Cataract Options

Cataracts and Their Treatment

The lens of the eye, like a camera lens, serves to focus a visual image on the retina which then sends it to the vision center in the brain. While usually clear at birth, a yellow-brown discoloration forms in all lenses overtime, and can often be seen under the microscope in 30 and 40 year old eyes.

Visual changes are generally mild at first, often requiring an adjustment in your eyeglass prescription and brighter lights for fine work and reading. At some point, daily visual tasks become difficult so when you need to see better the hazy, discolored lens must be removed. The focusing power of the eye must then be restored with an artificial lens implant. These intraocular lenses (IOLs) are made of biocompatible materials and are expected to last a lifetime.

Surgery for cataracts is an outpatient procedure with minimal discomfort in most cases. Healing and recovery time is usually quick with the no-stitch approach introduced to Douglas County by Dr. Weston in the early 1990’s. With over 25,000 cataract surgeries performed, Dr. Weston is the most experienced eye surgeon in Douglas County.

The standard lens implant allows us to make the eye relatively clear either for distance or near vision tasks.  This means that you choose either to have some distance vision, often legal to drive but not 20/20, or some near function, usually able to read large print, but not both.  Nearsighted individuals who have been able to do some near work without glasses often choose to remain somewhat nearsighted and be fully dependent on glasses for distance.  Most choose distance dominance but in either case glasses are needed for best vision at distance and near. 

The most recent lens implant technology, the multifocal IOL, provides focus both at distance and close-up, giving the closest approximation to Mother Nature’s original equipment. Although the multifocal IOL will make you less dependent on your glasses, you may need glasses to enhance your vision.

Dr. Weston was the first surgeon in Oregon to perform cataract surgery using the multifocal lenses, beginning with the Array implant in 1998. Today, there are mulit-focal options that allow over 95% of patients to both drive legally and read the newspaper without glasses. Not all cataract patients desire independence from eyeglasses and not everyone is a good candidate for these options. Dr. Weston and his staff will provide information and suggestions specific for your needs.

 

Eyeglass Independence

 

While many people are happy with wearing glasses to correct their vision, a growing number of Americans want to be able to function without artificial eyewear. Millions have had Lasik for this reason. Lasik sculpts the cornea, the front window of the eye, to nearly eliminate the need for distance glasses. To a 20 year old, this allows for both distance and near vision, since the lens of the eye is usually flexible enough to focus from distance to near vision for reading and fine close work.

 

Unfortunately, as our eyes approach their 40th birthday, the natural lens becomes less flexible, reducing the eyes focusing ability, which coincides with a mild discoloration of the natural lens, the earliest sign of cataract formation. This “Presbyopia” is the reason that most people need reading glasses or bifocals as they enter midlife. People in their 40’s and 50’s who have had Lasik will usually still need glasses for reading.

 

For some, “monovision,” where one eye is focused for distance and one eye for near vision, helps provide more seamless vision without glasses. There is some loss of contrast vision and depth perception, but approximately 60% of people who try monovision adapt to it readily. It can be most easily accomplished with contact lenses, and those who are successful can have their eyes surgically adjusted and be relatively free of artificial vision aides using monovision powered lens implants.