Cataracts in adults are due to aging changes within the lens of the eye. Cataracts may also occur secondary to environmental exposures and medications. Steroid-induced cataracts are a common cause of cataracts due to medications.
The aging lens may result in refraction changes in the early stages or the need for increasing strength in reading glasses. As the cataract progresses, symptoms include glare sensitivity and further difficulty reading small print even with the assistance of bifocals.
When the cataract substantially interferes with daily visual activities, cataract surgery may be warranted to improve the visual axis and attempt to improve the overall visual function. Cataract surgery in adults involves removing the cloudy lens and placing an intraocular lens implant to replace the removed lens focusing power. Various tests are performed to calculate the appropriate and specific lens power for each patient. Following cataract surgery, one may still require glasses for distance or reading glasses. Refractive errors may persist or change following cataract surgery.
As with any surgery, complications may occur. The rate of an intraocular infection that may disrupt or cause loss of vision is approximately 1 per 1,000 cases. This condition is called "endophthalmitis". Other risks include loss of lens particles, damage to internal eye structures, and retinal detachments. The pupil may be distorted after cataract surgery. If you are taking medications for urinary problems, please inform your surgeon as you may be prone to "floppy iris syndrome", an increasingly common problem with some bladder medications. Patients may also notice scarring at the surgical sites.
A common complication after cataract surgery is called "cystoid macular edema". Cystoid macular edema is the leading cause for vision loss after cataract surgery. Cystoid macular edema occurs from inflammation within the central part of the retina and results in blurred central vision and possible difficulty reading. Many cases of cystoid macular edema respond to medications and may result in prolonged healing following surgery. Unfortunately, not all patients with cystoid macular edema recover 20/20 vision.
Not all complications seen in cataract surgery are included within this section. The decision regarding cataract surgery should be carefully considered and discussed with your ophthalmologist.