Richie Eye Clinic - Faribault, Minnesota

Cataract Care

What is a Cataract? / Cataract Surgery

A cataract is a clouding or discoloration of the clear lens of the eye that blocks or obscures the passage of light, causing a gradual loss of sight. The amount and pattern of cloudiness within the lens can vary, and you may not know it is present. Cataracts occur as part of the normal aging process and studies show that virtually everyone age 65 has some cataract formation in their eyes. Most age-related cataracts progress gradually over many years. Other cataracts, especially in younger adults and people with diabetes, may progress rapidly. The aging process, family history, diabetes or other medical problems, smoking, trauma to the eye, some medications, and excessive unprotected UV exposure are known causes of cataracts.

Testing & Treatment

A thorough eye examination by your ophthalmologist can detect the presence of a cataract, as well as any other eye conditions. Cataract surgery is necessary when your decreased vision interferes with your every day activities.

Cataract surgery has become the most common surgery performed on adults in the United States.

During cataract surgery, the cloudy lens of your eye is removed and replaced with a clear lens implant. This implant is placed directly into the eye, reducing or eliminating the need for any glasses after surgery. The newest implants (called multifocal implants, or presbyopia-correcting implants) can even provide sharp vision at both distance and up close, reducing or eliminating the need for any kind of glasses, including reading glasses after surgery. Most patients notice an immediate improvement in their vision after surgery.

Cataract surgery is performed on an outpatient basis at Crossroads Surgery Center, which is on the second floor of our Faribault facility.

Dr. Richie has improved the vision of thousands of people suffering from cataracts. Please contact us to discuss your options for cataract care.

I have Cataracts… Now What?

A cataract is a very normal problem that we develop as we mature. The normally clear lens in the eye becomes yellowed, interfering with light as it enters the eye. As a result, your vision can be affected in any number of ways, including blurred vision, bad night vision, reduced vision in low lighting, trouble with street and road signs, or problems with small print. Cataracts do not cause watery, achy or sore eyes, nor will they cause red or irritated eyes.

Many find it helpful to think of the eye as an automobile, the retina like the engine and the lens like the windshield; a dirty windshield that can make it hard to see, but it will never damage the engine. It will not harm the eye to leave the cataract in place, and results are no different if the cataract is removed sooner or later. You should remove your cataract only when you decide you want it removed to make your vision better. How dirty is your windshield? You tell us... you are the one looking through it. If it bothers you, fix it. If not, wait until it does bother you.

In cataract surgery, we remove the cloudy, yellowed human lens and replace it with a plastic man-made lens called a LENS IMPLANT. The lens implant is much like a contact lens that fits permanently inside the eye. Because these implants are man-made and have focusing power, we measure the eye and build most of your glasses prescription into the implant, reducing your dependence on glasses. After cataract surgery, most people have good enough vision to drive without glasses, but will need glasses for reading. Rest assured, lens implants are not new devises and have been a standard part of cataract surgery for the last 25 years. Standard cataract surgery is not designed to correct astigmatism.

Hey, What about Reading Vision?

Vision following cataract surgery is usually very good, but will not adjust from distance to near. Most people will require reading glasses or a bifocal to see up close for near tasks and reading. Several options exist, however, to minimize your dependency on glasses after cataract surgery, each with its own advantages and disadvantages.

MONOVISION is a technique used to minimize glasses by choosing a conventional intraocular lens implant (IOL) for the dominant eye focused for distance, but using a similar IOL in the non-dominant eye focused up close for reading. This technique is commonly used with contacts and LASIK and works very well. The key is to understand that monovision is not perfect vision; rather it is a compromise in vision. Binocular vision (both eyes working together) is the best vision we can achieve with the best contrast sensitivity. Breaking the eyes apart with one eye focused for distance and the other for reading allows better versatility, distance and near, but reduces contrast sensitivity. Your vision will be more light-dependant, needing better lighting for reading, but monovision provides very good “indoor” vision. You may also have trouble with headlights and night driving since one eye is focused at the dash board instead of the headlights. Some people prefer “monovision driving glasses” to focus the reading eye at distance, restoring binocular vision for night driving. How well you are able to adapt to this technique depends on how your brain can adjust; we can even demonstrate monovision with contact lenses prior to surgery if you choose.
DELUXE LENS IMPLANTS are now available, at an additional cost, to help remedy the distance/near dilemma. Multifocal and accommodating IOLs are designed to give both good distance and near vision after cataract surgery. They all work well, but none are perfect; each has its own unique characteristics and shortcomings, but provides good versatile vision. The surgery itself, however is the same cataract surgery we have been doing for years, just with a new implant.
1. MULTIFOCAL IOLs are lens implants with a bifocal/trifocal design, the extra power in a ring pattern around the lens. They project several images onto the retina at the same time (distance, intermediate, and near); fortunately, the brain is able to interpret all this information quite well. They provide very good distance vision with very reliable reading and computer vision. As with monovision, you lose some contrast sensitivity and will be light-dependent for reading. Expect halos around lights at night as a result of the “ring” design of this lens. This lens is very stable in the eye and causes no surgical complications.
2. ACCOMODATING IOLs (the Crystalens) is a single vision IOL with a hinge system that allows the implant to adjust its position in the eye, thus changing focus from distance to near. It provides excellent vision with minimal loss of contrast sensitivity (because it is a “single vision” IOL), good for far and computer distances, less glare at night, but less predictable for reading than the multifocal IOLs. Near vision is good for most things and requires good lighting, but you may need weak readers for the small print or extended reading tasks. The Crystalens provides a smooth range of vision from distance through intermediate to near, maintaining good contrast with less glare at night. Because of the hinge design, this lens may slip and require repositioning.

Cataract Care Packages

Standard Cataract Care is our standard approach to cataract surgery that includes the latest technology for removing a cataract and placing an intraocular lens implant (IOL). This procedure is done with sterile technique in an operating room, is extremely safe, predictable and effective, and allows for restoration of vision hampered by the cataract.

The lens implant (IOL) is a high quality, manmade device inserted into the eye to replace the natural human lens that has become the cataract. With preoperative measurements, much of your glasses prescription can be built into the implant; cataract surgery patients are frequently less dependent on glasses than prior to surgery. Unfortunately, Medicare and insurance rules do not allow for surgical correction of astigmatism during standard cataract surgery. Following the operation, most people still have glasses with a bifocal to be used as needed, for reading, night driving, and to get the best vision possible. Financially, you are responsible for insurance deductibles and co-pays.

The goal of Custom Cataract Care is to maximize your vision following cataract surgery and minimize your need for glasses. This requires a more extensive preoperative evaluation, a thorough discussion of monovision, a clear description of what you can expect from your vision, and may include surgical approaches to reduce astigmatism, high-technology accommodative and multifocal IOLs, or even LASIK.

Custom Cataract Care has an added charge over and above your responsibility for insurance deductibles and co-pays.

Multi-Focal Deluxe Lens Implants

For years, ophthalmologists have treated cataracts by removing the natural lens of the eye and replacing it with an intraocular lens (IOL), or implant. Traditional IOLs improve vision at one focal point only, usually distance; and patients require glasses for up close and intermediate vision after cataract surgery.

Now there are new IOL options for patients with cataracts. These IOLs assist patients with their ability to see up close, intermediate, and at a distance, making them less dependent on reading glasses after cataract surgery. The cataract surgeons at Richie Eye Clinic now perform this new procedure. The new IOLs called Presbyopia Correcting IOLs are named after the natural aging process that leads to the need for reading glasses or bifocals.