera. Light enters through the cornea, the clear front “window” of the eye. In order to reach the back of the eye, it passes through the pupil, which is the hole in the iris (the colored part of the eye).
Immediately behind the pupil is the natural lens of the eye. Just as a camera lens focuses light onto film at the back of the camera, the human lens focuses light onto the retina, the thin layer of tissue lining the back of the eye. Like camera film, the retina forms the picture that is then relayed to the brain along the optic nerve.
Cataract Surgery
Your outpatient surgery will usually be performed at the Peninsula Eye Surgery Center, 1128 W. El Camino Real, in Mountain View, CA, (650) 964-3200. This was the first surgery center from San Francisco to San Jose to specialize in eye surgery only and performs one of the highest volumes of cataract surgery in Northern California.
I generally employ topical or “needle-free” anesthesia for cataract surgery. The eye is numbed by anesthetic drops. Thanks to light sedation, you will feel calm and relaxed but be awake enough to cooperate. Since your lids are gently held open, you will see light but not the operation itself. This advanced method eliminates sutures, anesthetic injections, eye bandages, and postoperative restrictions for most patients. An additional numbing injection can be performed if you need it for your comfort. Because the surgery usually takes less than 30 minutes, even patients in poor health can successfully undergo cataract surgery.

Eye with mature cataract

Surgery Recovery
You will receive detailed written instructions on care after the operation. An eye bandage is not necessary when topical anesthesia is used. The eye surface may feel scratchy at first. With small incision surgery, you may resume everyday activities and physical exercise within one week.
As with any surgery, the healing period will vary with each individual. Use of the eye is not harmful, but the
vision is normally blurry at first. Your eyeglass prescription will be different after surgery and will be changed approximately one month later.