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Q:
What is the success rate of cataract surgery? |
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 A:
Cataract surgery is a highly successful
procedure. Over 95% of patients experience
improved vision, unless there is a problem
with the cornea, retina, optic nerve or
other structures.
Q:
What causes the 5% failures in cataract
surgeries?
A:
There may be other reasons for visual
loss in addition to the cataract, particularly
problems involving the retina or optic
nerve. If these problems are present,
removal of the cataract may improve vision,
but perfect sight may not be possible.
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Q: Who
is a candidate for cataract surgery? |
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A:
If your vision cannot be improved by changing
the prescription of eyeglasses and you are limited
in doing your daily routine activities such as
driving, playing golf, watching television, or
reading due to cataract formation, you are a candidate
for cataract surgery. |
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Q: How does cataract surgery
improve quality of life? |
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A:
Cataract surgery improves quality of life of people
by increasing their independence through improved
vision; the ability to drive, work, watch TV, and
walk safely. |
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Q: Can cataract surgery be a
medical necessity? |
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A:
Sometimes, a cataract should be
removed even if it doesn't cause problems
with your vision. For example, a cataract
should be removed if it prevents examination
or treatment of another eye problem, such
as age-related macular
degeneration or diabetic
retinopathy. Under such circumstances,
your cataract surgery is a medical necessity. |
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Q:
What surgical methods are available to remove
a cataract? |
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A:
There are two primary ways to remove a
cataract. Your ophthalmologist can explain the
differences and help
determine which is best for you:
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Phacoemulsification,
or phaco or small
incision cataract surgery. This method
used today is an advanced method of cataract
removal. Your
ophthalmologist makes a small self-sealing
incision on the side of the  cornea
(the clear, dome-shaped surface that covers
the front of the eye).
The doctor then inserts a tiny probe into
the eye. This device emits ultrasound vibrations
(pulsing at 40,000 cycles per second) that
soften and break up the cloudy center of the
lens so it can be removed by suction. This
leaves the outer membrane of the lens intact
and transparent and provides support for other
vital eye components. A specially formulated
fluid replaces the fragments during the suction
process. Combined with the foldable lens implant,
and no-stitch surgery, phacoemulsification
is an advanced method of cataract surgery.
Phacoemulsification requires more costly supplies
and support equipment than other techniques.
The surgeon must also have advanced training
and considerable experience. Advocates find
these additional requirements to be well worth
the cost and effort.
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Extracapsular surgery. Your
surgeon makes a slightly longer incision on
the side of the cornea and removes the hard
center of the lens. The remainder of the lens
is then removed by suction. After surgery,
the wound requires six or seven stitches to
close it. This type of surgery takes more
time to heal and stabilize your vision.
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Q: Are there any lasers used
to remove the cataract? |
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A:
Cataract surgery
cannot be done with a laser by any surgeon at
this time. Cataracts are removed surgically by
phacoemulsification method. The YAG
laser is used only to treat "after
cataracts” but not to remove
the cataracts. |
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Q: Can I drive myself back home
after cataract surgery? |
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 A:
No, you will not be able to drive yourself.
Someone will need to drive you home after
your surgery. Someone will need to drive
you back to our office for your first postoperative
appointment.
Q: How soon can I go back to work?
A: New techniques
have significantly reduced healing times.
However, each patient's healing time varies
with the type of procedure performed, medical
history and physical health. You can expect
to go to your work place within a few days.
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Q: How soon will my vision return
to normal? |
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A:
Some people will see quite well by the next morning.
Even with no problems some people will need several
weeks of healing for their vision to return to normal. |
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Q: When can I resume regular
exercise or play sports after cataract surgery? |
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| A:
You should plan to take it easy
and not work out or play sports for a week.
Aerobic and other exercise programs are
not allowed for at least two weeks to decrease
the risks of bleeding, swelling and bruising.
More strenuous activities, such as weight-lifting
and contact sports, are not allowed for
at least two weeks. Absolutely no bending,
lifting or straining during the postoperative
period as these activities can increase
swelling and delay healing. |
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Q: When can I return to normal
activities? |
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A:
Most patients watch TV and listen to radio 1-2 days
after surgery. People generally can read and work
at the computer 3-4 days later, though the eyes
fatigue faster than usual. |
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Q: When can I take shower? |
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A:
You may take a tub bath and wash your hair in the
sink about one week following the procedure. Hot
steamy showers should be avoided because they could
prolong swelling. Routine showers at one week are
fine. |
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Q: What is an intraocular lens
or a lens implant? |
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| A:
In most cataract surgeries, the
removed lens is replaced by an intraocular
lens (IOL). An IOL is a clear,
artificial lens that requires no care
and becomes a permanent part of your eye.
With an IOL, you'll have improved vision
because light will be able to pass through
it to the retina. Also, you won't feel
or see the new lens.This IOL can be of
different material such as plastic, silicon
or acrylic. All of these materials are
tested for years and do not cause any
problem once they are nicely implanted
in your eye.
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Some
people cannot have an IOL. They may have
problems during surgery, or maybe they
have another eye disease. For these people,
a soft contact lens may be suggested.
For others, glasses that provide powerful
magnification may be better. |
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Q: What are the instructions for
taking care of my intra-ocular lens (IOL)? |
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 A:
An IOL is a permanent replacement
for your natural lens. After it has been
placed inside your eye during cataract surgery,
it requires no further care. You probably
won’t be able to feel your new lens;
and others will not notice it either. An
IOL never needs to be handled, adjusted,
or cleaned.
Q: Are the risks of
complications in cataract surgery greater
with an IOL?
A: There is
a very slightly increased risk of surgical
complications, such as displacement of the
IOL, but most people feel that the benefits
far outweigh the risk. Today, almost all
patients having cataract surgery safely
choose an IOL as part of the procedure.
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Q: Is the result of cataract
surgery permanent? Can cataracts grow back after
surgery? |
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A:
A cataract once removed, cannot
grow back. However, during cataract surgery
the "posterior capsule", a very
thin, clear membrane that wraps around the
backside of the cataract is left intact,
and eventually this becomes cloudy. This
so called "after cataract" can
be treated with a YAG
laser. This is a painless office
procedure, which restores vision in a matter
of minutes to patients with "after
cataracts". |
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Q:
What tests are performed before surgery?
A: A week or two before surgery, your
ophthalmologist will measure the curvature of
the cornea and the size and shape of the eye.
For patients who will receive an IOL, this information
helps your doctor to choose the right type of
IOL.
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Q: What happens during surgery?
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| A:
Surgery
is usually performed on an outpatient
basis. The operation usually lasts
less than 1 hour and is almost painless.
When you arrive for surgery, some
eye drops will be instilled to dilate
your pupil. Many people choose to
stay awake during surgery, while others
may need to be put to sleep for a
short time. If you are awake, you
will have an anesthetic to numb the
nerves in and around your eye.
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The
area around your eye will be thoroughly
cleansed, and sterile coverings are
placed around your head. Under an
operating microscope, a small incision
is made in your eye. Microsurgical
instruments are used to break apart
and suction the cloudy lens from your
eye. The back membrane of the lens
(called the posterior capsule) is
left in place. An intraocular lens
implant is placed inside your eye
to replace the natural lens that was
removed. The incision is then closed.
No stitches are used.
After
the operation, a patch will be placed
over your eye and you will rest for
a while. You will be watched by your
medical team to see if there are any
problems, such as bleeding. Most people
who have cataract surgery can go home
the same day. Since you will not be
able to drive, make sure you make
arrangements for a ride. |
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Q: What happens after surgery?
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| A:
It's
normal to feel itching and mild
discomfort for a while after cataract
surgery. Some fluid discharge is
also common, and your eye may be
sensitive to light and touch. If
you have discomfort, your eye doctor
may suggest a pain reliever every
4-6 hours. After 1-2 days, even
moderate discomfort should disappear.
In most cases, healing will take
about 6 weeks.
After
surgery, your doctor will schedule
exams to check on your progress.
For a few days after surgery, you
may take eye drops or pills to help
healing and control the pressure
inside your eye. Ask your doctor
how to use your medications, when
to take them, and what effects they
can have.
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Q: When will my surgeon see me
again after the cataract surgery? |
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A:
We see all surgery patients one day after the surgery.
Further follow-up will depend upon your individual
condition and schedule. Dr.
Tandon will be available to see you
in the office, if necessary. There is no charge
for future visits after surgery. |
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Q: Will I need any special prescriptions
following cataract surgery? |
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A:
Yes. Postoperative prescriptions
are provided well in advance of surgery
day so you arrive home completely prepared.
Postoperative prescriptions and over-the-counter
medications for cataract patients include
the following: an antibiotic drop and an
anti-inflammatory drop four times a day.
These drops will be tapered off over 3 weeks.
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Q: When do I start taking these
prescriptions? |
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A:
Patients take their pain medication as needed.
You will begin the antibiotic and swelling medications
when you arrive home from surgery or next day after
surgery. |
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Q: Will I need glasses after cataract
surgery? |
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A:
Cataract surgery and lens implantation
are intended to restore your vision to normal,
minimizing your dependence on glasses /
contacts. Although many patients are able
to function without glasses, most patients
will find that they need glasses for near
vision (reading and close-up work), distant
vision, or both after cataract surgery. |
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Q: Is it normal for the eye to
feel scratchy and watery? |
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A:
Yes, the eye is healing and may feel irritated
at times. This experience usually clears in 1-3
weeks. Lubrication with artificial tears may help
and excessive dryness may be present at first. |
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Q: Should I feel any pain after
surgery? |
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A:
For the first few hours there may
be some discomfort, but usually not severe.
If the pain persists, call your doctor.
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Q: When will my vision be normal
again? |
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| A:
You can quickly return to many everyday
activities, but your vision may be blurry.
The healing eye needs time to adjust so
that it can focus properly with the other
eye, especially if the other eye has a cataract.
Ask your doctor when you can resume driving.
If
you just received an IOL, you may notice
that colors are very bright or have a blue
tinge. Also, if you've been in bright sunlight,
everything may be reddish for a few hours.
If you see these color tinges, it is because
your lens is clear and no longer cloudy.
Within a few months after receiving an IOL,
these colors should go away. And when you
have healed, you will probably need new
glasses. |
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Q: What precautions do I need
to take after the surgery? |
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 A:
Your sight will usually improve
within a few days, although complete healing
may take several months. It is a good idea
to have some help at home if you can, especially
if you find it difficult to put your eye
drops in. You can do light housework, cooking,
walk, and climb stairs.
- Take it easy for a couple of weeks
so your eye can heal
- Wear an eye shield or eye glasses
to help protect the eye for two weeks
- Avoid rubbing or pressing on your
eye
- Try not to bend or lift heavy objects,
bending increases pressure in the eye
- Avoid strenuous exercise and swimming
for two weeks
- Take care if it is windy, in case
something blows into your eye
- Wash your hair leaning backwards rather
than forwards
- Avoid eye make-up for two weeks
- You can resume your sex life two weeks
after the operation
- Avoid driving until your surgeon tells
you it is safe
- New glasses are usually prescribed
four to eight weeks after the operation
- How long you are off work will depend
on the job that you do. Ask your eye
doctor about this.
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Q: Can I sleep on either side
after surgery? |
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A:
With the eye guard taped in place, you
can sleep on either side. If the guard is off
try to sleep on the opposite side. |
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Q: Must I wear sunglasses provided
all the time? |
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A:
Wear the sunglasses when outdoors for
about a week. If you prefer you may wear your
own sunglasses. There is no need to wear them
indoors or outdoors in dim or overcast light. |
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Q: Are red spots or stains on
the white of my eye serious? |
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A:
Small or conspicuous blood spots over
the white of the eye are common. They are harmless
and usually clear in a matter of days or weeks. |
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Q: What is an "after-cataract"?
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A:
Sometimes the thin natural bag (capsule)
that supports the intraocular lens becomes
cloudy and may blur your vision. This is
called an after-cataract. An after-cataract
can develop months or years later. Unlike
a cataract, an after-cataract is treated
with a laser. In a technique called YAG
laser capsulotomy,
your doctor uses a laser beam to make a
tiny hole in the lens capsule to let light
pass through. This is a painless outpatient
procedure. |
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Q: How soon can I get glasses
after my surgery? |
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A:
Your old glasses
may be adequate at first. You won’t harm
the eye by wearing old glasses. After a couple
of weeks the eye may be ready for testing and
preliminary lens replacement. However, if you
wait until about 4-6 weeks, refraction
will be more stable.
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Q: How soon can I drive after
cataract surgery? |
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A:
As soon as you see well enough to be confident,
are alert from medication, and you are comfortable
in the lighting of the day or night. |
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Q: How long should I use my eye
drops? |
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A:
Use the eye drops
for at least a 3-4 weeks in tapering dose as instructed
by your eye doctor.
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Q: How
is glaucoma different from cataract? |
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A:
Glaucoma
is a disease that results in the damage of optic
nerve due to high eye pressure. A person may lose
peripheral vision due to nerve damage. This loss
of vision is permanent and cannot be regained.
In contrast, cataract can cause loss of vision
which can be regained by successful cataract
surgery. Sometimes, cataract and
glaucoma can occur together in the same eye.
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Q:
Do I continue with the drops usually applied to
my other eye for glaucoma? |
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A:
Yes. Continue with
your drops on the other eye as usual.
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Q:
How soon can I have the second eye operated? |
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A:
If the second eye
is appropriate for surgery, as little as two weeks
may elapse between surgeries, that is if it's
convenient for you and agreed upon by your surgeon.
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Q: Does cataract in an infant
have the same prognosis as in adults? |
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A:
In adults, cataract
usually causes blurry vision which is reversible
if cataract is surgically removed. Rarely, hypermature
cataract can induce glaucoma or inflammation
in your eye and urgent cataract removal is recommended.
If an infant or newborn child has cataract, it
can cause permanent blindness. Cataract surgery
is urgent in this situation.
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Q:
Can a child have a lens implant? |
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A:
Yes. If a child
is more than 3 years old, lens implant can be
considered. The lens power may not be calculated
very precisely in children because of the growing
age.
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Q:
My child has juvenile form of arthritis. Is he /
she at risk for developing cataract? |
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A:
Children with this
condition may have to be treated with steroids.
Eye inflammations associated with this condition
are usually treated with long term steroid eye
drops. Cataract and glaucoma at the young age
may be the result of this treatment. A routine
and thorough eye examination is recommended to
diagnose and treat glaucoma
and cataract in these children.
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| Q: What are
the possible complications of cataract surgery?
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 A:
With prompt medical attention, most of the complications
usually can be treated successfully. Possible
complications that could occur during surgery
include the following:
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Q:
How do I know that I am getting a serious infection? |
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A:
Typically, your
vision will decline and the eye may become achy.
In a matter of hours the vision may be totally
foggy. Call your doctor or seek emergency help.
The greatest risk is during the first week. |
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Q:
If I am eligible for cataract surgery, what is the
next step? |
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A:
Schedule a pre-op appointment
with your surgeon at NeoVision
Eye Center. In keeping with our
efforts to maintain the highest
standards of patient safety and
in an ongoing effort to avoid
possible complications, we ask
that each of our cataract patients
undergo an extensive and comprehensive
eye exam by an ophthalmologist
prior to surgery. During your
pre-op visit, your health history
will be reviewed, all your questions
will be answered, you will be
instructed on how to prepare for
surgery, you will be given the
prescriptions for use after surgery
and we will tell you what to expect.
If you are on blood thinners,
you will be asked to stop them
approximately one week prior to
surgery. You will be asked to
sign an informed consent. |
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Q: What
does “informed consent” mean?
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A:
Informed consent
means you have an excellent understanding about
the benefits of surgery as well as any risks,
and all the preoperative and postoperative information.
You are making an "informed" decision
as to whether surgery is right for you.
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Q:
Who will do my cataract surgery? |
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A: Dr.
Tandon will meet with you, examine you,
and discuss all the possible complications,
answer all of your questions, and perform
the surgery. Dr.
Tandon, MD, PhD is a trained
eye physician and surgeon from Stanford
University. She is a Certified by American Board of Ophthalmology.
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Q:
What are NeoVision’s charges for a cataract
surgery? |
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| A:
At NeoVision Eye Center,
we believe the fairest approach is to offer
cataract surgery for one Flat Fee. That
is why we offer one global comprehensive
fee, which includes all pre-operative, surgical,
and post-operative care. A price estimate
will be given at your consultation for cataract
surgery. Fees reflect the specific problem
that you have and the extent of surgery
to correct it. |
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Q: Will
my insurance company pay for cataract surgery?
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A:
Most of these operations are covered by
insurance. If cataract is interfering in your
field of vision, the procedure may be covered
as a "medically necessary" surgery and
some insurance plans will pay for all or part
of the surgery. You should check with your insurance
carrier about the coverage. |
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Q:
I want to get my eyes checked for cataracts, what
is the next step? |
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A:
Schedule an
appointment at NeoVision Eye Center by calling
toll free at: 1-877-NEOVISION
(1-877-636-8474). |
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A:
Cataract surgery is a highly successful
procedure. Over 95% of patients experience
improved vision, unless there is a problem
with the cornea, retina, optic nerve or
other structures.
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