What is a cataract?
A cataract is a “clouding” of the lens in your eye. The lens is located just behind the iris, or the colored part of your eye, which becomes clouded and hazy not allowing your sight to be as sharp as it once was. A cataract can be the reason sharp images become blurred or seeing things at night more difficult. It may also be why the eyeglasses or contact lenses used to help you read, or do other simple tasks, no longer help.
A cataract is not a “film” over the eye and neither diet nor lasers will make it go away. The best way to treat a cataract is to remove the old, clouded lens and provide a replacement that is plastic and stays in your eye forever. The new lens does not get rid of your need for glasses however they can in most cases be reduced in the power or thickness. You will have your glasses adjusted about 6 weeks after surgery, once the eye is healed.
When do I need cataract surgery?
For most people that are driving we remove the cataract at a time to allow them to meet the vision standards set by the province.
If you are not driving then a cataract needs to be removed only when vision loss interferes with your everyday activities, such as reading, watching TV or daily chores in your home.
Cataract surgery may be needed as a part of another eye problem treatment.
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 nor do we want you to.
Does the surgery work?
Cataract removal is one of the most common operations performed in Canada. Many of your friends, neighbors and relatives will have had it done. Ask them about their experiences. It also is one of the safest and most effective types of surgery. In about 95% of cases, people who have cataract surgery have better vision afterword.
As with any surgery, cataract surgery poses risks which are very rare:
- bad eye infection that can cause to lose your eyesight (1:1000)
- retinal detachment (1:100)
- dropped lens in the back of the eye needing a second surgery done by the retina surgeon
Sometimes a second surgery may be needed to remove the entire cataract or to place the implant in the eye. Most people do not need to stop their blood thinners before surgery, this is because of the way the cataract surgery is performed, causing minimal to no bleeding for the eye. You are then not taking extra risk for your medical conditions that require you to use blood thinners.
Before surgery
Before the surgery, you need to return to the office to have measurements to know the power of the lens you need for your eye.
You will need to see your family doctor for a pre-operative physical.
You will be given a prescription for drops to start few days before surgery, this help to get the eye ready for the procedure.
The day of surgery
- Do not eat or drink after midnight prior to your cataract surgery. Your surgery may be cancelled if you eat or drink the morning of the procedure.
- You may take your regular medications the morning of surgery with a sip of water. If you are diabetic, do not take your diabetic pills or insulin prior to your surgery.
- You must have someone to drive you to the hospital and take you home. You will need someone to stay with you for 24 hours after your cataract surgery.
- Leave all your valuables at home. Do not wear makeup
What is surgery like?
Cataract surgery is an outpatient procedure. You will spend about 3-4 hours at the hospital. Because your eyes will be treated with anesthetic, you should feel little or no discomfort during the actual surgery. Nearly all patients are given some relaxing medicine but not put right out to sleep, this makes your surgery far safer on your general health. After the surgery, you will be given a short time to rest, then that same day you can go home.
Someone will be required to drive you home. You should try to rest at home that day.
Within the next 24 Dr. Strungaru will see you back at her clinic. Drops will be prescribed to guard against infection and help your eyes heal. You will not normally be patched and you will continue your drops right after surgery. Your vision for the next few days will be cloudy and smoky as the eye heals. You may notice some scratchy or sandy feelings as the eye is healing, these experiences are normal.
How long will it take to recover? When can I drive?
Most patients notice a good deal of improved vision within a few days of surgery. It will however take 6 weeks before the eye heals enough to have the eyeglasses adjusted. You may be able to drive sooner with your other eye, depending on your particular situation. You should talk to the doctor before driving after surgery. Most people are back to normal within 2-3 weeks for normal activities.
Cataract surgery options
The cost of your cataract surgery is fully insured and covered by AHIP.
However, there are value added services or products that are optional and not AHIP covered. Your private insurance coverage may pay for this.
You will be given information about lens choice before booking your surgery to think it over and the staff will help you if you have any additional questions.
Implant options
Apsheric UV/Blue Light Blocking Lens (Alcon SN 60 IQ):
- UV and blue light is potentially harmful to the retina, especially for the macula. This lens has a yellow tint that mimics the natural lens and filters/blocks the UV and blue light. The yellow tint does not affect the quality of your vision.
- Patients should expect to have both eyes done with the UV blocking lenses for balance, now or in the future.
Toric Astigmatism Correcting Lens:
- Astigmatism mainly affects the shape of the cornea, front of the eye, resulting in a curvature that is not uniformly round and thus resulting in blurred or ghosting vision. You can consider a football shape (astigmatism) vs a soccer ball shape (normal).
- The implantable lens placed in the eye may be specially selected and rotated to correct most of this astigmatism and result in clearer vision that would normally not be corrected with a standard lens type.
- This may also be combined with multifocal lens.
Presbyopic Multifocal Lens:
- These lenses offer a range of vision rather than a single focus point. The distance vision is clear but the patient gains much more intermediate and near vision with this choice.
- They may be combined with astigmatism correcting lenses also.
Post operative eye care instructions
- Continue your drops the afternoon of your surgery and using them for the full four weeks. Continue using any other pre-existing drop medication (eg. Glaucoma). Ensure that you wash your hands thoroughly before cleaning your eye or instilling your drops. Always shake drops before use. Create a pocket with the lower lid to install the drops. Wait 5 minutes between drops.
- Do not rub, bump, strike or apply pressure to your eye, glasses and sunglasses may be worn for added protection. Do not bend at the waist – kneel or crouch to pick items from the floor. Do not lift anything over 10 pounds for 2 week.
- You must not shower from head to toe for 2 weeks. Do not get your eyes wet. A bath, sponge bath or hand held shower is permissible. Do not bend forward to wash your hair. Do not allow water to stream down your face, or immerse your face in water, no swimming.
- For 1 week wear an eye shield to bed. Sleep on your back or non-operated side.
- You may walk, watch T.V., read or knit, any activity that does not require heavy lifting or bending over at the waist. Simple non-strenuous household activities are permitted.
- It is normal for your vision to be blurry and seeing red for up to one week after surgery, to feel a mild ache, or scratchy feeling, you may use “Tylenol” for discomfort. In the event of any pain, swelling, increased redness, or decreased vision please call my office immediately or go to your nearest Emergency Department.
- DO NOT DRIVE until approved by Dr. Strungaru. Do not drink alcohol, make legal decisions, or perform any task requiring coordination or judgment for 1 day after surgery.
Please call the office if you experience increased eye redness, decreased vision or painful eye; increased in floaters, flashes or black curtain defect.