There are many conditions that can lead to low-vision problems and, sometimes, blindness. Conditions such as glaucoma, macular degeneration and retinitis pigmentosa can steal your sight with little to no hope of reversing their effects.
One sight-robbing condition that can be reversed is cataracts. Through an outpatient surgical procedure, the problem of cataracts can be eradicated for most people.
So, what is a cataract, exactly?
The black spot at the center of your eye – your pupil – is actually a hole. Images are viewed through this hole and projected onto the back of your eye through the eye’s natural lens. Much like the lens of a camera focuses objects onto film or an SD card.
When we are young, our natural lens is flexible and crystal clear. We are able to focus at nearly all distances and see well in most lighting conditions. We can go from television to book with little to no effort and are able to see colors and objects clearly.
As our birthdays accumulate, that crystal-clear, adjustable lens becomes less flexible. This is when many of us require correction for the first time or an adjustment to our current prescription to allow us to continue to focus smoothly, whether through progressive lenses or multifocal contacts.
Those birthdays also cause changes in the lens’s clarity. Over time, it turns a yellow-brown color which causes colors to become dim and lose contrast. It also causes objects and print to become blurry even with correction. In fact, in time, the clarity of our vision can no longer be corrected with prescription changes! These changes are caused by the formation of a cataract.
Surgical procedures to remove the eye’s natural lens have been around since the mid-1700s! Before that, a barbaric procedure known as “couching” had been in practice since the 6th century BC. Couching was, basically, forcibly disconnecting the lens from the muscles used to hold it in place inside the eye. Once disconnected, the lens was pushed back into the gel inside the eyeball. Where it stayed. Forever. Generally with poor results.
Believe it or not, couching is still performed in some west African countries!
Much later, the natural lens was removed in a more civilized – and sterile – fashion. After surgery, there was another problem. Removal of the natural lens was also the complete removal of the eye’s focusing ability. The only way to allow the patient to see was with the use of very thick eyeglass lenses or very strong contact lenses.
It wasn’t until 1981 that the United States Food and Drug Administration approved the use of the intraocular lens implant, or IOL. As its name implies, the IOL is placed inside the eye to replace the natural lens.
Since then, IOL design has advanced to the point where surgeons can use this device to closely mimic the eye’s natural focusing ability. In some cases, the patient will rarely – if ever – require any kind of external correction like glasses or contact lenses.
The procedure and recovery have also advanced. Early on, removal of the natural lens required a pretty good-sized incision and recovery required that the patient lie on his back, his head immobilized by sandbags until the incision healed. This form of recovery was still used into the middle of the 20th century.
More recently, a very small opening is created and a tiny, ultrasonic probe is inserted into the capsule that holds the natural lens. This instrument uses sound waves to break up the lens and these fragments are removed using a suction attachment at the tip of the probe.
The most advanced techniques use a special laser which creates the micro incisions and breaks up the lens all in about 1 minute. The implant is then inserted into the empty capsule using a tiny, tube-like instrument. This instrument is placed into the incision and the surgeon pushed the implant into the capsule where it unfolds. The surgeon positions it in place and, voila! It begins its job as your new lens!
In most cases, no stitches are needed and the incision heals quickly. No more sandbags! Your surgeon will want you to take it easy for awhile, but no more lying flat on your back for a few weeks!
Medical science has come a long way since couching! There are many different types of implants available today. Generally, there is something for everyone. Dr Kay and Dr Deweese will be able to determine the degree of any cataract formation and discuss the many options you have in the management of your condition.
If things are looking a little cloudy, even on a sunny, south Florida day, give us a call and we’ll get you started on your new life filled with bright colors and clear vision.