What Are Eye Cataracts?

Eye cataracts are a common eye condition that causes the eye’s lens to become cloudy. This cloudiness can interfere with vision, making everyday activities such as reading or driving challenging. Cataracts usually develop slowly over time and are often related to aging, but they can affect individuals of all ages. They can however in some cases mature very quickly.

Monitoring your vision clarity with an optometrist is a great way to find the optimum time to consider cataract eye surgery. Cataract surgery involves removing the cataract clouded crystalline lens from your eye and inserting a plastic lens.

Causes of Cataracts

Several factors contribute to the development of cataracts. Aging is the most significant risk factor, as the proteins in the lens begin to break down and clump together, causing cloudiness. Risk factors include:

  • Aging and environmental factors such as UV sunlight exposure. Up to 90% of people will get cataracts after age 65.
  • Genetic predisposition raises your likelihood of getting cataracts up to 58%.
  • Diabetes 7% higher risk than the normal population.
    • Smoking, Drinking, Obesity, and High blood pressure… all increase the risk of developing cataracts.
    • In addition, certain medications and past eye injuries can also increase the risk of cataracts.

How to Prevent Eye Cataracts

It is not possible to prevent cataracts entirely. But certain lifestyle changes can help reduce the risk:

  • Wear sunglasses to protect your eyes from UV rays. Or protective glasses when using dark light (UV).
  • Maintain a healthy diet rich in fruits and vegetables.
    • Quit smoking, or never start in the first place.
    • Manage underlying health conditions, such as diabetes and high blood pressure.

By adopting healthy habits, you can maintain healthier eyes for longer and lower the risk of developing cataracts as you age.

 

Background

Cataracts form inside the eye. A common misconception is that they form a film over the front, the clear part (Cornea) of the eye. But these are Pterygiums.

  • Pterygium are caused by exposure to ultraviolet (UV) radiation and made worse by chronic dryness or other eye irritations.

 

Cataracts form inside the eye.

There are many cataract growth patterns. However most start at the centre (lens nucleus) of the crystalline eye lens. (which is formed like the layers of an onion.)

Lens | Eye Patient

Are cataracts dangerous?

  • No. They are not life-threatening. However, you will gradually lose your ability to see objects clearly. The tipping point comes when your cataract-impaired vision becomes so blurry that you can no longer perform simple everyday activities safely or successfully. Cataracts can be devastating economically. Because a person gradually loses the ability to fend for themselves and others.
    • It is impossible to know how long it takes before your vision is so blurred by cataracts that you can no longer perform everyday tasks.
      • The tricky part is knowing when to leave cataracts alone, especially at the early stages and when to book an ophthalmic surgeon to replace your eye’s crystalline lens with a plastic lens.
      • In many countries, optometrists are great at managing cataracts. Ophthalmic insiders prefer optometrists over general doctors for cataract management. Learn more about this later…

The reasons to use optometrists for cataract management are varied and many…

  • Optometrists have slit-lamp microscopes and other high-tech slit-lamp-like instruments to see the eyes inside clearly. However, laws in many countries prohibit optometrists from discussing their findings with their patients. But, if you consult an optometrist regularly every 2 years, after age 50… you will definitely benefit from your case history and eye change history. Because your optometrist can judge your cataract progression and advise you about your driving vision safety and adjust your glasses prescription to get you the best pre-surgery vision possible.
    • Optometrists see many patients before and after eye surgery. Because Optometrists (Latin for optical measuring and optical clarity specialists) are highly trained to measure your eye clarity etc… they know how to grade eye surgeons by the vision clarity they measure before and after surgery.
    • Optometrists keep records that tell them how quickly or slowly your eye cataracts change. Comparing you to the many other cataract patients they see. Optometrists are very capable of advising you when it is time to be referred to an eye surgeon.
  • Not all cataracts are the same. There are many cataract types and patterns. Therefore, Optometrists can discern which operating method, plastic lens implant, or eye surgeon and their many individual operating techniques are more successful. This naturally causes friction between the professions. But this friction can also be a great catalyst to be directed to a super-sub-category eye specialist with great implant products and surgery methods. The best eye specialists foster great relationships with their local optometrists and are using optometrists to co-manage patients to fine-tune spectacles before and after surgery.
    • Yes! Many patients require spectacles post-surgery! Even when the operation was a total success. Statistically cataract surgery is a very common procedure with great outcomes.  But the eye is a living organ and plastic lenses are fixed in their lens powers and focus. The eye however might move on and develop minor vision imbalances over time.

 

Things become a little confusing from here on… 

  • …because the plastic-implanted eye lenses vary greatly. Some hi-tech lenses have great features but might be terrible for nighttime driving. While others are super for all driving situations but are a nuisance for reading and computing and you still might require one or many different types of reading or distance glasses. Others again use optical trickery like monovision which allows you to get ok, but not super vision almost anywhere without glasses…
  • Eyes also change and implanted eye lenses might have to be changed or laser cleaned by an eye surgeon to maintain clarity. Optometrists discuss cataract pre and post-surgery cases endlessly among themselves and whilst they are not eye surgeons. They however are super experts at measuring, diagnosing and comparing pre and post-surgery successes, failures and normal complications.
    • But don’t be surprised if optometrists are not very talkative. It is up to you to coax information out of them by asking polite questions that do not insult eye surgeons. Remember that optometrists and eye doctors compete and support each other and that their professional relationship can be very fragile.
    • Sadly, many cataract patients are also stingy. Wasting their optometrist time and then go and buy $2 or junky internet reading glasses. Or by not allowing their optometrist to adjust their vision clarity before and after surgery.
    • Optometrist patients often clam up when it comes to purchasing glasses from optometrists because they are stingy thinking it a waste of money to buy new glasses when a future cataract surgery renders them useless. Added to that is the peculiar fact that many eye surgeons advise their patients to buy $2 reading-glasses-magnifiers after surgery.
    • It is a little-known fact that optometrists make custom reading glasses that must adhere to very well-researched, high-vision standards of eye comfort and eye clarity. However, $2 reading-glasses-magnifiers can be sold without having to conform to the same standard. The difference causes eye strain and blurry vision. Period!
  • However, eye surgeons are somehow addicted to telling their patients that they ‘…no longer need glasses’. But can now buy just $2 magnifier-(reading)-glasses.’… because the surgery was a great success. Go figure!?
  • The reality is that patients are enamoured with their eye surgeon …and so they should be! Eye surgeons are without reservation or exception fabulously skilled doctors!  But patients frequently either put up with inferior vision (which might even be ok for their lifestyle ie. they don’t read or drive much… ) or they are running the gauntlet of optical chains’ rip-off marketing hype, trying hard to get better vision or eye comfort.
  • Many cataract patients, however, crawl post-surgery back to their kind and knowledgeable local optometrist and quietly get advice on how to focus their vision to a higher standard of clarity and eye comfort. It is however becoming more common for eye surgeons to co-manage patients with optometrists. If you can find such a co-managing pre and post-surgery optometrist-eye surgeon team you will have the best of both.
    • We live in a world of specialisation. Ophthalmologists have up to ten sub-specialisations. Eye testing (refraction) for glasses is just a small, sadly unprofitable part of their skill set. Often they get good fees for a medical consultation and very very low optometrist fees for refracting. They also often refuse to take refracting appointments because of their high surgery caseloads etc…
    • Optometrists however specialise in hands-on Eye testing, which is a totally unprofitable ‘loss-leader’. Because their equipment and eye testing training are their major practice operating costs. Most eye tests are done at a financial loss. Optometrists need to sell you glasses because they simply cannot survive on eye testing fees alone!
  • Realising that both professions need $ turnover to survive, you would be wise to pay both to get the best eye care possible.
    • Being stingy doesn’t pay because new spectacles or just new spectacle lenses fitted to your old frames are chump-change!
    • Even a few new spectacles cost less than filling your car’s tank.
    • When pre and post-cataract spectacle costs are compared to eye surgery, pre and post-surgery glasses and spectacle lenses cost peanuts! However, the potential vision clarity, vision convenience and professional guidance, pre and post-surgery, can be substantial for many patients.

 

The bad…

  •  A patient has waited too long and has post-surgery complications.
    • The eye eventually heals but has sustained a little damage during or post surgery. (Anecdotally it is better to find a tipping point for the eye surgery before the cataracts become totally opaque (mature and hard).)
      • There are many factors… but eyes go blind gradually when they can not see clearly.
      • Simple cases are when an eye with a turn is slowly switched off by the brain because of the lack of brain stimulation. Whilst crude orientation vision often remains. Fine vision clarity is often lost. Also, imagine having to wait years before surgery. Either partially or fully blinded by cataracts. You will really suffer and become incapacitated. Great eye surgeons like Fred Hollows of Australia have left a gigantic legacy that has restored sight and normal life to millions around the world.
  • I hate to say this. But many eye surgeons suggest that patients just buy a $2 ready-made magnifier for reading after surgery.
  • Optometrists are usually horrified when they learn about these crude post-surgery optics cheapskates. Unsurprisingly this causes tension between the professions. Especially when local eye surgeons are a little high and mighty in their attitude towards optometrists. However, in many locations they get along fine… but when not, it is the optometrist who quietly picks up and corrects post-surgery optical focus and clarity issues.

 

Why are pre and post-surgery optometry visits and glasses a great option to see better after surgery?

 

Implant lens vision quality pros and cons…

 

Single vision distance lens implant

Simple Single-vision cataract lens implants, often referred to as monofocal(only focused for distance viewing) lenses, have their advantages and disadvantages. Here’s a concise overview:

Advantages:

1. **Clarity of Vision**: Single focal lenses provide clear vision at a single distance, typically far away, which is ideal for many activities like driving. Dysphotopsia, which are reflection nuisance spots on lens implants are more predictable, small and rare.

2. **Simplicity**: The technology is well-established and understood, which often leads to predictable outcomes. ie. if you chose your tipping point well and wore distance glasses before the operation. You will have a great chance of having only a tiny or even no distance glasses prescription.

3. **Cost-Effective**: They are generally less expensive compared to more advanced lenses, such as multifocal lenses.

4. **Reduced Risk of Complications**: Because the design is simpler, the risk of complications related to lens optics is lower.

5. **Quick Recovery**: Many patients experience a quicker recovery time and less post-operative discomfort and complications.

Disadvantages:

1. **Limited Versatility**: Patients will still require glasses for intermediate and near vision tasks, such as reading or using a computer, which can be a significant inconvenience. However the post operation clarity achieved with glasses is usually very good.

2. **Adjustment Period**: Some individuals may take time to adapt to their new vision, especially if their previous prescription varied significantly. ie. if you wore high powered glasses before the operation. Your vision without glasses will see things either larger or smaller, requiring a period of time to normalise.

3. **Not Ideal for All Patients**: Those with certain visual demands or lifestyle preferences may find that single-vision implants do not meet their needs. ie. you are a very active person with basic reading and night driving needs. Multifocal implants might suit you in this case better.

4. **Presbyopia like reading vision**: Presbyopia is no-longer an issue after surgery (no accomodation). Because an implanted lens can-not change its shape to adapt to focus on close objects. After surgery you have an eye that only focuses on distant objects. To read you will need reading glasses.

This means you experience the reading vision of a 75 years old person who has healthy old eyes and if you buy $2 reading magnifiers you’ll get poor reading vision. Should you seen an optometrist for new reading glasses, you’ll definitely get very clear reading and intermediate vision with the right spectacle lens choice and expert advise.

3d-readers.xyz are a neat, natural 3D optical alternative to magnifying and progressive reading glasses.

 

5. **Surgical Risks**: Like any surgical procedure, cataract surgery carries risks such as infection, inflammation, or lens dislocation.

### Conclusion:

Single-vision cataract lens implants are suitable for many patients Particularly those who prioritize very clear vision. However, they may not be the best option for those who desire a vision correction without glasses. It’s essential for patients to discuss their lifestyle and vision goals with their ophthalmologist(eye surgeon) to determine the best option for their individual circumstances.

 

Multifocal cataract lens implant

Multifocal cataract lens implants offer unique advantages and disadvantages which can-not be post-surgically altered. The following points are important to consider when evaluating their use for cataract surgery. Here’s a summary:

Good Points

  1. Improved Vision at Multiple Distances: Multifocal lenses are designed to provide clear vision for near, intermediate, and distance tasks, reducing the need for glasses after surgery for many patients. But patients who require exceptionally sharp vision are advised to study and discuss their hard disadvantages.

  2. Reduced Dependence on Glasses: Many patients find that they can perform daily activities without corrective eyewear, leading to greater freedom and convenience. Providing they do not perform strenuous distance or close vision tasks. ie.Shopping and dining out will be great. But designing things or making fine stuff like jewellery will be nigh impossible.

  3. Potential for Better Quality of Life: Improved vision can enhance quality of life, allowing for activities like reading, using a computer, and driving without additional lenses. They are idea for active people who do not need accurate night time driving or fine detailed near vision.

  4. Technological Advances: Newer multifocal lenses often have improved design features, such as aspheric optics, which can reduce glare and halos, enhancing overall visual quality.

Bad Points

  • Visual Distortions: Some patients may experience visual disturbances such as glare, rainbows or halos around lights, or reduced contrast sensitivity, particularly in low-light conditions.

Fresnel multifocal implants lenses have all the distortion problems that a regular Fresnel lens has. Spherical and aspheric aberrations. chromatic rainbow effects and uncontrollable reflections on its rings. These distortions are naturally minimised by the manufacturer. However patients expectations vary greatly and what is super vision for one, when measured and compared scientifically, equates to rubbish vision for another. Because of this ‘human’ factor, patients who require exceptional night and super sharp, color perfect near vision or who have prismatic lens corrections, are often disappointed by the outcome.

So, if this choice looks interesting to you. Take a long holiday to adjust to your new vision.

    • Some manufacturers produce seamless multifocal implants. Akin to a spectacle lens. The surface has a gradually changing, smooth radius. The changing radius give implants an egg like shaped. They also do have fewer dysphotopsia issues. But are not free of dysphotopsia issues or astigmatic distortion created by the seamless lens power transition algorithms. Distortions like normal Multifocal astigmatism, just like any other astigmatism causes a point to be pulled into a line, which then distorts your vision. Luckily patients adapt to multifocal lens peculiarities if they persevere…

 

  • Not Suitable for Everyone: Certain eye conditions or lifestyle factors may make multifocal lenses less appropriate, necessitating careful pre-surgical screening.

  • Adjustment Period: It can take time for some patients to adapt to multifocal lenses, which might lead to initial dissatisfaction or frustration.

  • Potential Need for Glasses: Some patients may still require glasses for specific tasks (especially very fine print or night driving (dysphotopsia reflections are however always present when strong light and brightness contrasts occur.) after surgery.

  • Higher Cost: Multifocal lenses are more expensive than standard monofocal lenses, and insurance may not cover the additional costs.

  • Limited Near Vision: In some cases, the near vision achieved may not be suitable for activities requiring especially fine detail, such as intricate crafts or fine print reading. But dysphotopsia, which are uncontrollable reflection spots on the surface of multifocal implants can be annoying. Also reflections on the surface of the implanted lens and the shadows or black spots they can cast onto the retina of the eye, can add to the list of dissatisfaction. Further, dysphotopsia is irreversible unless another operation is performed to replace them with another implant lens type. However disturbing the eye with another operation carries new risks that need to be discussed with your surgeon.

In summary, multifocal cataract lens implants can enhance daily living for non-discerning happy-go-lucky active patient by providing versatile good vision. But they may also introduce certain visual complications that require consideration of an individual patient needs and vision conditions. It’s crucial to discuss these factors with an eye surgeon professional before making a decision.

 

Mono vision lens implant

Mono vision is one of the least costly cataract surgery method but also one that can, with the help of glasses, restore vision to the highest standard with only minor dysphotopsia glare spots. It also has one of the smallest rates of surgical complications.

As long as the fundus and general eye health in both eyes remains good monovision implants are a great choice. Comparing monovision implants with multifocal implants, the monovision technique produces less spherical blur and astigmatism. Post surgery interventions are also rarely required. One of the major advantages of monovision is that any perceived vision clarity deficit can be corrected with the use of spectacles, thus fully restoring both eyes vision to near normal clarity. It is important that patients understand that eyes are living organs that must and will change over time. Glasses can easily be renewed and refocused, as well as re-designed to add vision comfort improvements. They therefore play an important roll in restoring a patients sight to a near pre-cataract level of quality.

 

How does monovision work?

Our vision is produced by our brain and not by our eyes. The eye just collects images that are focused onto its inner nervous system .The retina. The vision is then send to the opposing brain half for processing and deciphering which in turn we call vision. Our brain can turn an individuals eye on and off as well as it can overlap clear and blurry vision images from both eyes to form three dimensional vision.

  • Monovision (this also applies to 3D glasses) relies on our brain’s ability to fill in missing vision signals. If one eye is focused for reading and the other eye is focused on the distance. Our brain conjures up a remarkable trick. It simply substitutes the signal from the blurry eye with a construction created from its vision memory and mixes it with the signal from the clearly focused eye. Without realising it. We think we see clearly with both eyes.
  • This process of mixing blurry eye vision and clear eye vision is an all-day event in our vision system.
    • For example. Three dimensional vision relies on the image at the back of our eyes to be a different size. Just like 3D movies are blurry when viewed without 3D glasses. Our brain uses the size difference of the image created in each eye to create the illusion of three dimensions.
  • As a teenager i had two perfect and totally identical eyes and therefore the image in each eye had the same clear focus and identical size. But I could hardly park my car because I could not judge distances. I simply did not have 3D vision! Then stupidly a small piece of aluminium (non-magnetic and therefore my eye surgeon could not use a giant magnet to pull it out.) metal shaving embedded in my cornea. My eye surgeon pulled it out of my cornea with a kind off corkscrew knife. My cornea healed perfectly. But the curvature of my cornea had permanently changed. Creating a different, slightly blurry eye power and therefore the image size in each of my eyes was different as well as one eye was always a little blurry. But to my surprise I suddenly had super clear 3D vision like every other normal human being. Adding to my delight was the fact that my driving and parking, where 3D vision is essential, improved remarkably! 🙂

Since that incident I have had a lifelong fascination with 3D vision and our brains amazing ability to mash unfocused and different sized images to perfrom its own remarkable natural vision tricks. Today, as my retirement project, I produce a range of affordable, but high quality 3D glasses (and vision improving sunglasses) which offer an alternative to conventional optics, its limitations and loud marketing hype.  It is fair to say that my magnifying spectacles are unorthodox. They are a mix of various ophthalmic optics and natural eye 3D trickery, that when inspected by regular opticians sends their brains into a spinn 🙂

  • 3D vision is a totally natural phenomena!
  • 3D refers to three dimensional vision which we need to judge distances. 3D also refers to seeing clearly at 3 distances with both eyes. ie. close reading, intermediate (1 to 2meter clarity) reading and distance vision.
  • 3D works for most people, as long as you have two healthy eyes.
  • A healthy eye is one that can see clearly with the help of glasses or contact lenses. Because blurry vision which can be corrected with glasses or contact lenses is not an eye disease. It is simply an eye focus problem in 99.9% of cases.
  • Cheap 3D junk lenses can only produce crude 3D trickery. Only ophthalmically polished and coated lenses produce exceptional 3D effects.
  • 3D effect glasses for distance or reading work as long as you have two healthy eyes and are willing to patiently adapt to the different but fabulous vision my 3D glasses produce. They are often an instant success. But can take up to a few month with some individuals. Especially if the person stubbornly dislikes change. Getting 3D glasses when normal reading problems first surface is a smooth way to exceptional vision which bypasses the hard limitations of conventional reading glass optics.
  • A particular 3D effect is often limited in scope. It is not uncommon to have several 3D magnifying glasses, for specific purposes, to produce exceptional clarity and 3D effects.
3d-readers.xyz are a neat, natural 3D optical alternative to magnifying and progressive multifocal reading glasses.

 

 

How is a cataract operation performed?

  • Local or general anesthetic numbs the eye and with special operating tables the head and eye are steadied and prevented from moving during surgery.
  • At the edge of the cornea a small 2 to 3mm cut allows a suction extraction needle to remove the cataract blinded crystalline eye lens. A capsule skin which surrounds the crystalline lens remains relatively undisturbed. In a fully mature cataracts this process is more difficult and can lead to small eye deformation. It is therefore advisable to judge the operation tipping point well. Cataract removal is generally better done early, but not too early is better than later or very late and fully matured.
  • The implant lens is cleverly wrapped to fit into the tiny incision hole. The tricky part is positioning the implant so that it is optically fully useful as well as secure. Avoiding light retinal flashed because of implant movement or vibrations.
  • Most implants are self centering and stable. But they can and do move if the patient performs stupidly strenuous activities during the healing phase.
    • Astigmatic cataract patients might still have astigmatism after cataract surgery. However there are methods to cut cataract extraction holes into the edge of the cornea at axis of the steeper curve of a corneal astigmatism. This incision location would flatten the astigmatic curve and result in reduced astigmatism. https://crstodayeurope.com/articles/2011-jul/solutions-for-surgically-induced-astigmatism/
    • Lens implants can also correct some types of astigmatism.
    • The go-to method is do to topography of the various eye sections which could hold one or several astigmatisms. But cloudy cataracts may prevent optical topography. But sonar topography might see behind the cloudy cataract.
      • Needless to say that this is a developing operating technique which relies on the surgeons experience. I personally found that most patient in Australia (Thanks to the Fred Hollows foundation leading the way in low invasive cataract operations). Whereas in German, a different technique is used which creates almost without fail astigmatism during cataract surgery between -1.5 and 4.0dpt.

Glasses may or may not be required after surgery. Using $2 magnifiers are the crudest way to improve reading vision. Optometrist designed glasses create very clear and significantly more convenient vision.

3d-readers.xyz are a neat, natural 3D optical alternative to magnifying and progressive reading glasses.

 

 

 

 

Please select: