Monday, October 31, 2011

Cataracts and Medicare Coverage

Question: Are there any requirements for Medicare to cover cataract surgery to remove my cataracts?

Answer: In general, if you have a Cataract that is visually significant in that it disturbs your visual acuity to worse than 20/40 or causes you problems with glare so that your vision is worse that 20/40 with the glare, Medicare will cover the cost of the Cataract operation including a portion, in not all, of the Cataract Surgeon Fee, the Cataract Surgery Facility Fee, the cost of a Monofocal Lens Implant and the necessary follow up care after your Cataract Surgery. Usually if there is a fee for the pre surgery office examination, consultation and IOL measurement you will responsible for a co-pay or a deductible. Should you require a pre surgery physical with your medical doctor, you might have to pay that physician's co-pay as well. In addition, if you require anesthesia, you may be responsible for the anesthesia co-pay and/or deductible as well.

Important Note: The information presented on the About Cataract Surgery Blog or provided in response to a request for information in the Ask Cataract Surgeons section on aboutcataractsurgery.com is not intended to diagnose or treat eye problems, eye conditions or eye diseases including appropriateness of treatment, risks, complications or side effects as related to Cataracts, Cataract Surgery of Lens Implants. In particular a response to an inquiry made on the Ask Cataract Surgeons section of aboutcataractsurgery.com is not meant to take the place of the professional medical care provided by your eye doctor, ophthalmologist and Cataract Surgeon surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.

Tuesday, October 25, 2011

Cataract Surgery and Alzheimer's Disease

Cataract Surgery for patients with mild Alzheimer's Disease not only improves vision but also can offer improvement in cognitive ability, mood, sleep patterns and other behaviors according to researchers reporting at the 2011 Annual Meeting of the American Academy of Ophthalmology in Orlando, Florida. In the first study of its kind to specifically assess whether Cataract Surgery could benefit Alzheimer's patients, researchers selected participants who had a debilitating Cataract in at least one eye and were appropriately treated with Cataract Surgery and Intraocular Lens Implantation (IOL) to replace the eyes' natural lenses in order to provide vision correction. The Alzheimer's patients were assessed for mood and depression, behavior, ability to function independently and cognitive abilities at one month before and three months after Cataract removal. Cognitive status, the ability to perceive, understand and respond appropriately to one's surroundings, improved in 25 percent of patients. Depression was relieved in many of them, and the level of improvement was similar to what commonly occurs after Cataract Surgery in elderly people who do not have dementia. No changes were found in patients' level of autonomy, that is, their ability to function independently. In addition, sleep patterns improved and night time behavior problems decreased in most study patients. Other studies have shown that when cataracts are removed, levels of the sleep-regulating hormone melatonin become normalized. In future the researchers will study what factors, specifically, led to the positive effects so they can boost the quality of life for Alzheimer's patients, their families and caregivers.

Crease after Cataract Surgery

Question: My daughter has recently had cataract surgery but still has blurred vision. She has been told by the cataract surgeon that this has been caused by a 'creasing' when the lens was implanted. Is this normal and what is the remedy and prognosis ?


Answer: Typically, when a Cataract is removed it requires that the Cataract Surgeon remove the cloudy material of the crystalline lens while leaving in place the thin lens "capsule" as a support in order to effectively place the Lens Implant in a stable position. From time to time the lens "capsule" can get a small "crease" in it which will almost certainly blur the vision. As the eye heals, say over 3 months after the Cataract Surgery, the "capsule" becomes fibrotic and can change configuration. Sometimes this eliminates the crease by itself. More often, the Cataract Surgeon will perform a YAG Laser Capsulotomy which is a painless laser procedure using eye drops to numb the eye, in order to create an opening in the creased capsule along the visual axis. This procedure takes a few minutes and almost always provides a huge improvement in vision within a few minutes!

Important Note: The information presented on the About Cataract Surgery Blog or provided in response to a request for information in the Ask Cataract Surgeons section on www.aboutcataractsurgery.com is not intended to diagnose or treat eye problems, eye conditions or eye diseases including appropriateness of treatment, risks, complications or side effects as related to Cataracts, Cataract Surgery of Lens Implants. In particular a response to an inquiry made on the Ask Cataract Surgeons section of www.aboutcataractsurgery.com is not meant to take the place of the professional medical care provided by your eye doctor, ophthalmologist and Cataract Surgeon surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.

Monday, October 24, 2011

Driving after Cataract Surgery

Question: How soon after unilateral cataract surgery can I drive?


Answer: How soon you are able to drive after Cataract Surgery depends on when you achieve 20/40 vision and can pass a drivers test as well as when you personally feel comfortable enough with your vision to drive. Your Cataract Surgeon will be able to discuss both answers with you based on how quickly you heal and your vision recovers. For most patients who have routine, uncomplicated Cataract removal with modern Cataract Surgery and Lens Implants, they find that both they and their eye surgeon are comfortable with them driving within a week or so after their surgery. Follow your Cataract Surgeon's advice as each person heals slightly differently.

Important Note: The information presented on the About Cataract Surgery Blog or provided in response to a request for information in the Ask Cataract Surgeons section on www.aboutcataractsurgery.com is not intended to diagnose or treat eye problems, eye conditions or eye diseases including appropriateness of treatment, risks, complications or side effects as related to Cataracts, Cataract Surgery of Lens Implants. In particular a response to an inquiry made on the Ask Cataract Surgeons section of www.aboutcataractsurgery.com is not meant to take the place of the professional medical care provided by your eye doctor, ophthalmologist and Cataract Surgeon surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.

Is Cataract Surgery Permanent?

Question: Is cataract surgery a permanent one-time procedure or do patients have to undergo this eye surgery every 10 years?


Answer: A Cataract is a clouding of the crystalline lens inside your eye. During the Cataract Surgery operation, a Cataract Surgeon will microscopically remove the cloudy material and typically leave behind the "capsule" that surrounds the crystalline lens to act as a support for an Intraocular Lens Implant (IOL) to correct your vision. Once the cloudy lens material is removed by the surgeon it does not come back-ever. However, in some 30% of instances the "capsule" may become cloudy causing patients to experience symptoms that may actually mimic having a Cataract. This is called "posterior capsular opacification" and is often referred to as a "secondary cataract". Fortunately in these instances where the capsule does become cloudy, using a YAG Laser it is possible to open the cloudy capsule along the visual axis with a procedure called a YAG Laser Capsulotomy. This procedure is performed using only eye drops, takes only a few moments, is painless and provides clear vision almost instantly.

Important Note: The information presented on the About Cataract Surgery Blog or provided in response to a request for information in the Ask Cataract Surgeons section on www.aboutcataractsurgery.com is not intended to diagnose or treat eye problems, eye conditions or eye diseases including appropriateness of treatment, risks, complications or side effects as related to Cataracts, Cataract Surgery of Lens Implants. In particular a response to an inquiry made on the Ask Cataract Surgeons section of www.aboutcataractsurgery.com is not meant to take the place of the professional medical care provided by your eye doctor, ophthalmologist and Cataract Surgeon surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.

Distorted Vision after Cataract Surgery

Question: I have a question about why my vision is distorted after cataract surgery. I had cataract surgery 10 days ago. The sac had a tear in it and a piece of the cataract dropped into the back of the eye. At first the lens was very blurred (like a frosted window) then it cleared. 5 days after the cataract operation my vision was slightly distorted and has remained so. When I look at someone's face their head appears narrow and pinched looking. When looking at a picture the sides bend in the middle. As I have to have the other eye done I am very worried. I have been back to see the cataract surgeon twice and after having a scan and pressure test and eye test (which I could read very little) he could see no reason for this and didn't appear to have encountered it before. Can you tell me if this will last and what is the cause.


Answer: When a Cataract is removed, the "capsule" is typically left intact as a support for the Intraocular Lens Implant (IOL). In your case the capsule was torn which makes the Cataract operation even a bit more complicated as it often requires a procedure called a vitrectomy when the capsule ruptures. The fact that some lens material did drop into the eye adds yet another source of potential complications. The complications you have experienced are unusual but do happen from time to time. The "frosty" vision you experienced and the distortion you describe suggest that there may be additional complications in the vitreous gel in the back of your eye and/or the retina-possibly due to inflammation which could occur due to cataractous lens material being introduced into the vitreous gel as you describe. You do not say whether you are being treated aggressively with anti-inflammatory medications. However, it would be a conservative, cautious and prudent course to request a consultation with a retinal specialist sooner rather than later in order to determine the best course of action here.

Important Note: The information presented on the About Cataract Surgery Blog or provided in response to a request for information in the Ask Cataract Surgeons section on www.aboutcataractsurgery.com is not intended to diagnose or treat eye problems, eye conditions or eye diseases including appropriateness of treatment, risks, complications or side effects as related to Cataracts, Cataract Surgery of Lens Implants. In particular a response to an inquiry made on the Ask Cataract Surgeons section of www.aboutcataractsurgery.com is not meant to take the place of the professional medical care provided by your eye doctor, ophthalmologist and Cataract Surgeon surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.

Thursday, October 20, 2011

Dry Eye after Cataract Surgery with Multifocal IOL

Question: I am experiencing dry eyes and still having to read with a magnifying glass after cataract surgery with a multifocal lens implant. I am not satisfied with my surgery. I also have glaucoma.

What are my options now?

Answer: Dry eye and the symptoms of dry eyes are not uncommon after Cataract Surgery. The tear film is both an integral part of the optical system of the eye as well as the healing and "comfort" mechanisms of the eye's surface. Thus, if you have a dry eye-either as a primary diagnosis, secondary to the Cataract Surgery, secondary to any preservatives in glaucoma eye drops or even an eyelid health problems-you will not be comfortable or see well. The complex optics of Multifocal Lens Implants (IOL) are even MORE sensitive to inadequate tear film integrity. Thus, this might be a contributing factor to multiple issues you report-or not. If you are comfortable with your Cataract Surgeon, the best course of action is for you to tell him or her exactly what you stated and to give them a chance to confirm the dry eye problem and identify its cause as well as offer treatment. If however you are not comfortable and would prefer to have a second opinion regarding your situation, you should schedule a consultation with the best Cataract Surgeon in your area and may even wish to choose one who is also a Corneal Specialist so that they can offer additional insight into the health of the eye's surface and external structures.

Important Note: The information presented on the About Cataract Surgery Blog or provided in response to a request for information in the Ask Cataract Surgeons section on www.aboutcataractsurgery.com is not intended to diagnose or treat eye problems, eye conditions or eye diseases including appropriateness of treatment, risks, complications or side effects as related to Cataracts, Cataract Surgery of Lens Implants. In particular a response to an inquiry made on the Ask Cataract Surgeons section of www.aboutcataractsurgery.com is not meant to take the place of the professional medical care provided by your eye doctor, ophthalmologist and Cataract Surgeon surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.

Tuesday, October 18, 2011

Toric Lens Implant Cost for Astigmatism

Question: I currently need cataract surgery and my doctor has recommended toric lens implants. My prescription is around -9.5 diopters with .75 diopters of astigmatism correction. His plan sounded fine until they told me it would cost $1300 extra (out of pocket) for the toric lens, etc.. When we were discussing multifocal lenses (and decided against them) he said he could make an LRI incision to relax the astigmatism for an extra $200. The one option he didn't offer was to implant a normal lens and use LRI to correct for astigmatism. Other than the cost, is one method better than the other, given that the amount of astigmatism is pretty small? Is there any increased risk using LRI? Longer recovery time? More pain? Less predictable results? I'd like to be able to see, but I'd like not to have to sell my car in order to pay the extra (possibly unnecessary) cost.


Answer: Patients with Cataracts in need of Cataract Surgery who have preexisting astigmatism.are able to opt for three different methods of correcting that astigmatism after the Cataract has been removed. First, they can simply buy eyeglasses and use them to get the best possible vision. Second, they can have Limbal Relaxing Incisions (LRI) a secondary surgical procedure or third they can have an astigmatism correcting Toric Lens Implant. You do not state whether .75 diopters is your spectacle correction for astigmatism or the predicted postoperative astigmatism to be corrected.

These two values MAY be different as depending on the orientation of the astigmatism and the position of the incision it is possible that during the healing process some Cataract Surgeons find an increase in the amount of astigmatism. Let's assume that the actual amount to be corrected in .75. LRI is as the name suggests an incisional surgical procedure and is dependent on wound healing to produce its effects. ANY time we depend on wound healing there is patient to patient variability and less predictability. Further, some patients require repeated LRIs as the effect tends to neutralize-sometimes never quite producing the exact desired effect. yes, each repeated procedure is another slight set of surgical risks.

Last, with LRI there is a the question of permanence and whether the quality of the optical correction is equivalent to the optics of an intraocular lens implant (IOL) in terms of aberrations and distortions.Yet, with a skilled Cataract Surgeon the results of LRI can be quite good for many patients. Astigmatism correcting Toric Lens Implants can offer greater precision of the correction upon careful measurement, analysis, surgical planning and surgical procedure-and they are manufactured with controlled aspheric optics to minimize aberrations. So, from PURE OPTICAL STANDPOINT, astigmatism correcting toric lens implants are generally preferred. Shortly, astigmatism correcting multifocal lens implants will become the correction of choice for most patients upon their FDA approval and marketing availability. Really the choice of how to correct the astigmatism is entirely yours. It sounds as if your Cataract Surgeon is presenting you with what in his or her opinion is the best clinical options and trying not to let the short term cost of the Toric Lens Implant influence the best clinical choice over the longer term

Important Note: The information presented on the About Cataract Surgery Blog or provided in response to a request for information in the Ask Cataract Surgeons section on www.aboutcataractsurgery.com is not intended to diagnose or treat eye problems, eye conditions or eye diseases including appropriateness of treatment, risks, complications or side effects as related to Cataracts, Cataract Surgery of Lens Implants. In particular a response to an inquiry made on the Ask Cataract Surgeons section of www.aboutcataractsurgery.com is not meant to take the place of the professional medical care provided by your eye doctor, ophthalmologist and Cataract Surgeon surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.

Sunday, October 16, 2011

Cataract Surgery & Lens Implant Focal Distances

Question: I am considering cataract surgery and concerned about what distance to focus the lens implant for.. I am very nearsighted with slight astigmatism and with eyeglass prescription of R -9.50 and L -7.75 and +1.50 bifocal can correct to 20/60. I am 72 with mild diabetes and had surgery in 2004 for severe Retinal Detachment on my left eye and have had retinal laser repair of both eyes. I don't care to risk the possible problems for multifocal implants, since I am willing to wear bifocal glasses. If I get monofocal implants, would I be likely to be most comfortable with implants that focus in distance (20 feet or more), medium 6-20 feet, 2-4 feet, or closer? I use computer a lot, watch TV, and hike a lot so want to see my feet as I easily can now thru main lens or the bifocal. My bifocals do not let me focus within 6 inches, so I remove my glasses for really fine print and some precise hobby work. I think most people get distant or medium focus implants and use bifocal glasses for close up. On the other hand, I'm used to wearing strong glasses to see in distance. A related issue is that I would like to correct which may affect focal-distance choice is that with my +1.75 bifocals, I have difficulty reading and viewing computer because my left eye focuses most clearly at 20" and the right at 15".


Answer: You have a number of pretty complex questions and issues here regarding Cataract, Cataract Surgery and Lens Implants. Although it isn't really possible to answer them thoroughly in this medium we can offer some suggestions to consider when you have a consultation with a top Cataract Surgeon who is also a Refractive Surgeon. We would strongly suggest seeking an opinion from the best Cataract Surgeons who are ALSO accustomed to solving refractive error correction problems in complex visual situations. First you are a relatively high risk Cataract Surgery candidate due to your history of Retinal problems. it is not clear what level of vision you were correctable to after your retinal surgery. Your Cataract & Refractive Surgeon may suggest that you get clearance from your Retinal Specialist prior to your Cataract removal. Second, the path of selecting a more simple Lens Implant type such as a monofocal, or perhaps even better an aspheric lens implant is probably a good choice. The aspheric lens implant-if carefully selected-may offer considerable optical advantages over your myopic spectacle correction in terms of aberrations and depth of focus-these may actually surprise you in their benefit. However, this really depends on careful measurement and proper selection of a focal distance as you suggest. To help your Cataract and Refractive Surgeon get you the best possible result-BEFORE your consultation-just as you have done above, list the various distances you need to have clear vision for. Then list which ones you would be happy wearing glasses for and which ones you would prefer not to wear glasses for. Finally, take that list and put it in order of decreasing importance for your everyday activities and desires. From your rank ordered list, your Cataract & Refractive Surgeon will have a discussion and refine the list and be best able to help select the proper focal distances. Please be aware, it may entirely be the case that NOT every priority can be met and that you need to have realistic expectations and goals.

Important Note: The information presented on the About Cataract Surgery Blog or provided in response to a request for information in the Ask Cataract Surgeons section on www.aboutcataractsurgery.com is not intended to diagnose or treat eye problems, eye conditions or eye diseases including appropriateness of treatment, risks, complications or side effects as related to Cataracts, Cataract Surgery of Lens Implants. In particular a response to an inquiry made on the Ask Cataract Surgeons section of www.aboutcataractsurgery.com is not meant to take the place of the professional medical care provided by your eye doctor, ophthalmologist and Cataract Surgeon surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.

Friday, October 14, 2011

Cataract Surgery for Nearsightedness

Question: I just had cataract surgery and can see so clearly after years of being nearsighted it is a miracle. How come I could not have had this done even before a cataract? I am 72 and wonder about all the years of having to depend on glasses!

Answer: Actually, Lens Replacement Surgery for the correction of nearsightedness, farsightedness and astigmatism is performed by top Cataract Surgeons who are also Refractive Surgeons. Some years ago patients had to wait for a Cataract to "ripen" before the crystalline lens could be safely removed. using modern Cataract Surgery techniques it is readily possible to remove the crystalline with beginning Cataracts as well as even with a clear lens in order to correct a refractive error such as nearsightedness.

Important Note: The information presented on the About Cataract Surgery Blog or provided in response to a request for information in the Ask Cataract Surgeons section on aboutcataractsurgery.com is not intended to diagnose or treat eye problems, eye conditions or eye diseases including appropriateness of treatment, risks, complications or side effects as related to Cataracts, Cataract Surgery of Lens Implants. In particular a response to an inquiry made on the Ask Cataract Surgeons section of aboutcataractsurgery.com is not meant to take the place of the professional medical care provided by your eye doctor, ophthalmologist and Cataract Surgeon surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.

Wednesday, October 12, 2011

Lens Implants for Octogenarians

Question: Do you recommend a lens implant for cataracts for an 88 year old?


Answer: One would think that the Cataract Surgery and Lens Implant complication rate would increase with age and at some age not really be either safe or effective. As it turns out that is not the case. If you are in generally good health with otherwise healthy eyes-especially with regard to the health of the Retina-Cataract Surgery and Lens implants are safe and effective for 80 and 90 year patients.The key to a good result is being sure that the Macula, at the center of the Retina, is in reasonably good condition and not compromised by Age Related Macular Degeneration (ARMD) to any great degree as well being sure that the overall eye health and condition is sound. If this is the case, then it is reasonable for an 88 year old to have Cataract Surgery with Lens Implants by a top Cataract Surgeon and have a good result.

Important Note: The information presented on the About Cataract Surgery Blog or provided in response to a request for information in the Ask Cataract Surgeons section on aboutcataractsurgery.com is not intended to diagnose or treat eye problems, eye conditions or eye diseases including appropriateness of treatment, risks, complications or side effects as related to Cataracts, Cataract Surgery of Lens Implants. In particular a response to an inquiry made on the Ask Cataract Surgeons section of aboutcataractsurgery.com is not meant to take the place of the professional medical care provided by your eye doctor, ophthalmologist and Cataract Surgeon surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.

ReZoom™ Multifocal Lens Implant Haloes

Question: I had ReZoom™ Multifocal Lens Implants after Cataract Surgery a few years ago. A short time later I had YAG Laser done. Right after the ReZoom™ lenses were implanted I could no longer drive a vehicle at night because of all the haloes and difficulty seeing in the dark. I also can see halos during the day wearing sunglasses, but that isn't a problem for me. I also had astigmatism. I am 58 years old now and would like to find a way to have better vision. Please help with any suggestions you may have for me.

Answer: Your situation poses a number of challenges that are not necessarily the easiest to deal with. First, there are in fact some patients who do experience the continued haloes with the ReZoom™ Multifocal Lens Implant. Sometimes it is possible to have your Cataract Surgeon prescribe eye drops that can make your pupils a bit smaller and this improves the halo problem. Usually there is some benefit to this but not always. This is a simple first step to explore. In the ideal world you could consider having a Lens Implant exchange whereby your ReZoom™ Multifocal Lens Implants are exchanged and replaced with other Lens Implants-most likely Monofocal Lens Implants and then you would wear glasses to read and for arm's length vision. This would have a high probability of alleviating the halos. In your case, the fact that you have had a YAG Laser Capsulotomy and that it has been a few years since your Cataract Surgery makes a lens exchange considerably more complex and difficult-but not impossible. The most prudent course of action is to schedule a visit to your Cataract Surgeon to discuss these and any other options they may have for you. If they are unable to offer these or other options seek a second opinion with the best Cataract Surgeon you can find in your area.
Important Note: The information presented on the About Cataract Surgery Blog or provided in response to a request for information in the Ask Cataract Surgeons section on aboutcataractsurgery.com is not intended to diagnose or treat eye problems, eye conditions or eye diseases including appropriateness of treatment, risks, complications or side effects as related to Cataracts, Cataract Surgery of Lens Implants. In particular a response to an inquiry made on the Ask Cataract Surgeons section of aboutcataractsurgery.com is not meant to take the place of the professional medical care provided by your eye doctor, ophthalmologist and Cataract Surgeon surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.

Tuesday, October 11, 2011

Medicare & Astigmatism Correction

Question: I need to have cataract surgery and am nearsighted and have astigmatism. Is there any procedure that will correct all 3 safely and is covered by Medicare? I have been diagnosed as having fibromyalgia and have taken inhaled steroids and predispose and cortisone shots for asthma and allergies for years. Is this likely to cause a problem with surgery?


Answer: Medicare really only covers the cost of basic Cataract Surgery and Lens Implants and not the correction of astigmatism whether it is corrected whether it is corrected with an astigmatism correcting Toric Lens Implant or a Limbal Relaxing Incision (LRI)-neither is covered by Medicare as part of your Cataract Surgery and they ask Cataract Surgeons to bill you for both types of astigmatism correction. Your nearsightedness could likely be corrected using a Monofocal Lens Implant however. Thus you need to opt and pay for the Toric Lens Implant for the astigmatism or have the nearsightedness corrected with a basic Lens Implant with the astigmatism corrected with eyeglasses after your Cataract Surgery. Make sure your advise your cataract Surgeon of all of the medications you have indicated however they should not pose a problem.

Important Note: The information presented on the About Cataract Surgery Blog or provided in response to a request for information in the Ask Cataract Surgeons section on aboutcataractsurgery.com is not intended to diagnose or treat eye problems, eye conditions or eye diseases including appropriateness of treatment, risks, complications or side effects as related to Cataracts, Cataract Surgery of Lens Implants. In particular a response to an inquiry made on the Ask Cataract Surgeons section of aboutcataractsurgery.com is not meant to take the place of the professional medical care provided by your eye doctor, ophthalmologist and Cataract Surgeon surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.

Cataract Night Driving Glare

Question: I have a question about cataracts and night driving glare. I need new glasses I have cataracts and am almost blinded at night driving with all the cars lights is there a an optical lens that can help block the glare I am getting an eye exam in a week and would like your advice


Answer: If you are experiencing that significant a problem with night driving glare from your Cataracts you may very well want to consider having the Cataracts removed. The glare you describe can be debilitating and dangerous. regarding eyeglass lenses that cut glare, they are all really designed for daytime glare and not nighttime glare. While there may be some lens coatings that offer a minimal amount of night glare help it is not likely they will overcome the Cataract symptom glare you report. Further if they did it would mist likely only be temporary. A worthwhile step would be to schedule an appointment with the best Cataract Surgeon you can find and discuss the situation with them.

Important Note: The information presented on the About Cataract Surgery Blog or provided in response to a request for information in the Ask Cataract Surgeons section on aboutcataractsurgery.com is not intended to diagnose or treat eye problems, eye conditions or eye diseases including appropriateness of treatment, risks, complications or side effects as related to Cataracts, Cataract Surgery of Lens Implants. In particular a response to an inquiry made on the Ask Cataract Surgeons section of aboutcataractsurgery.com is not meant to take the place of the professional medical care provided by your eye doctor, ophthalmologist and Cataract Surgeon surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.

Monday, October 10, 2011

Cataract Surgery Second Opinion

Question: I have had two cataract surgery procedures on my right eye and want to know if I have gotten the best results-can I get a second opinion?


Answer: If there is a question in your mind that your Cataract Surgeon has not satisfied then you should feel free to schedule an examination and consultation with a top Cataract Surgeon your area. The best Cataract Surgeons do not mind and respect the need for patients to sometimes seek a second opinion.

Important Note: The information presented on the About Cataract Surgery Blog or provided in response to a request for information in the Ask Cataract Surgeons section on aboutcataractsurgery.com is not intended to diagnose or treat eye problems, eye conditions or eye diseases including appropriateness of treatment, risks, complications or side effects as related to Cataracts, Cataract Surgery of Lens Implants. In particular a response to an inquiry made on the Ask Cataract Surgeons section of aboutcataractsurgery.com is not meant to take the place of the professional medical care provided by your eye doctor, ophthalmologist and Cataract Surgeon surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.

Scuba Diving after Cataract Surgery Recovery

Question: I am a scuba diver and wondering about recovery from cataract surgery. I am 72 years old and participate in multi dive trips 3 to 4 times a year. How long after cataract surgery will I have to wait before I can dive again?

Answer: Recovery from Cataract Surgery is generally pretty quick. Assuming that you are able to have routine Cataract Surgery and an Intraocular Lens Implant (IOL) using modern small incision Cataract Surgery and if as one would expect, surgery goes uneventfully without complications, it would be expected that 4-6 weeks after your Cataract operation you should be able to participate in water sports such as scuba diving. Now, while most modern Cataract Surgery is performed as "no-stitch surgery", in your case do not be surprised if your Cataract Surgeon elects to place a single stitch in the incision in order to make it even tighter and lessen any risk of wound leak or separation due to the big pressure gradients you are exposed to both entering and below the surface. This may be a prudent precaution. However, depending on the advice of your Cataract Surgeon this could lengthen the "no dive" time as each person heals slightly differently and your eye surgeon will want to be sure that you are free or risk of eye rubbing and water contaminations as well.

Important Note: The information presented on the About Cataract Surgery Blog or provided in response to a request for information in the Ask Cataract Surgeons section on aboutcataractsurgery.com is not intended to diagnose or treat eye problems, eye conditions or eye diseases including appropriateness of treatment, risks, complications or side effects as related to Cataracts, Cataract Surgery of Lens Implants. In particular a response to an inquiry made on the Ask Cataract Surgeons section of aboutcataractsurgery.com is not meant to take the place of the professional medical care provided by your eye doctor, ophthalmologist and Cataract Surgeon surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.

Double Vision after Cataract Surgery

Question: I have double vision since I had cataract surgery. First I had the right eye done in April 2011 followed by the left eye in May 2011. It was fine after the first eye but a few weeks after the second eye I had double vision. In August 2011 the optometrist said it was 6th nerve palsy caused by high blood pressure. I have high blood pressure but don't think it was that. If I close 1 eye it goes away. First it happened in the car when I looked on the left side of the road but now it happens when I see straight ahead. Should I get a 2nd opinion?

Answer: While your double vision is not likely to have any relationship to the Cataract Surgery, you should immediately schedule an appointment with both your Cataract Surgeon and your primary care physician who treats you for the high blood pressure. ANY new onset of double vision or diplopia requires a thorough medical and ophthalmologic examination in order to identify the underlying cause of the diplopia, of which high blood pressure might be one, along with a number of other systemic and neurological conditions. Identifying the cause and ruling out other causes is absolutely necessary.

Important Note: The information presented on the About Cataract Surgery Blog or provided in response to a request for information in the Ask Cataract Surgeons section on aboutcataractsurgery.com is not intended to diagnose or treat eye problems, eye conditions or eye diseases including appropriateness of treatment, risks, complications or side effects as related to Cataracts, Cataract Surgery of Lens Implants. In particular a response to an inquiry made on the Ask Cataract Surgeons section of aboutcataractsurgery.com is not meant to take the place of the professional medical care provided by your eye doctor, ophthalmologist and Cataract Surgeon surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.

Glasses vs Contacts after Cataract Surgery

Question: I see that some people are said to have to wear glasses after cataract surgery. I do not mind wearing reading classes but would prefer to wear contact lenses if necessary for distance vision correction instead. Is this allowed after cataract surgery?


Answer: With proper Lens Implant selection through careful consultation and measurement, the vast majority of people who have Cataract Surgery to day are not in need of glasses after Cataract Surgery for seeing at a distance. Even for those with astigmatism, it is possible to use astigmatism correcting toric lens implants to minimize or even eliminate the need for eyeglasses after a Cataract operation. Most patients find that if they need distance glasses it is usually only for a limited number of activities and not typically for full time wear. However, if you did require glasses after a cataract removal then as long as your eyes and tear film were otherwise healthy, you could elect to have your distance vision corrected with contact lenses after Cataract Surgery. Your Cataract Surgeon will be able to help you determine whether you actually will need glasses at all and whether contact lens correction is possible.

Important Note: The information presented on the About Cataract Surgery Blog or provided in response to a request for information in the Ask Cataract Surgeons section on aboutcataractsurgery.com is not intended to diagnose or treat eye problems, eye conditions or eye diseases including appropriateness of treatment, risks, complications or side effects as related to Cataracts, Cataract Surgery of Lens Implants. In particular a response to an inquiry made on the Ask Cataract Surgeons section of aboutcataractsurgery.com is not meant to take the place of the professional medical care provided by your eye doctor, ophthalmologist and Cataract Surgeon surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.

Friday, October 7, 2011

Flashing & Curves after Cataract Surgery

Question: I had cataract surgery one week ago and see the curve of the lens as well as flashing constantly-is this to be expected?

Answer: What you are describing may well be an occurrence called "dysphotopsia". A dysphotopsia is an optical phenomenon caused by the Lens Implant used for vision correction for Cataract Surgery in some patients. A number of patients who have just had Cataract Surgery and a Lens Implants experience a problem that often shows up at night when viewing a light. A halo appears around or near the light. For most, this happens when seeing the headlights of oncoming cars while driving or riding in a car. Sometimes it appears just as little "glistening's" or flashes of light. It is very common and usually of short duration and lasts no more than 1-2 months or less after their surgery. Some patients experience what is termed a "negative dysphotopsia" in which instead of a halo, they experiences a dark curved region on the temporal edge of their field of vision. This optical phenomenon is usually caused by the way in which light is reflected off the edge of the lens implant due to its shape. This creates a new visual pattern that patients adapt to shortly after their Cataract Surgery. Both the dysphotopsia and the negative dysphotopsia are caused by the presence of the new lens and the pattern of light reflected and refracted through the Lens Implant and its edge. In almost all cases the brain adapts to the new light pattern after a brief time as noted earlier and patients simply forget that it was ever there.

Important Note: The information presented on the About Cataract Surgery Blog or provided in response to a request for information in the Ask Cataract Surgeons section on aboutcataractsurgery.com is not intended to diagnose or treat eye problems, eye conditions or eye diseases including appropriateness of treatment, risks, complications or side effects as related to Cataracts, Cataract Surgery of Lens Implants. In particular a response to an inquiry made on the Ask Cataract Surgeons section of aboutcataractsurgery.com is not meant to take the place of the professional medical care provided by your eye doctor, ophthalmologist and Cataract Surgeon surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.

Cataract Surgery and Blood Thinners

Question: I have severe heart disease with A-fib and have a cataract-what is the policy for coumadin and cataract surgery?


Answer: Coumadin or Warfarin is used to prevent blood clots from forming or growing larger in your blood and blood vessels. It is prescribed for people with certain types of irregular heartbeat, people with prosthetic (replacement or mechanical) heart valves, and people who have suffered a heart attack. Warfarin may also used to treat or prevent certain types of strokes by thinning the blood. Top Cataract Surgeons can use a technique called "small incision clear cornea phacoemulsification" in which there is no bleeding or trauma to blood vessels. It is performed in completely in vascular-or blood vessel free tissue. By using this procedure for Cataract removal it is not necessary to discontinue taking Coumadin prior to Cataract Surgery. The key here is to find the best Cataract Surgeon you can and have an examination so he or she can tell you if it is possible for you to have this type of Cataract Surgery procedure.

Important Note: The information presented on the About Cataract Surgery Blog or provided in response to a request for information in the Ask Cataract Surgeons section on aboutcataractsurgery.com is not intended to diagnose or treat eye problems, eye conditions or eye diseases including appropriateness of treatment, risks, complications or side effects as related to Cataracts, Cataract Surgery of Lens Implants. In particular a response to an inquiry made on the Ask Cataract Surgeons section of aboutcataractsurgery.com is not meant to take the place of the professional medical care provided by your eye doctor, ophthalmologist and Cataract Surgeon surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.

Thursday, October 6, 2011

Causes of Cataracts

Question: I have a question about getting a cataract. What are the probable causes of a 70 year old male needing a right eye cataract removal with intraocular lens implants? Are they a good candidate for this procedure?

Answer: The most likely reason a 70 year old male would get a Cataract and need a Cataract removal and Intraocular Lens Implant (IOL) is simply age. In the United States, the incidence of senile Cataract has been reported to be approximately 42% in those aged 52 to 64, 60% in those aged 65 to 74 and 91% in those aged 75 to 85. Thus increasing age is factor in developing a Cataract. Other factors that increase the risk of developing Cataracts includes diabetes, a family history of Cataracts, eye injury or inflammation, the use of steroid medications, exposure to excessive sunlight and ionizing radiation as well as smoking and obesity. If patients are in good general health and their Cataract Surgeon suggests that they are good candidates there is every reason to believe that they will do well.

Important Note: The information presented on the About Cataract Surgery Blog or provided in response to a request for information in the Ask Cataract Surgeons section on aboutcataractsurgery.com is not intended to diagnose or treat eye problems, eye conditions or eye diseases including appropriateness of treatment, risks, complications or side effects as related to Cataracts, Cataract Surgery of Lens Implants. In particular a response to an inquiry made on the Ask Cataract Surgeons section of aboutcataractsurgery.com is not meant to take the place of the professional medical care provided by your eye doctor, ophthalmologist and Cataract Surgeon surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.

Monovision vs. Multifocal Lens Implants

Question: Which type of IOL Lens Implant correction has a higher success rate...multifocal or monovision? What are the possible drawbacks to each?


Answer: Unfortunately it is not possible to provide you with actual data as you haven't defined what you mean by "success".

In addition, if one were to use a quantitative definition of uncorrected distance visual acuity, uncorrected near visual acuity as well as a subjective component of "patient satisfaction" in being able to do what they want to do each day without glasses after cataract surgery it would still really be inaccurate as it really depends what they want to do. So for arguments sake lets say that in each case "success" is defined simply as "not needing glasses for 90% of the things I do each day".

IF, and a big IF, we assume that patients have been carefully screened and are good candidates for either monovision Cataract Surgery or having a Multifocal Lens Implant, then the clinical studies suggest that 80-90%+ of Multifocal Lens Implants recipients and 75-80% of Monovision Cataract Surgery patients are "successful"-DEPENDING ON WHAT TYPE OF ACTIVITIES THEY REQUIRE THEIR EYES FOR EACH DAY.

The drawbacks to Multifocal IOL's is that depending on the lens design, they typically have 2 out 3 "zones" of clear vision-some are best for far and near with a bit weaker arm's length vision-some are best for far and intermediate and bit weaker up close and some are "okay" for all three but not perfect.

In general all types of true multifocal lens implants have some type of glare, halo or mild optical or light distortion. Monovision Cataract Surgery is limited in the amount of correction that it can provide for up close vision, does degrade the distance vision slightly and also can distort depth perception for some patients. However, with careful patient selection, measurement and surgery by the best Cataract Surgeons BOTH methods of vision correction for Cataract Surgery provide a high level of patient satisfaction and functioning for patients who wish to be less dependent or independent of eyeglasses after Cataract Surgery.

Important Note: The information presented on the About Cataract Surgery Blog or provided in response to a request for information in the Ask Cataract Surgeons section on aboutcataractsurgery.com is not intended to diagnose or treat eye problems, eye conditions or eye diseases including appropriateness of treatment, risks, complications or side effects as related to Cataracts, Cataract Surgery of Lens Implants. In particular a response to an inquiry made on the Ask Cataract Surgeons section of aboutcataractsurgery.com is not meant to take the place of the professional medical care provided by your eye doctor, ophthalmologist and Cataract Surgeon surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.

Tuesday, October 4, 2011

Images after Cataract Surgery

Question: Why do I have "images" after cataract surgery? I had cataract surgery in May on both eyes and have toric lens implants. When I look at round lights such as traffic lights, headlights, taillights or dots, I see a triangular shape in my right eye and a horizontal ragged line in my left eye. This is occurring night and day. Before surgery, I saw halos only around auto taillights at night. I had a YAG Laser procedure in August for a secondary cataract to correct the triangular shape in my right eye. It did not correct the image nor has it improved.


Answer: It is impossible to really tell exactly why you are seeing these images after Cataract Surgery without an actual examination as you are describing optical images that could be caused by one or more factors. First, although you had a YAG Capsulotomy to clear an opening in the "secondary cataract", it is possible that the shape and/or location of that opening is such so as to create an odd optical image by itself or in conjunction with other factors. Another factor that could cause or contribute would be a slightly imprecise location or rotation of the toric lens implants or even a small defect in the lens implant itself. Further it is possible that reflections off the edge of the lens implants called dysphotopsia could contribute. Last, there is the remote possibility of irregularities in the retina contributing-impossible to say without detailed examination. Any of these factors individually or together could create odd optical images. You need to discuss the images with your Cataract Surgeon to see if he or she can determine the single or multiple causes and hopefully offer options to minimize them. If you are unable to get a satisfactory answer then you may want to consider getting a second opinion from a top Cataract Surgeon in your area.

Important Note: The information presented on the About Cataract Surgery Blog or provided in response to a request for information in the Ask Cataract Surgeons section on www.aboutcataractsurgery.com is not intended to diagnose or treat eye problems, eye conditions or eye diseases including appropriateness of treatment, risks, complications or side effects as related to Cataracts, Cataract Surgery of Lens Implants. In particular a response to an inquiry made on the Ask Cataract Surgeons section of www.aboutcataractsurgery.com is not meant to take the place of the professional medical care provided by your eye doctor, ophthalmologist and Cataract Surgeon surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.

Monday, October 3, 2011

Lens Implant Alternatives for Cataracts

Question: Are their alternatives to lens implants for cataract surgery? My dad has cataracts just starting and he doesn't like the idea of having lens implants. Are there other procedures that can be done that do not involve implants?


Answer: Historically, vision correction after Cataract Surgery has been provided by using aphakic spectacles as well as contact lenses-however bot of these methods of vision correction after a cataract has been removed offer SIGNIFICANT OPTICAL AND FUNCTIONAL DISADVANTAGES to the use of Lens Implants after Cataract Surgery. Aphakic eyeglasses-even more advanced design lenses-create some level of distortion and restriction of peripheral vision such that they can often impair comfortable mobility. This is in addition to creating significantly magnified images that are disturbing to many patients.

Contact Lenses after Cataract Surgery overcome both the limits of peripheral vision loss and magnification however they do require a healthy cornea and a normal tear film. Somewhere between 30-50% of patients who have Cataract Surgery experience some degree of dry eye symptoms and find contact lens wear uncomfortable if not intolerable. Your dad would be much better off having a serious discussion with a top Cataract Surgeon regarding any misgivings about Lens Implants. Eye surgeons have been using Lens Implants for cataracts for more than 30 years and there are literally millions of successful patients using Lens Implants with excellent safety and efficacy. It is a real question as to whether the best Cataract Surgeons would actually even consider not using a Lens Implant as the optical alternatives discussed here are actually so limiting as to expose patients to a high likelihood of dissatisfaction, inconvenience and limitation in their daily lives. That said, it is possible that your dad could convince a Cataract Surgeon not to use a Lens Implant but it for whatever reason he changes his mind down the road it would require another eye surgery procedure to insert the implant, exposing him to additional risks.

Important Note: The information presented on the About Cataract Surgery Blog or provided in response to a request for information in the Ask Cataract Surgeons section on aboutcataractsurgery.com is not intended to diagnose or treat eye problems, eye conditions or eye diseases including appropriateness of treatment, risks, complications or side effects as related to Cataracts, Cataract Surgery of Lens Implants. In particular a response to an inquiry made on the Ask Cataract Surgeons section of aboutcataractsurgery.com is not meant to take the place of the professional medical care provided by your eye doctor, ophthalmologist and Cataract Surgeon surgeon. Contacting us via e-mail or any other means is not a substitute for medical care.