The Cataract Quiz

Answer: lens

A cataract is a clouding of the lens of the eye. The lens lets light pass through to the retina. If the lens is not clear, the eye cannot focus properly and images appear blurry. If left untreated, cataracts can require exceptionally strong corrective lenses or can lead to blindness. Cataracts are the leading cause of reversible blindness and visual impairment worldwide but the key word here is 'reversible'.

Answer: True

Cataracts are normally caused by proteins in the lens clumping together and clouding the lens, usually as the result of aging. They can also develop at birth or be caused by trauma to the eye or certain types of radiation.

Answer: True

This is an example of another old wives' tale being proved correct. Current research indicates that the carotenoids in many vegetables, along with antioxidants and vitamin E, can reduce the risk of cataracts although they probably won't prevent it. Along with carrots, leafy vegetables, including kale, spinach (particularly cooked) and turnip greens along with some beans and peas contain notable amounts of what your eyes need.

Answer: 3 million

About 3 million cataract surgeries are performed in America each year at the time of writing this quiz. In 2010 about 24 million Americans had cataracts. That number is predicted to reach 50 million by 2050. Other parts of the world are also seeing an increasing number of cataract cases as people live longer. Much of it is because of the natural aging process but frequent exposure to strong sunlight, other environmental factors and smoking can hasten eye problems.

Answer: Phacoemulsification

Cataract surgery has been documented back to the fifth century B.C (I'll spare all of us from having to read about what it was like back then!). If you picked the one with the longest name you were correct. Phacoemulsification means emulsifying the lens with an ultrasonic device and suctioning the particles away, sometimes using the same device.

There is a small incision or two (2 to 3 mm) in this method. ECCE (extracapsular cataract extraction) is similar, performed less often anymore and requires a larger incision (10 to 12 mm) and suturing when done. Phacoemulsification often requires no suture.

Answer: an artificial lens

A rolled-up artificial lens, known as an IOL (intraocular lens), is pushed through the incision, unrolled and put in place of the original lens. It becomes part of the eye and usually needs no changing or maintenance. Sometimes an IOL won't work for certain people and special contact lenses or magnifying glasses are called for. My ophthalmologist didn't really explain to me how she unrolls a lens once it's placed inside the iris; one of the tricks-of-the-trade, no doubt!

Answer: 15 minutes

Modern equipment and techniques have brought the time for cataract surgery down to 15 minutes or less per eye. Very experienced surgeons can do the actual work in less than 10 minutes. If you were to need surgery in both eyes, expect to wait one to four weeks in between as that allows the ophthalmologist enough time to examine the first eye and make sure there is no infection or other problem before operating on the other eye.

Answer: almost all vision problems

Intraocular lenses (IOLs) can be made to give you good distance, intermediate or close-up vision. It may be necessary to wear glasses or contact lenses to improve other areas. The latest IOLs , Accommodating Monofocal IOLs can shift their focal point depending on what the eye is looking at. That's right folks, the Borg have arrived and this is one of their cybernetic implants! Well, not really, but the IOLs physically move inside the eye in response to the focusing action of the eye muscles.

They are currently very expensive and health insurance plans usually require the patient to pay a substantial amount over the normal cost of cataract surgery.

The AMIOLs are in their third iteration, mimicking the human lens more with each advancement.

Answer: often none; it is usually done on an outpatient basis

Modern cataract surgery is quick and minimally invasive so patients usually go to a hospital or surgery center and plan on staying just a few hours. Much of the time required is to properly administer and observe the reaction to anesthetics.

Answer: one to three months

The length of time to achieve optimal vision after cataract surgery depends on the patient but one to three months is the expected time. Vision will improve steadily but may not be noticed from day to day. Think of this though, if you have cataracts, they have been developing over many years and you probably didn't notice something was wrong until you had trouble reading signs at moderate distances or noticed that while driving at night, approaching car headlights seemed exceptionally bright or had big halos around them or your optometrist did a dilation test on your eyes and said "Do you know what cataracts are?" Perfect vision won't come overnight but it will improve every day.