Pre- and Post- Operative Cataract Evaluation

The complexity of the eye and the ability to see are wonderful miracles. And the marvel of restoring eyesight is no less miraculous. We want you to be knowledgeable about what cataracts are, how to treat them, and what to expect when we determine cataract surgery is right for you. Dr. Bearden will evaluate your lenses each time he or she preforms a comprehensive eye examination and follow the status of your cataracts. When it comes time for surgery, we will determine which surgeon will best suit your needs, and Dr. Bearden will review all of your lens implant options and help you determine which implant will best suit you.

What Is a Cataract?

A cataract is a cloudiness that develops in the normally clear lens of the eye. This cloudiness usually worsens until it scatters or blocks the light trying to enter the eye, causing vision to become dim, blurry and distorted. Most cataracts develop slowly over time and may take several years before seriously affecting a person’s vision.

When the clear lens becomes milky or dirty looking, it is called a cataract. The word cataract means white water falling because it is like looking through white, frothy water. A person with cataracts cannot see clearly and colors may appear dim and faded.

Dr. Bearden may discover developing cataracts in the course of your eye exam. If you have cataracts that are causing visual difficulties, he or she may recommend surgery, the only known cure for cataracts.

When the eye's natural lens is removed during cataract surgery, it is replaced with an artificial lens implant. Today, patients are becoming increasingly involved in selecting the type of lens implant that meets their needs. There are three basic types of implants.

1. Standard Single-focus Lens Implants

Most choose the standard single-focus lens implant. They provide excellent vision at one distance and glasses are usually required to achieve the full range of vision. For example, if the lens implant's focusing power is selected to give good distance vision, glasses will likely be needed to read, sew, work on crafts and use a computer. Over the last 20 years, surgeons have implanted tens of thousands of single-focus lens implants and most patients are very happy with the vision they provide.

Strengths

  • Excellent quality of vision
  • Independent from glasses for many activities
  • Proven safe and effective in millions of procedures
  • Glare and halos around lights are rarely noticed
  • Monovision is possible, where one eye is corrected for near vision and the other for distance, for people who have successfully tried this with contact lenses

Limitations

  • Unable to change focus for both near and distance vision
  • Glasses are generally needed for either near or distance vision and sometimes both
  • Do not correct astigmatism

2. Lens Implants for Astigmatism

Astigmatism is a focusing problem caused either by an irregularly curved surface of the eye or an irregularly shaped lens. It is normally corrected with glasses, laser vision correction or specialty contact lenses, but several lens implants are available that can compensate for this condition. Lens implants for astigmatism must be precisely positioned and aligned inside the eye for maximum benefit. A small percentage of patients may require additional minor surgery to optimize positioning. Before surgery, these lenses require extra eye measurements and services that insurance companies do not usually pay for. If you are interested in reducing your astigmatism to become less dependent on glasses, discuss this option with Dr. Bearden.

Strengths

  • Excellent quality of vision
  • Independence from glasses for many activities
  • Monovision is possible, where one eye is corrected for near vision and the other for distance, for people who have successfully tried this with contact lenses

Limitations

  • Glasses are generally needed for either near or distance vision and sometimes both
  • Can only correct certain amounts of astigmatism
  • May require additional surgery to optimize position
  • Evaluation and surgery cannot be done on the same day
  • More exams are required
  • Involves extra costs

3. Multifocal Lens Implants

If you have a strong desire to not wear glasses, these lenses may be right for you. Presbyopia is the eye's inability to change focus from distance to near — the age-related condition that usually requires reading glasses or bifocals between age 40 and 50. Several types of multifocal lens implants offer the possibility of seeing well at more than one distance without reading glasses or bifocals. One option popular with many surgeons is the ReZoom lens by Advanced Medical Optics.

Multifocal lens implants cost significantly more than standard lens implants and require additional exams, tests and follow-up care. Insurance companies do not usually pay the extra costs of these services but financing options may be available.

Multifocal lens implants are not well suited for everyone and require adaptive personalities to adjust to the vision they provide. They allow most people to function most of the time without glasses. But if you expect multifocal lens implants to provide perfect vision without glasses, you will likely be disappointed.

Strengths

  • Greater independence from glasses for most activities
  • Good reading vision in most situations
  • Very good intermediate vision (computer distance)
  • Excellent distance vision day and night
  • Most people say they function well and are happy with the vision these lens implants provide

Limitations

  • Glare or halos will be noticed around lights at night
  • May take weeks or months to adapt to vision
  • Approximately 20% of people will need glasses for some tasks
  • May slightly reduce the ability to see subtle differences in shades of gray
  • Do not correct astigmatism
  • May require fine-tuning with laser vision correction
  • Evaluation and surgery cannot be done on the same day
  • More exams and doctor visits are required
  • Involves significant extra costs
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2222 James Street; Suite A
Bellingham, Washington 98225
Optometric Phys. NW Whatcom Optical
(360) 676-4030 (360) 733-2332
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