Understanding Cataracts: What is a Cataract?

Cataracts New YorkA cataract is a clouding of the eye’s natural focusing lens, which is located behind the iris of the eye. Cataracts are usually associated with the normal aging process and are the leading cause of vision loss among adults over 55. Eye injuries and certain medications and diseases can also cause cataracts.

When the lens of the eye is clear, it permits light to pass clearly to the retina at the back of the eye, producing clean, crisp images. As a cataract develops, however, two things happen. The cataract becomes denser and progressively clouds the lens, resulting in less light reaching the retina. Additionally, the light that does reach the retina is scattered and blurred, causing a gradual impairment of vision. Consequently, people with cataracts see images less crisply and vividly, and colors may be subdued. The condition can be compared to a window that is fogged over with steam (see image) or darkened over by soot.

Eye Diagram | New York

Common Symptoms of Cataract Patients:

  • Blurry vision
  • Poor near vision
  • Double vision in one eye
  • Glare or sensitivity to light
  • Declining night vision
  • Fading of colors

The general treatment for cataracts is cataract surgery, one of the safest and most effective surgical procedures available today, particularly when performed by skilled surgeons such as Dr. Koster. For more information on cataract surgery and the newest cataract treatment innovations, such as FEMTO laser-assisted cataract surgery and the ORA measuring system, click here.

To see a simulation of the difference in vision after cataract surgery when monofocal implants are used versus presbyopia-correcting multi-focal implants, please click here:

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Benefits of Cataract Surgery

Cataract Surgery Reduces Risk of Hip Fractures;  Reduces Car Accidents and Related Costs

Cataract surgery has benefits beyond the obvious improvement to vision.  For example, a recent study published in the Journal of American Medical Association (JAMA)* showed that the risk of hip fractures was significantly reduced in patients who had cataract surgery as compared to patients who did not undergo such surgery.  This study adds to other research (including as described below relating to a reduction in car accidents) that indicates that cataract surgery, a relatively safe outpatient procedure with high rates of success, may enhance the quality of life for the elderly.

The study tracked hip fracture incidence in a random sample of 1,113,640 US Medicare patients 65 years or older who had a diagnosis of cataracts between 2002 and 2009.  The study compared the incidence of hip fractures in 410,809 patients who had cataract surgery against patients who did not have cataract surgery.  The study concluded that patients who had cataract surgery had a 16% decrease in their odds of developing hip fractures within 1 year of surgery compared to patients who had not undergone cataract surgery.

The benefits of cataract surgery were most pronounced with older patients and those who were very ill.  Patients aged 80 to 84 experienced the largest benefit with 28% fewer hip fractures, and those who had other illnesses and/or chronic conditions were 26 to 28% less likely to have a hip fracture than equally situated patients.

"This study shows that you should never assume that you or family members are too old for cataract surgery," says Dr. Harry Koster, Medical Director of NY Vision Group.  "The benefits of cataract surgery, go well beyond improved vision---resulting in a better quality of life."

*Source: Tseng VL, MD; Yu F, Ph.D.; Lum F, MD; Coleman AL, MD, Ph.D., Risk of Fractures following Cataract Surgery in Medicare Beneficiaries, JAMA August 1, 2012.

Similarly, research presented at a recent American Academy of Ophthalmology ("AAO")* demonstrated that cataract surgery not only improves vision and quality of life for older people, it also potentially reduces the number of car crashes.  Good vision is clearly important to driving safely, but Australia researcher Jonathon Ng, MD, and his colleagues wanted to know if a common, vision-improving treatment like cataract removal could reduce the chance of car accidents. They studied accident rates in Western Australia for people before and after cataract surgery on the first eye to answering that question.

Dr. Ng's study included 27,827 patients who had a cataract removed from one eye between 1997 and 2006. Patient records were linked to the Western Austrial Road Injury Database to identify those involved in a motor vehicle crash 12 months prior to and 12 months following their surgery dates. All patients were 60+ years. The majority of patients involved in crashes were males aged 70-79 who lived in metropolitan areas. Dr. Ng's research colleagues were based at Curtin University and the Eye & Vision Epidemiology Research Group.

The Australian study found that cataract surgery reduced the frequency of all crashes by 12.6% after accounting for all other potential factors. That resulted in a cost savings of AUD $4.3 million, or approximately AUD $150 in crash costs per operation. By including all crashes rather than just fatal and hospitalization crashes in the research, all possible benefits of cataract surgery were taken into account. (In American dollars, the cost savings would be approximately $4.38 million.)

Dr. Koster notes that this study is just one more example not to delay getting cataract surgery if such surgery is recommended by an eye doctor. "This study shows that not only does cataract surgery provide benefits to a patient's quality of life, cataract surgery also provides public safety and economic cost benefits to society at large."

Dr. Ng and the study's other authors say more research is needed to compare accident rates before and after cataract surgery on patients' second eyes.

* Research presented at the AAO's Scientific Program of the 2012 AAO MEACO Joint Meeting in Chicago, USA.  

For more information about cataract surgery and its benefits, please do not hesitate to contact our surgical coordinator at 212.243.2300.