Your Guide to Cataracts from Eye Exam to Surgery.

What is a Cataract?

A cataract is when the natural lens inside of the eye becomes cloudy. The symptoms of cataracts that are most commonly reported include increased glare and halos especially at night, as well as an overall decreased quality of vision. The classic line patients will tell their optometrist is that “my glasses always feel like they are dirty no matter how well I clean them,” or “it looks like I am looking through a dirty windshield.” 

Are Cataracts Common?

Cataracts are extremely common affecting more than 2.5 million Canadians. Cataracts are much more commonly found in senior populations, with the main risk factor for developing a cataract being age and sunlight (UV) exposure. 

Fortunately, in most cases cataracts are easily treated. Cataracts are managed by surgically extracting the cloudy lens inside the eye and replacing it with a plastic lens implant to restore a person's vision. The surgical process generally takes less than 30 mins and is performed under topical anesthetic. Complications from the procedure are not common, but it is important to follow all post operative instructions for using medicated eye drops to ensure proper healing and a successful procedure.

In 2022, around 35 000 cataract surgery procedures will be performed in Alberta according to the Minister of Health. The procedure to surgically remove cataracts has a very high safety profile, and is one of the most common surgeries in North America with almost 3 million procedures being performed in the United states annually. 

How do I know if I have cataracts?

During your comprehensive eye examination your optometrist will be able to clinically determine if you have cataracts. To do this, you will likely have your eyes dilated. This is to allow your optometrist to thoroughly assess the lens inside of the eye as well the health of the optic nerve, macula and retina as this information will be important to relay to the surgeon if a referral is needed. 

The decision to refer someone for cataract surgery also involves a thorough discussion of that individual's occupation, hobbies and visual goals. Cataracts mainly cause a decrease in our ability to resolve fine details and have clear vision. But because cataracts limit the amount of light entering the eye they can also affect our night vision and color vision. In some cases, certain types of cataracts can cause double or triple vision that can be particularly disorienting. 

The Cataract Referral.

The next step is a referral to an ophthalmologist for a cataract consultation appointment. At this appointment the specialist will take several other measurements during their examination to then make a plan for a successful surgery. Additionally, the surgeon will have a discussion about the risks and benefits of the surgery to ensure the patient makes an informed choice before proceeding with the procedure. The actual procedure to remove the cataracts will take place on a separate visit, often following several weeks later. 

You’ve Got Options.

When the eye's natural lens that has become cloudy and opaque is surgically removed, it is replaced with a plastic lens called an intraocular lens (IOL). Alberta Health covers a standard single focus IOL that will restore your ability to achieve a certain level of vision. However, depending on your pre operative prescription and your overall eye health you may still require glasses for driving, reading or other activities. 

The surgeon may also present two other categories of IOL options. 

The first option is called a toric lens implant. This type of intraocular lens implant has built in correction for astigmatism that you may already require in your glasses or contact lens prescription. After completing the surgery you may be less reliant on glasses for distance vision but may still require glasses for close up activities such as computer and reading. 

The other option is called a multifocal lens implant. This special type of implant has a number of optical zones that contain different amounts of prescription. The goal is to get you seeing both near and far without the need for glasses. This can be optimized for distance, intermediate or near zones depending on the individual's visual environment.

The upside to these premium lens implant options is you may be less dependent on glasses after completing surgery. Both of these premium implant options are associated with costs that are the responsibility of the patient. 

Time and Money.

Alberta Health will cover the complete cost of the procedure in most cases. Currently, wait times for cataract surgery are approximately 4 to 12 months or more depending on the surgeon in the Edmonton region. These wait times are highly variable and do change regularly. It is also important to inform the patient that private pay options also exist. While the surgical procedure itself is inherently the same, private pay cataract surgeries come with significantly shorter wait times. 

How Can I Ensure My Cataract Surgery is Successful?

Step 1 occurs long before the surgery or even the initial consultation. The main eyecare tip to ensure an optimal outcome from cataract surgery is to make the surface of the eye and the eyelids clean and pristine. Dealing with any signs of ocular surface disease or eyelid inflammation will make the preoperative measurements at the surgeon's office more accurate, ultimately resulting in better vision after surgery. This will reduce the chances of infection after the operation and help with faster healing. 

The best way to take care of any surface dryness and eyelid inflammation is with preservative free lubricating eye drops and a consistent eye lid hygiene routine. At Helio optometry we recommend Theoloz Duo for the month leading up to your consultation appointment along with hot compresses using a Bruder mask. 

After completing cataract surgery you will be issued a package of instructions from the ophthalmologist and their team. This will give directions on what activities must be limited following the procedure and more importantly a schedule of post operative medications. After surgery you will need to take eye drops for about 1 month to prevent infection and ensure proper healing.  

Post-Cataract Surgery Follow-Ups with your Optometrist.

After a successful cataract surgery operation, your surgeon will send you back to the referring optometrist for a 2 week and 6 week follow up. This is to ensure healing and that no postoperative complications need to be addressed. Your optometrist will communicate all the results to the ophthalmologist to ensure everyone is on the same page. If everything goes according to plan you will be issued your final glasses prescription. At that point we resume routine care annually. It is important to continue to monitor for other eye conditions and to continue keeping you seeing your best for work and play.

If you have questions about cataracts, cataract surgery referrals or if you have already had cataract surgery and are having a visual concern, please feel free to reach out to us. Alberta seniors are covered by Alberta Health for their annual eye health examination, as well as any eye urgencies or emergencies that may occur.