What are Cataracts?

Cataracts are a clouding of the lens

Cataracts are a clouding of the lens of the eye that affects vision. Most cataracts are related to aging and are very common in older people. According to the National Eye Institute, by age 80, more than half of all Americans either have a cataract or have had cataract surgery.

Common symptoms of cataracts include cloudy or blurry vision or glare. Headlights, lamps, or sunlight may appear too bright or a halo may appear around lights. You may notice poor night vision. Another sign may be frequent prescription changes.

Although most cataracts are related to aging, cataracts can also occur as a result of glaucoma, diabetes or after a traumatic eye injury. Cataracts can also result from radiation therapy or can occur at birth.

Cataract Vision
Normal vision and Cataract vision

People who are 60 years old or older should have a comprehensive dilated eye exam at least once every two years. In addition to cataracts, eye care professionals can check for signs of age-related macular degeneration, glaucoma and other vision disorders.

Early symptoms of cataracts may be improved with new eyeglasses, brighter lighting, anti-glare sunglasses or magnifying lenses. If these measures do not help, surgery is the only effective treatment. Surgery involves removing the cloudy lens and replacing it with an artificial lens. Cataract removal is one of the most common, safest and most effective types of eye surgery. The most common method for improving vision after cataract surgery is to replace the cataract with a permanent implant called an intraocular lens, or IOL.

What to expect in Cataract Surgery?

After undergoing in office testing and measurements, cataract surgery is usually scheduled in an outpatient surgery center. Anesthesia is provided by anesthesiologists, and medical clearance is required from your internist or family physician. Most patients can expect to spend several hours at the surgery center, however the procedure itself takes about 45 minutes.

Cataract SurgeryCataracts are removed by ultrasound energy through a small incision in the eye. The lens is then replaced with a silicone or acrylic implant (intraocular lens implant), whose power was determined by ultrasound measurements taken in the office. All patients receive eye drops to use before and after the surgery to prevent against infection and the development of sight threatening inflammation. It is important to use these eye drops as Dr. Dealy instructs, as they directly impact the healing process.

Most patients feel back to normal in a day’s time, and many are able to drive the next day. There is sometimes an adjustment period required, because your old glasses prescription will no longer work for the eye that has just had surgery. Most patients wait about 2 weeks until having surgery on the second eye. Sometimes a new glasses prescription is needed for fine tuning after your surgery, and a refraction for that prescription will be performed about 4 weeks after surgery. Some patients only need to wear drug store reading glasses, while others may still need to use prescription bifocals.

Cataract Surgery Diagram
1.  Removal of cataract with ultrasound probe, 2. insertion of new lens, 3. Intraocular lens in place.


Lens Implant and Refractive Choices after Cataract Surgery

Standard Lens

  • Allows for excellent distance vision
  • Does not correct for near (reading) and may not correct for intermediate (computer) vision
  • You will most likely need glasses for reading and computer
  • Covered by Medicare and other insurances


  • Standard lenses are used in both eyes
  • The non-dominant eye is made to be near-sighted so reading and potentially computer vision (or vice versa) can be accomplished without glasses
  • One eye is clear for distance and the other eye is blurry for distance
  • One eye is clear for near and the other eye is blurry for near
  • Allows for the opportunity to decrease your dependence on glasses
  • Does not have significant side effects of glare and halo
  • May require an adjustment period as the brain learns how to use the two eyes with separate functions
  • Covered by Medicare and other insurances

Presbyopic Lens

  • Lenses are specially made to allow for an expanded range of vision without glasses when compared to a standard lens
  • Offer an opportunity to decrease dependence on glasses
  • You can have functional vision at distance, intermediate, and near but not necessarily perfect vision at each distance. Side effects include but are not limited to glare and halo (typically dissipates over the ensuing months), neuroadaption (the brain needs to learn how to use the lenses), over-correction, or under-correction
  • The procedure and partial cost of the lens is covered by Medicare and other insurance but expenses for extra eye measurements and for the advanced technology of the lens is the responsibility of the patient. Extra measurements may include:
    • Corneal mapping
    • Pupil size
    • Corneal thickness
    • Dominant eye
    • Immersion and/or IOL Master eye length measurement

There are three types of presbyopic lenses. Crystalens® is a pseudo-accommodative IOL that helps to increase your range of vision by simulating accommodation (the eye’s ability to focus on a near target).

An alternative to the Crystalens implant is a multifocal lens. There are three main multifocal lenses, including ReStor® and ReZoom®, and the Tecnis Multifocal, each has strengths and weaknesses.

Dr. Dealy can help you decide if surgery is your best option. She has years of experience with both standard and complex cases and have been trained in the most up-to-date techniques and instrumentation.

Please note: The above is meant to be an introduction into your experience with cataract surgery and lens implant choices. It is not meant as a complete description of lens choices and cataract surgery. There is no guarantee that you will be completely free from glasses with any of the options above. Additional procedures to treat astigmatism may be necessary to help reduce dependence on glasses. Discussion with Dr. Dealy will help in choosing the best option for you. There are some eye conditions that prevent one from being an eligible candidate for the specific options above.

To schedule an appointment or for more information, please contact us.