 I'm Dr. Adam Briganza, and today we're going to learn all about cataracts. In the next few minutes, we'll show you what cataracts are and how they can be treated with surgery. We'll tell you about what you can expect before and after surgery, some of the types of lenses that can be implanted, and about possible risks associated with the surgery. In the healthy eye, light rays enter through the clear cornea, pupil, and lens. The light is focused directly onto the retina, the light-sensitive tissue lining the back of the eye. The retina converts light into electrical signals which travel through the optic nerve to the brain where they are recognized as images. Cataracts occur when the lens inside the eye becomes cloudy. The cataract blocks light entering the eye and causes blurry vision. Cataracts usually develop slowly over a period of years as we get older. When cataracts interfere with your daily activities such as reading, watching television or driving, surgery can usually improve your vision. Patients with cataracts who do not have problems with their vision can safely wait to have surgery. An exam by an optometrist may show whether your vision can be improved with glasses or contact lenses. The goal of cataract surgery is to help you see better when glasses no longer help. Now that you know how cataracts can affect your vision, let's cover what is necessary to prepare for surgery. We'll next have an appointment with an ophthalmic technician. The technician will measure your eyes to determine the power of the lens to be implanted after the cataract is removed. This is called biometry. If you normally wear contact lenses, please do not wear them for at least one week for soft contacts and at least three weeks for hard contacts before this test. If you have had refractive surgery such as LASIK, PRK or RK, it's important to alert the technician. This is so that an accurate measurement can be taken. You'll also meet with a cataract surgeon for an evaluation and pre-op. At this visit, your eyes will be dilated for the exam, so you may want to bring a driver. This appointment may be the same date or a separate date is your biometry appointment. Your surgeon will help you decide if surgery is needed and whether it's best to have surgery on one or both eyes. At this visit, you'll have a chance to discuss your lens options with your surgeon and to ask any questions about the procedure. Your doctor will send an electronic prescription for eyedrops, which you can pick up at any Kaiser Permanente pharmacy. Carefully follow all directions for the eyedrops. After this visit, any changes that you would like to make to the planned lens or surgery should be discussed directly with your surgeon. After the decision is made to proceed with cataract surgery, a surgery scheduler will contact you to book the surgery. You'll receive some information in the mail. If you have kp.org, you can also view this letter online. This will include the date of surgery and one to two post-op appointments. The post-op visit is one day after surgery. Occasionally, your surgeon may recommend a second post-op visit. A final visit with an optometrist is usually about one month afterwards. There may be co-pays for each of these visits. You may find out more information about the cost by contacting member services. It's a good idea to plan on staying in town for the first week after surgery. If you have any conflicts with these dates, please call our office right away. If you will be having surgery on both eyes, the second eye may be scheduled on the same day or typically one to two weeks after the first eye. You won't need to see your regular medical doctor or take additional lab tests unless you've experienced a recent change in your health. If this is the case, please notify our office. You also won't need to stop aspirin or other blood thinners such as cumatin and less advised by your doctor. You'll know the date of your surgery from the mailed information, but the exact time of your surgery won't be known until a few days before. You'll get a phone call advising you when to arrive at the surgery center. Don't worry if you're not home. We'll leave the time to report to the surgery center on your voicemail. You may eat up to eight hours before your surgery appointment. You may have clear liquids up to two hours before your surgery appointment. After this, please don't take anything by mouth except necessary medications like blood pressure and heart medicines. Take them with a small sip of water. However, if you are diabetic, do not take your diabetes pills on the morning of surgery since you will be fasting. If you take insulin, please ask your surgeon or a primary care provider about what you should do on the day of surgery. You'll need a responsible adult to drive you back home from the surgery center. Wear comfortable clothes, no facial makeup, and leave any jewelry at home. The actual operation only takes about 10 to 20 minutes, but be prepared for a two to three hour total visit as there are many steps involved in preparing for your surgery. You can receive IV medication to help you relax without putting you fully asleep. You'll also receive some drops, which will numb the eye and dilate your pupil. During the operation, we'll ask you to lie quietly and stare into a light. Your surgeon will make a small incision in your cornea, which will allow them to enter the eye and access the cataract. Ultrasound is then used to liquefy the cataract and then vacuum it out. A foldable lens implant is then placed into a clear bag called the lens capsule, where it unfolds and remains permanently. Sometimes your surgeon will place a shield over your eye to protect it overnight. After surgery, you'll receive instructions on the care of your eye. Please read these carefully. Most patients are able to resume their usual activity, including driving, within a few days. Your vision should improve during the first week, but some patients may take a little longer to heal. Everyone's a bit different. It's normal for your eye to feel a little scratchy for a while after your surgery. But you should call if you notice pain in your eye, redness or worsening vision, especially during the first week or two. It could be a sign of serious infection. While cataract surgery is successful for the vast majority of patients, it is not risk-free. Changes in your vision can occur days, weeks, months or even years later. Even though your doctor uses your biometry measurements to choose an implant power to reduce your need for glasses after surgery, there is a chance that you will need a small prescription for glasses to get the sharpest vision. Occasionally, a film develops on the lens capsule holding the lens implant. You'll notice it when your vision gets a little blurry, months or years after surgery. A simple in-office laser procedure called a YAG can correct this. Another risk of surgery occurs when the lens capsule holding the lens tears during surgery. In this case, your surgeon may need to implant a different lens than the one planned so that it will safely remain in position. Your eye may also heal a little more slowly. In most cases, however, the final visual result is excellent. Other more serious risks of surgery include the possibility that cataract pieces could be left behind after surgery, the lens implant might slip out of place, the retina could detach or you could develop a serious infection of the treated eye, some problems may require another surgery and rarely permanent vision loss or blindness may result. If you have other conditions affecting the vision in your eye, such as macular degeneration, glaucoma or diabetes, cataract surgery alone may not be able to restore full and complete vision. You may also choose not to have surgery. Cataracts develop slowly and waiting to have surgery later on when your vision is more severely affected will not usually decrease your chances of a successful surgery. The good news is that in most cases cataract surgery offers a fast, painless way to improve your quality of life.