Cataracts will affect most people if they live long enough. This disorder affects 60 percent of people older than 60 and occurs when the normally clear, aspirin-sized lens of the eye starts to become cloudy, impairing vision. Experts estimate that over 1.2 million Americans are diagnosed annually with cataracts that require treatment. Advances in medicine have made cataracts much less worrisome. The clouded lens is surgically removed and replaced with an intraocular lens (IOL) in a short operation that requires no hospitalization.

How does a cataract form?
A cataract forms in the eye's lens. The lens focuses light on the retina, the light-sensitive membrane at the back of the eye which converts light impulses into nerve signals to produce clear visual images. Clouding of the lens can develop at any age but most often appears in people older than 42. Most cataracts are caused by a change in the chemical composition of the lens. In a small percentage of cases, the chemical changes are caused by a hereditary enzyme defect, trauma to the eye., diabetes, or use of certain drugs, such as the steroids. Precisely why cataracts occur with age is unknown, but ultraviolet radiation, particularly from the sun, is thought to play a major role in causing the chemical change in the lens. A cataract can develop so slowly that a person may not even know it's there. If the cataract is on the outer edge of the lens, no change in vision may be noticeable. Cloudiness near the center of the lens, however, usually interferes with clear sight. What are the symptoms of cataracts?

Symptoms of developing cataracts include double or blurred vision, sensitivity to light and glare (such as bright sun or auto headlights), less vivid perception of color, and frequent changes in eye-glass prescriptions. As the cataract grows worse, stronger glasses no longer improve sight.

How are cataracts diagnosed?
Cataracts are typically detected through a medical eye examination. The doctor can see the abnormal lens using a hand-held viewing instrument (ophthalmoscope). Other tests-which measure for glare sensitivity, contrast sensitivity, night vision, color vision, and side or central vision help to determine diagnosis. Because most cataracts that are associated with aging develop slowly, many patients may not notice their visual loss until it has become severe. Some cataracts remain small and never need treatment, others grow more quickly and progressively larger. Only when a cataract seriously interferes with normal activities is it time to consider surgery. What are the treatment options?

During the diagnostic examination, Dr. Poppell and Dr. Alabata will carefully measure the shape, size and general health of the eye. Then they will discuss with you if an implantable intraocular lens will work best for you. Because the implant is placed in or near the original position of the removed natural lens, vision is restored with good peripheral vision and depth perception yet with minimal magnification and distortion. Some experts estimate that about 94 of every 100 persons receiving IOLs that do not have other eye diseases will achieve 20/40 vision or better. IOLs remain permanently in place, require no maintenance or handling, and are neither felt by the patient nor noticed by others. Eyeglasses with thin lenses for near or distant viewing may still be required, but thick glasses are not necessary. The staff at Emerald Coast Eye Institute can determine the appropriate implant prescription with an ultrasound device that measures eye length and corneal curvature. These measurements are combined by computer to calculate the lens power required. What is the procedure for implantation of an IOL?

Cataract surgery is done on an outpatient basis at a local surgical center. Dr. Poppell or Dr. Alabata will make a tiny incision in the cornea-the surface of the eye. A very small ultrasonic probe is then inserted and breaks up the cataract with high speed vibrations, breaking the lens into microscopic pieces, and then it is suctioned out, leaving intact the transparent capsule that encloses the lens. Dr. Poppell or Dr. Alabata will then place the selected lens in it's place. Two tiny "c" shaped arms attached to the lens eventually become scarred into the side of the eye and hold the lens firmly in place. No stitches are required. This results in quicker healing and better vision sooner after surgery.

What happens after the IOL procedure?
Within a few days of the operation, most people are back at work. In several office visits during the first six to eight weeks after surgery, the doctor will check for infections or other complications and fit the patient for glasses if they are needed. Vision is significantly improved in 95 to 98 percent of cases. However, after the IOL implantation, a clouding of the lens capsule, known as a "secondary cataract," occurs in roughly 40 percent of cases. To restore vision, a pulsed yttrium, aluminum, garnet (YAG) laser is used to produce a hole non-thermally, by "optical breakdown" in the capsule to allow the normal passage of light rays back to the retina. This painless procedure only takes a few minutes and visual improvement usually is immediate. Other problems that may occur in a small percentage of patients include swelling of the cornea, increased intraocular pressure, and swelling of the retina, which distorts vision.