Riemer Eye Center - Dr Andrew S Riemer DO - Ophthalmologist - Wavefront Custom Lasik - Ophthalmology - Eye Care

Cataracts

Most people have some clouding of their eye's natural crystalline lens after the age of 60. This clouding is more commonly referred to as a cataract. About 50% of Americans in the age group of 65-74 have at least one cataract. Simply stated, when the eye's lens becomes cloudy, light cannot be properly focused on the retina; thus, visual acuity decreases. The only "cure" for poor vision due to cataract is removal of the eye's lens and implantation of a new, man-made focusing device called an intraocular lens (IOL).

Many people with cataracts may experience symptoms such as:

Cloudy, fuzzy, foggy vision
Difficulty in seeing to drive, especially at night
Trouble seeing to do close work
Problems seeing television
Colors that seem dull, faded, not as bright
Frequent changes and a stronger glasses prescription
Halos around lights
Bothersome glare
A milky white spot or cloudy spot visually apparent in the center of the eye

Diagnosing a cataract

Most cataracts develop as part of the aging process, but may be present at birth (congenital) or result from an injury, systemic disease (diabetes), or steroid use. Using specialized equipment, cataracts as well as other eye diseases are diagnosed during a complete eye examination by an eye doctor at Riemer Eye Center. The mere presence of a cataract does not indicate the need for surgery. Some cataracts may be slow growing, and vision may be corrected by stronger glasses for a period of time. Some cataracts develop more rapidly than others, and your doctor can monitor changes in vision and cataracts with periodic eye examinations.

Cataract Surgery

Cataract surgery has undergone tremendous technological advances in recent years. In fact, cataract surgery has become one of the safest, most common, and most effective types of surgery.Each year, nearly three million cataract surgeries are performed in the United States.

For most patients, cataract surgery is a relatively simple operation. It typically is an outpatient procedure that requires patients to spend just a few hours at the site. Also, it involves little discomfort for patients as their eyes will be treated with an anesthetic.

The actual procedure involves the surgeon making a tiny incision in the eye. Through this incision, the surgeon inserts an instrument about the size of a pen tip that breaks up and gently removes the cloudy lens. Once the clouded lens has been removed, it is replaced with an artificial lens, called an intraocular lens (IOL).

After the surgery is completed, patients are required to rest for a short time and then are allowed to go home. Within the next 24 hours, the surgeon most likely will want to see the patient for an evaluation. Drops will be prescribed to guard against infection and help the eyes heal. For a few days, patients may need to wear a clear shield, especially at night, to prevent them from rubbing their eyes. Generally, most patients can resume normal activities the day following the procedure.

What is an IOL?

An intraocular lens (IOL) is an artificial lens that is implanted in the eye during cataract surgery. Traditionally monofocal IOL’s were used meaning most people would still have to wear reading glasses or bifocals after surgery. Recent advances in IOL’s can allow good vision for both distance and near vision without the need for glasses. There are currently three primary types of lenses available:

Monofocal lenses have one point of focus and usually give clear distance vision after surgery leaving the need for glasses for reading and near work.

Multifocal lenses focus the eye for distance and near. After cataract surgery with a multifocal implant most people are free of glasses for most tasks. For more information on multifocal lenses visit acrysofrestor.com. Or view our videos here.

Astigmatism correcting lenses are for patients with existing corneal astigmatism. These lenses usually give patients quality distance vision however most patients will still need glasses for reading.

Astigmatism and LRI

What is astigmatism?

The cornea is the clear, curved front surface of the eye that is in front of the colored part of the eye (the iris). Astigmatism is present when the cornea does not have one curve but instead has two different curves. If the cornea has only one curve it is shaped like a basketball and there is no astigmatism present. If the cornea has two different curves (astigmatism) then it is shaped like a football. That means there is a steeper curve and a flatter curve to the front surface of the eye (cornea).

What is a Limbal Relaxing Incision (LRI)?

Limbal relaxing incisions (LRI) are a surgical procedure that Dr. Riemer performs to reduce the amount of astigmatism. An LRI is a small incision on the edge of the cornea that allows the cornea to reshape itself as the incision heals. Remember astigmatism is having a steeper and flatter curve to the cornea. The LRI decreases the difference between the two curves to make the cornea more shaped like a basketball than a football, lessening the amount of astigmatism.

A LRI can be performed in conjunction with cataract surgery to help reduce the amount of astigmatism and thus increase the chances for better vision without glasses for distance tasks. A glasses prescription will usually still be needed to read and do close work.

Who is a candidate for a LRI?

those who have low to moderate amounts of astigmatism
those who would like to reduce their dependence on glasses after cataract surgery
those who have healthy corneas

Although we cannot guarantee you will have the results you desire, serious complications with an LRI are extremely rare. The most common side effects are visual fluctuations and mild irritation. The cornea usually takes two to four weeks to heal and visual fluctuations and changes may be noted during that time period and are not unusual. The LRI is an extra cut at the time of cataract surgery and there is usually a mild irritation as that incision heals for the first one to two weeks.

The decision to have a LRI is an important one that only you can make. The goal of any refractive surgical procedure is to reduce your dependence on corrective lenses.

The correct lens or procedure for you will depend on your eyes and your desire to be glasses- free. Our team of doctors will discuss your options with you and make recommendations suited best for you and your eyes.