Cataract Awareness Month Interview with Dr. McHale

This June is Cataract Awareness Month. And, in honor of this month, we sat down with COA’s Director of Cataract Services, Dr. James McHale, to ask him everything you need to know about cataract treatment.

Do young patients get cataracts? If so, what are the causes?

Young people do get cataracts from time to time. The peak age or most common age of cataract surgery in America is 73. Younger patients oftentimes present with a cataract that is most likely in just one eye. This can be due to previous trauma, infection, or inflammation of that eye. Steroids are the most common medication that causes cataracts in younger patients and are often related to underlying diseases such as arthritis and lupus or linked to those who take chronic steroids due to an organ transplant. There are also some genetic or metabolic diseases that can also lead to the early development of cataracts. It’s quite rare, but sometimes even newborn children are born with cataracts and require surgery shortly after birth to prevent a permanent loss of vision.

Once a cataract has been discovered, what types of tests are necessary to conduct before surgery? Why are these important?

Before cataract surgery, a comprehensive, dilated examination of the eye is required. Notes are made regarding a variety of things, including ocular dominance, pupil size, and visual acuity. Other more high-tech measurements are taken like the length of the eye, the curvature of the cornea, the positioning of the cataract inside the eye, and scans of the retina. All of these factors will then help a surgeon determine the most appropriate treatment option.

If I had LASIK when I was younger, can I still have cataract surgery?

Absolutely. Everyone develops cataracts if they live long enough. Having LASIK will not prevent cataracts and does not change the way we perform cataract operations. However, having had LASIK previously can impact your focus following surgery and will be a vital factor in determining which type of lens implant your surgeon recommends for you.

What type of lens implants will provide me with the greatest freedom from glasses?

In reality, all of the lens implants that we use for cataract surgery will reduce your dependence on glasses to some degree. In most patients, we give them freedom from glasses for distance vision. We have lens implants that correct both nearsightedness, farsightedness, and astigmatism to accomplish this task. There are also more advanced lens implants that can help people see up close and far away, which delivers the greatest freedom from glasses. Some of these even come in a form that corrects astigmatism at the same time. These continue to improve with each generation of lens implants and about 35% of our patients choose these lenses.

What are some of the rare types of complications that occur with cataract surgery?

Fortunately, cataract treatment is the most successful and has one of the lowest complication rates of all surgeries that are performed today. It’s also the most common surgery in America, with over 3 million performed every year. Of course, there are risks, which are typically confined to the eye. Things like blurred vision, infection, bleeding, elevated eye pressure, and the need for additional surgery following your procedure are possible but unlikely.

Can you explain technically what you are doing during the procedure?

During a cataract extraction, a microscope and advanced equipment are used to fracture the cloudy lens into small particles. These particles are then aspirated from the inside of the eye. Because of advanced technology, we’re able to do this through the tiniest of incisions. Once the cataract has been removed, we implant a microscopic, synthetic lens into the eye and replace it right where your original lens was situated. This is all typically done without sutures and with a nice and comfortable recovery.

Why do I need to use drops after cataract surgery?

Drops are used after surgery to help reduce inflammation in the eye, make the eye feel more comfortable, and prevent infection.

Can a cataract come back after surgery?

Once a cataract has been removed, it will never come back. Surgery is a permanent solution to the problem. Sometimes scar tissue can build up behind the lens implant in an eye and cause blurring of vision. However, another cataract surgery is not required for this. There’s a very simple in-office laser procedure that we do that removes the film from behind the lens implant and enhances the vision greatly. This laser is completely comfortable, and the procedure takes less than one minute to perform.