What are cataracts?
A cataract is a cloudiness that develops in the normally clear lens of the eye. For the sake of easy reference, a natural lens is referred to as a cataract when it has turned cloudy.
The lens of your eye is located just behind the pupil, and is responsible for fine focusing of light on the retina. It is about the size of an ordinary pill and consists of a strong, transparent outer capsule filled with a transparent flexible gel. When you focus on a near object, the focusing muscle around the lens contracts, causing the lens to become thicker. This mechanism, called accommodation, enables the eye to focus on both near and far objects.
When light enters the eye, it passes through the cornea (the eye’s clear front window) and then through the pupil and the lens, which fine focuses the light rays onto the retina at the back of the eye. The retina changes the light images into electrical impulses and sends them to the brain via the optic nerve.
A cataract occurs when the normally clear lens in the eye becomes cloudy. When a cataract is present the amount of light reaching the retina is diminished. As the cataract develops and grows, less and less light reaches the retina causing the vision to worsen. Depending on the size and location of the cataract, the clouding effect may have either a small or large impact on the vision. For instance, a small to medium lens opacity may cause a dramatic reduction of vision if it is located in the center of the lens.
Almost everyone who lives a long life will develop cataracts. The cloudiness does not spread from one eye to the other; but cataracts usually develop in both eyes at some time. Some cataracts mature slowly over a period of years, whereas others can form rapidly within a few months.
What causes a cataract and what are the cataract symptoms?
Cataracts are the leading cause of vision loss in the world. Studies have shown that about 10% of all Americans suffer from cataracts. The number drastically rises with age, 70% of Americans over the age of 75 suffer from cataracts. Because cataracts are so common, advances in technology have made cataract surgery one of the most successful surgical procedures in the world.
Cataracts are caused mainly by age. They can also occur as a result of medical conditions such as diabetes, or after the use of certain medications such as steroids. Other causes of cataracts are trauma, heredity cataracts, and significant exposure to ultraviolet radiation.
Age related cataracts affect vision after the sixth decade of life. A person may have a cataract in each eye but the cataract may develop at different paces. A cataract is usually slow developing, thus the brain has time to adapt to the reduction in vision. Some people may not even be aware that they suffer from a cataract. On the other hand, others have a noticeable cataract and cannot see well enough to perform tasks of daily living such as driving, ambulating, watching television or reading.
Cataract surgery can restore vision to people and allow them to return to activities that may have been put on hold. Cataract surgery has become the most common procedure in the United States, with over one million cataract surgeries performed each year.
What happens during cataract surgery?
After appropriate sedation and instillation of numbing drops on the eye your cataract surgeon makes an approximately 2.5 mm incision in the peripheral cornea. The incision is located where the colored part of the eye (iris) meets the white part of the eye (sclera). Modern day cataract surgery is also called micro-surgery because the incisions are so small. A delicate instrument is inserted through the incision. The tip of this instrument vibrates at ultrasonic frequency and the lens material is emulsified and aspirated. The capsular bag is vacuumed with an irrigation/aspiration instrument to prepare it for the intraocular lens implant (IOL). The foldable IOL is then injected through the incision and unfolds inside the capsular bag that contained the old lens. Antibiotic solutions are used around the new implant lens to reduce any risk of infection and the surgery is normally completed without stitches since the incisions are designed to be self-sealing.
Intraocular lenses have haptics (lens arms) to hold them in place. With the cataract removed and the IOL in place, light can once again travel unimpeded to the back of the eye and focus on the retina where the image is interpreted and transmitted to the brain. The end result is generally clear youthful vision.
Laser Cataract Surgery
There is a new type of cataract surgery that involves the use of a femtosecond laser, and this is known as laser cataract surgery also commonly referred to as laser refractive cataract surgery. To learn more about our laser cataract surgery experience and this exciting technology CLICK HERE for our link to LenSx laser cataract surgery.
What are advanced technology lens implants?
When undergoing cataract surgery or refractive lens exchange, you have options when it comes to intraocular lenses (IOL). Taking into consideration that all people over age 45 will eventually experience presbyopia, the lens type you select will help determine how you will experience the effects of that age-related condition.
Up until recently everyone who had cataract surgery received a standard monofocal lens implant. This lens enabled for vision at only one focal point, typically distance vision. With new innovations better technology lenses are now available. These lenses are referred to as advanced technology lenses and come in three types:
Some of these lenses may even provide the chance of living generally glasses free forever! Dr. Feinerman will work together with you to determine the right lens for your particular eyes. If an advanced technology lens implant is suitable and the chances of success are good, you may explore this path. Advanced technology lenses typically come with an extra cost that Medicare does not cover. However, if you lead an active lifestyle and want more independence from glasses, then it may be worth it.
Accommodating lens implants
Accommodation is the process where the lens changes the eye’s optical power in order to maintain focus on an object as the distance varies. The lens in your eye is accommodating when you focus on your computer or read a book.
The crystalens is the only FDA approved accommodating IOL. Unlike any other IOL implant, the crystalens is designed to be flexible like your eye’s natural lens when you were younger.
In people below the age of 45, the eye’s natural lens flexes in order to adjust focus between objects at near and far distances. The crystalens is designed to mimic the actions of the eye’s youthful natural lens as closely as possible, providing the highest level of vision correction of the advanced technology lenses. People who select this option will be advised to perform daily focusing exercises, in an effort to strengthen the crystalens’ ability to flex and focus at various distances. The crystalens can reduce or even eliminate a dependence on corrective lenses.
FDA Clinical Trial Information (ALL US based, not specific to crystalens Orange County):
• 100% could see intermediate (24″ to 30″) without glasses, the distance for most of life’s activities
• 98.4% of patients implanted with crystalens in both eyes could pass a driver’s test without glasses
• Some patients did require glasses for some tasks after implantation of the crystalens
• 98.4% could see well enough to read the newspaper and a phone book without glasses.
• Significantly more patients implanted with a crystalens (88.4%) could see better at all distances then patients implanted with a standard IOL (35.9%)
If you are seeking an orange county crystalens surgeon please contact our practice at 949.631.4780. You can also request an appointment on our website.
Multifocal lens implants
This type of lifestyle lens corrects the patient’s ability to see at a distance, and can provide an improved ability to adjust focus at near or intermediate distances. A multifocal IOL can virtually eliminate dependence on glasses for most people. Some patients may still use glasses to see very fine details up close. Due to the unique capabilities of this IOL, the patient may need to go through an adjustment period, similar to adjusting to a new pair of bifocals or progressive lenses.
If you are seeking an orange county eye surgeon who performs multifocal IOLs, please contact our practice at 949.631.4780. You can also request an appointment on our website.
Toric Lens Implants
With a toric IOL, people are able to achieve the same results of basic cataract surgery, but will have the added benefit of astigmatism correction. This specialized IOL has the ability to correct nearsightedness or farsightedness, as well as astigmatism (a condition in which the shape of the cornea is irregular, causing blurry vision without the help of corrective eyewear). A toric lens can help to adjust the focus of light appropriately for individuals who have astigmatism; however it is a monofocal lens. Thus, it has a fixed focal point and is generally used for distance vision.
Trulign Toric IOL
The Trulign Toric IOL combines the benefits of crystalens, cataract surgery, and reduces or eliminates your astigmatism!
If you have a cataract and astigmatism, then the Trulign Toric IOL may be a great choice for you.
“Toric” means the IOL corrects astigmatism. The Trulign Toric IOL is basically the same lens as the presbyopia treating crystalens, with the added benefits of astigmatism correction.
Many people with cataracts also have astigmatism, which can cause blurry vision. The shape of a normal eye is round, but some people are born with an oblong-shaped eye which alters the pathway of light coming through the lens, causing a distorted image. Traditional cataract surgery involving standard monofocal intraocular lenses (IOLs) did not treat astigmatism, making eyeglasses necessary even after cataract surgery. A revolutionary new product from Bausch + Lomb now makes it possible to treat both cataracts and astigmatism with one unique product.
The latest in lens replacement products, Trulign™ is the first FDA-approved premium IOL that not only solves the problem of cloudy lenses from cataracts, it also corrects astigmatism. It also offers you a wider range of vision. Trulign™ not only improves near, intermediate, and distance vision, but also offers superior rotational stability. By conducting a thorough ophthalmic exam, your eye doctor can determine if you are a good candidate for Trulign™ and custom-select a lens for your specific degree of astigmatism. This customized approach offers you the most ideal treatment option to improve your vision while reducing or eliminating your dependence on eye glasses. Trulign™ is also built to last, having been designed and tested to be a permanent solution for your vision needs.
Dr. Feinerman was part of the FDA study for Trulign; and he implanted the most Trulign lenses of all the surgeons in the FDA study. He was also the first surgeon in California to implant the Trulign Toric IOL.
If you lead an active lifestyle, then chances are you don’t have time to deal with the inconvenience of cataracts or astigmatism. If you experience any of these signs or symptoms, schedule a visit to Feinerman Vision Center for an eye exam. Treatment is fast, convenient, and safe, so you can soon be back to living your life on your own terms.
After cataract surgery?
Recovery from cataract surgery is generally very quick. In fact, most people obtain dramatic improvement in vision within the first 24 hours of the procedure. Although many are surprised how easy the recovery process is, some mild irritation or discomfort is also normal. There may also be some tearing and the eye may be sensitive to light and touch for a short period of time. If you have significant discomfort, you should contact your surgeon so he or she can suggest treatment. After one or two days, any moderate discomfort should disappear.
Dr. Gregg Feinerman provides the best quality care and takes pride in his work. He thoroughly explains what you can expect after cataract surgery. For a few days after surgery, Dr. Feinerman will ask you to use eye drops to help healing and decrease the risk of infection. He gives all of his patients an easy to follow postoperative instruction guide that explains the purpose of each eyedrop prescribed. During the first few days after surgery you should wear an eye shield or eyeglasses to help protect your eye. Avoid rubbing or pressing on your eye for the first 14 days.
Choosing Your Cataract Surgeon
How do I select the best Orange County cataract surgeons?
Selecting an Orange cataract surgeon can be difficult if you are not properly educated about cataracts, cataract surgery, and advanced technology lenses. We hope that our educational ophthalmology website has provided an easy to understand outlook on the state of cataract surgery. Although cataract surgery is one of the most commonly performed medical procedures, it is highly suggested that you carefully select an Orange County cataract surgeon with a high level of experience who is using the latest techniques and technologies.
Dr. Feinerman completed his ophthalmology residency at UC Irvine, and then completed a refractive surgery fellowship at the prestigious Gimbel Eye Centre. Both of these experiences helped make Dr. Feinerman one of the top cataract and LASIK surgeons in the USA.
Does Health Insurance Cover Cataract Surgery?
“Medicare and private insurance often cover at least a portion of the costs when you choose a monofocal IOL. Advanced technology lenses are typically not covered.”
Personal health insurance for cataract surgery is usually quite comprehensive but also extremely variable. If you have questions regarding what is covered and what is not covered our office staff will be happy to explain this after researching your insurance provider. In most instances personal health insurances cover a portion, if not all, of the cataract surgeon fee, the facility fee, the cost of a basic monofocal lens implant as well as the important follow up care after surgery. If you elect to have advanced technology implants their will be an additional expense and this might be very worthwhile. If you need help affording these special implants, we have financing programs available at Feinerman Vision Center.