Will I Go Blind? Cataract Surgery Frequently Asked Questions
Cross Section of an Eye
Will I Go Blind?
Cataracts and cataract surgery do not normally cause blindness. Cataracts are a normal effect of the aging of the eye, but can occur due to eye injuries. Cataracts are the result of the eye's lens becoming cloudy. The clouded part of the lens will get more difficult to see through as the cataract grows and hardens
By themselves, cataracts do not generally cause complete blindness. Cataract surgery is one of the most common surgical procedures in the world of medicine today. Ophthalmic surgeons perform thousands of these procedures daily.
With new advanced laser technology, cataract surgery is also the safest surgery one can have. Both regular and laser surgery only take minutes to perform, general anesthesia is extremely rare, and recovery after surgery is almost instantaneous. There is a six to eight week total recovery time, but your vision will improve the second the new lens is inserted.
An Eye Exam is the First Step
How do I Know if I Have a Cataract?
A regular eye exam by an optometrist will detect cataracts in your eye. They will refer you to a specialist for evaluation and possible surgery.
The first step in cataract surgery is a typical eye exam by an ophthalmologist with special training in treating disorders of the eye. Typically, they spend an extra three years after medical school learning how to treat diseases and conditions of the eyes. Most ophthalmic surgeons will have experience doing thousands of cataract surgeries.
This eye exam will thoroughly document the cataract, if present. Your eyes will be 'dilated' with special eye drops. More drops will be used to anesthetized the eye so more measurements can be taken, such as the pressure inside of your eye (glaucoma evaluation). They will document your vision, the size and hardness of the cataract, the basic measurements of your eye, and how good your vision is.
It is recommended that someone drive you to the specialist's office as it is difficult to drive after the dilation drops are put in your eyes.
After this initial evaluation, the eye surgeon will recommend for or against cataract surgery and discuss with you how to proceed. The surgeon can implant regular lenses, multifocal lenses, or lenses that correct for astigmatism. He or she will also discuss the costs associated with each type of procedure.
What Your Eye Surgeon Needs To Know
Your eye surgeon, or assistant, will fill out a complete medical history on every cataract surgery patient. You will need to provide a medication list of everything you take on a daily or as needed basis.
Make a list of all the medication you take with the name, date of Rx, dosage, and frequency. Don't forget to list over the counter vitamins and supplements also. Remember to include your pharmacy's phone numbers.
Make a list of every surgery. Include dates and reasons for the surgeries. List all of your doctor's names, addresses, and phone numbers.
Tell your doctor how well you would like to see going forward, and what distance is most important for you to see best at. If you drive a lot, distance vision will probably be most important. Mid-distance sight is best for watching TV or seeing across a classroom. Near distance vision is best for those who read a lot.
You will also need to provide your medical insurance information to the surgeon's office as well as the surgery center where the operation will be done. It's possible that these may be the same place.
Will It Hurt?
I can tell you from experience that none of the eye exams hurt. The surgery itself does have some slightly painful pressure, and the intra-venous line insertion is almost always the most painful thing associated with cataract surgery.
Be sure to tell your anesthesiologist if you are a red haired person! Apparently, red heads have a very high tolerance to most anesthesia and usually require stronger doses of fentanyl and/or Versed. (pronounced Ver Sed).
Patients are awake and aware of the surgery as general anesthesia is not normally used. You will actually be able to see what is happening. If the anesthesia is just right, all you will remember is a bright light and your surgeon will be telling you to "look at the light".
However, the actual surgery only takes an average of eight minutes and you can tolerate anything for eight minutes. At least that is what the nurses will tell you!
It is scary, especially the first time, but it isn't really painful, so just relax and take some deep calming breaths of the oxygen that they give you during the procedure.
Before you know it, you are out the door and on your way home. Your eye is still dilated, but you will notice that you can now SEE through your brand new permanent lens!
Your eye will be slightly swollen and painful for a few days. You will have to sleep with an eye protector taped over the eye to keep you from rubbing it for a week. I also had a headache, so I did take some pain pills. Ask your doctor's advice on what to take for post-op pain.
Eye Drop Schedule for Cataracts
Before, During, and After Cataract Surgery
Your eye surgeon will provide prescription eye drops to use before, on the day of, and after surgery. It is very important to follow this schedule for the full amount of time indicated. Do not stop taking your drops until you are told to do so.
You will receive an eye exam about a week prior to the surgery. At this visit, the doctor will either give you the drops or the prescription for the drops. These medications must be started before the surgery in order to clear out any microbes that may be residing in your eye. This is normal for everyone.
The surgery center will call you the day before surgery and give you pre-op instructions. You must be fasting, no food or drink after midnight the night and morning before your surgery. You will be allowed to take some of your regular medications, but not all of them. They will go over these with you. Write these instructions down!
When you arrive at the center, you will be given a gown and cap to wear and it may be possible to wear the gown over your regular clothes. Don't wear anything with metal in it.
The surgical assistants will take your vital signs, start numbing drops in your eye, start an I.V. line for the anesthesiologist, and answer any questions you may still have.
The anesthesiologist will visit with you and take notes. He or she will decide what type of anesthesia you will need and the dosage.
After a short wait, you will be wheeled back to the surgical suite and the assistants will get you ready on the table. The anesthesiologist will administer his cocktail of drugs.
The most disturbing part comes when your surgeon stands over you and starts to tape your head down to the table. Your head will be completely immovable! Then he or she will place some sort of tape over your eye to keep it open and you will not be able to blink.
By this time, the drugs should take effect and you should be relaxed and no longer anxious. There is also some oxygen for you to breathe to make you more comfortable, so take slow, deep breaths.
You will see a very bright light in your operative eye! I saw three square dots also, and I do not know what these are. I also had standard surgery, not laser surgery, so I cannot describe what the laser would look like.
After a bit of pressure here and there, the surgery is over and you can see things immediately after the new lens is implanted! There will be a bright light shadow (like looking at the sun too long) for a few days, this will eventually clear up.
Then you will have another brief bout of pain when the tape is removed. This really is like ripping a band-aid off rapidly! But it only lasts a few seconds.
Next you are back in the waiting room getting everything removed - the gown, hat, booties, I.V. line, and then out the door you go! You will be given a pair of dark sunglasses to wear and a kit with your eye guard and tape to stick it down with.
You will also get post-op instructions. Do read and follow them! It's important.
What Happens After Cataract Surgery?
You will be hungry, so it's ok to go eat something. Make it a light meal though. You may have a headache and/or an upset tummy. The nurse did give me an antacid before the surgery. I think that's to make sure you don't throw up during the procedure.
You will not be able to see well for a few days. It may give you a headache to watch TV or read. But it is possible to drive with the dark sun glasses on. I drove to the first post-op visit the next day after surgery. They will check your vision and make sure the surgery went well.
Don't forget to put your eye protector in place when you sleep. Even if you are just taking a nap. You might forget and rub your eye! This is a big no-no.
When you take a shower or bath, you must try not to get water in your eye. Bathwater is not clean enough for your eyes.
Very important! Don't forget to use your eye drops! These drops will help your eye heal, prevent swelling, and prevent infections. One of the eye drops is very thick, but don't forget it because that is the anti-biotic one!
After a week, you will visit the eye doctor again and he or she will release you from restrictions and give your new post-op orders. No, you probably don't get to stop the drops! If you work, you should get a release to go back to work at this time.
After a month goes by, you will see the doctor again. He or she may make some adjustments to the lens by using a laser in the office. No special preparation is needed, but they will probably dilate that eye again.
After six weeks, you are probably well healed and can go about your normal day.
If you have cataracts in both eyes, the doctor will set you up for the second eye surgery which will be almost identical to the first one. At least you will know what to expect.
What Does Cataract Surgery Cost?
Usually you have a co-pay amount from your insurance company for a specialist visit
Usually $1500 to $5,000 and may be covered by private insurance, but not Medicare
Usually only a co-pay for surgery with private ins. and Medicare, but the cost of special lenses may need to be paid for out of pocket. Cost of lenses vary, mine cost about $800 each.
For this surgery, my Rx eye drops cost $150 out of pocket, not covered by Medicare
If you are self- pay, the amount will vary by doctor
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