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Visionary advances in cataract surgery

If you're older than 65, you have a better-than-average chance of developing cataracts. Your risk is somewhat higher if you have a family history of the eye disease. But even if you inherited your parents' eyes, there's good news. Modern cataract surgery is definitely not the eye operation your folks had.

Age-related cataracts cause the lens in the eye to become clouded, affecting vision. About 50 percent of Americans ages 65-74 have a cataract in one or both eyes. Those 75 and older have up to an 80 percent chance of developing a cataract. Cataracts often develop slowly, so the change in vision is gradual and can go unnoticed. And because there is no pain associated with the disease, it is sometimes not caught in its earliest, most curable stage.

"Cataracts are very easily treatable," says Dr. Carolyn Shih, director of refractive surgery at North Shore-LIJ Health System's Department of Ophthalmology. "But if you wait too long, the surgery becomes much more difficult and risky."

The most remarkable changes in cataract surgery over the past few decades are how common it has become and its overwhelmingly successful results. After the surgery, which Shih calls "elegant," as many as 90 percent of patients have their vision fully restored to precataract levels. Compare that to years past, when the typical outcome was much less certain. "You would end up with Coke-bottle glasses, and the surgery itself was so high risk that the risk of bad bleeding and completely losing your eye was very high," Shih says. Because the surgery is less invasive than in the past, healing times are faster.

Many people develop cataracts in both eyes. In that case, most surgeons, including Shih, operate on one eye and let it heal. The second eye is operated on as quickly as a few weeks later. Medicare and most private health plans cover most of the costs.

Shih advises anyone 40 or older to see an eye doctor at least once a year so any eye problems, including glaucoma and macular degeneration, can be caught early.

While the result of cataract surgery is usually uplifting, there is at least one downside to seeing so clearly again. Shih says that after a successful surgery, one patient told her, "I didn't know my house was so dirty."

For more information, download "Cataract: What You Should Know" at from the National Eye Institute.

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