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After the age of 50 most people will eventually be diagnosed with cataracts. Cataracts are when the natural crystalline lens of the eyes become clouded, causing vision impairment that can not be corrected by glasses or contact lenses. While commonly an age-related condition, occasionally there are infants born with a congenital cataract, and it’s possible for young people to develop a cataract related to trauma, injury or infection.

Cataracts are one of the leading causes of visual impairment and the leading cause of blindness worldwide. As of 2010 they were responsible for 51% of world blindness and as life expectancy continues to grow, so does the incidence of cataracts. The condition can be cured by surgical removal of the cataract, which is one of the most common surgeries performed in the United States and Canada.

Cataract surgery involves removing the clouded natural crystalline lens of the eye and replacing it with a clear intraocular lens (IOL).  It is typically an outpatient procedure which does not require an overnight stay. Cataract surgery is one of the safest and most effective surgeries performed in North America today, having a 90% success rate (patient has improved vision, between 20/20 and 20/40 following the procedure).  

Implants (IOLs)

In this day and age, there are several types of implants available. Traditionally, implants have been single vision where the patient’s new lenses are optimally focused for distance vision in both eyes. This usually necessitates the use of reading glasses after the surgery. Implants can also be done in what is called monovision, in which one eye is focused for distance and the other focused for reading. People that have previously used monovision contact lenses are usually able to tolerate this with surgery as well. Recently, there have been many advances in the use of bifocal and multifocal implants. Like glasses, these implants try to give a patient vision at all distances without having to use glasses. Your eye doctor can counsel you on the best option based on your history and prescription. No matter which correction type is chosen for cataract surgery, since presbyopia continues to worsen with age, eventually most patients do require reading glasses again.

Before the Surgery

Cataract surgery is not for everyone. Your eye doctor may advise that your cataracts (and therefore vision) are not bad enough yet to necessitate treatment.  Additionally there may be other risk factors or issues with the health of your eyes that could contraindicate the option of surgery.  

A comprehensive eye exam will be performed to check your overall eye health and your vision.  During the pre-surgery exam, measurements will be taken of your cornea and your eye as well, to help fit the right intraocular lens for your eye and vision needs. You will also be asked to go over a brief medical history including any medications (including over the counter medications) and supplements that you take to ensure the success of the surgery. For example, some medications, such as Flomax, can can affect the iris causing floppy iris syndrome, which creates a challenge for the cataract surgeon.

During the Surgery

The entire procedure from start (pupil dilation and administration of local anesthetics and sometimes a sedative to relax) to finish (post-operative evaluation and discharge) will probably take about an hour to an hour and a half. Nevertheless the actual surgery – removing the clouded lens and replacing it with the IOL – typically takes only about 15 minutes.  You will not feel or see the IOL after the implant.

There are lasers that are sometimes used to assist with cataract surgery, creating precise incisions. However a skilled cataract surgeon is still required for the procedure.

Post-surgery

You will not be able to drive home from the procedure and shouldn’t drive until you have been given approval by your eye doctor after a follow-up exam the next day. You will be required to take medicated eye drops for a number of weeks following the surgery to prevent infection, control eye pressure and reduce inflammation. It is important to take the eye drops as directed by your doctor to avoid complications.  

You will also need to protect your eyes from bright light with sunglasses and to wear a protective shield at certain times, such as when you are sleeping. It is advised to avoid strenuous activity, swimming or any other activities that would put your eyes at risk of getting dirty or infected for at least a week following the procedure.

Vision will usually begin to improve within a few days of the procedure. You may however experience some blurred vision or redness for a number of days or weeks during the healing process. It is normal to feel some initial discomfort or itchiness in the days following the surgery. If you have cataracts in both eyes, your doctor will probably schedule a second surgery a month or two after the first to allow your eye to heal properly before undergoing the second procedure.

If you experience any serious symptoms such as loss of vision, persistent pain or redness, flashes or floaters or nausea contact your doctor immediately.

The majority of patients will still need eyeglasses at least sometimes following the surgery so once your eyes have healed your doctor will fit you for a prescription. Secondary cataract can occur months or years after the initial cataract surgery. This is when an opacity develops behind the IOL and can mimic cataract symptoms. Regular checkups with your optometrist can detect this, and arrangements for a simpler laser treatment instead of surgery can resolve this problem.

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When people think of workplace dangers to the eyes, it is usually machinery, chemicals or construction materials that come to mind.  However, a growing danger to the eyes is one that may be less obvious – exposure to blue light from digital devices, television and computer screens and artificial lighting.  

While the long-term effects of blue light or high-energy visible (HEV)  light emission are not yet fully known, what is known is that blue light is a cause of computer vision syndrome (CVS) and sleep disruptions.  60% of people spend more than 6 hours a day in front of a digital device and 70% of adults report some symptoms of computer vision syndrome (CVS) which include eyestrain, headaches, blurred or double vision, physical and mental fatigue, dry or watery eyes, difficulty focusing, sensitivity to light, or neck, shoulder or back pain (caused by compromised posture to adjust to vision difficulty). Most people do nothing to ease their discomfort from these symptoms because they are not aware of the cause. 

In its natural form, blue light from the sun is actually beneficial to your body by helping to regulate your natural sleep and wake cycles – also known as your circadian rhythm.  It can also boost your mood, alertness and overall feeling of well-being. However, prolonged exposure to artificial sources of blue light, such as that found in electronic devices, television and energy-efficient fluorescent and LED lights, has been shown to cause disruptions in the circadian rhythm as well as more serious vision problems. Researchers at Harvard University have linked blue light with damage to the retina at the back of your eyes, indicating that long-term exposure to blue light could be linked to age-related macular degeneration (AMD) and possibly other serious health and vision problems. 

Since 43% of adults work at jobs that require prolonged use of a computer, tablet or other digital monitor, blue light is an increasingly serious threat to your vision, health and productivity. There are a number of options for reducing your exposure to blue light which include computer glasses, specialized lenses and protective coatings. Speak to our eye care professionals to determine which option is best for you.

  • Single Vision Computer Glasses: Provide the optimum lens power and field of view for viewing your computer screen without straining or leaning in to reduce symptoms of CVS. These are ideal for when the computer is at a fixed working distance, and work well if the user needs to view multiple screens at the same working distance.
  • Office Lenses or Progressive Lenses: No-line multifocal eyewear that can be made to correct near, intermediate and some distance vision with a larger intermediate zone for computer vision if indicated. Perfect for those with presbyopia which is the gradual loss of focusing ability that occurs naturally with age. Office lenses work like progressive lenses but provide a wider field of view for intermediate (1-3 m) viewing distance and near working distance (about 40 cm). 
  • Blue-Blocking Lenses: Definitely recommended for this electronic age, blue-blocking lenses block blue light emitted from computer screens that is associated with glare, eye strain and possible sleep disturbances. 
  • Anti-glare and filtering coatings (treatments): Eliminate reflections from the surfaces of your lens to reduce eye strain and discomfort from glare. Some coatings can also block blue light emitted from computer screens. 

While all of these are good options for protecting your eyes, the 20/20/20 rule still applies – after every 20 minutes of near tasks, look at something beyond 20 feet away for at least 20 seconds…it’s a good time to stretch the rest of the body too. 

Additionally, diets high in lutein and zeaxanthin, which are carotenoids found in dark, leafy green vegetables like spinach and kale are protective to blue light damage.

A note about children and blue light:

Children are more prone to blue light damage than adults because the natural lenses in their eyes are so clear that blue light passes easily through to reach the retina.  Adults are somewhat less prone since the older we get our natural lenses become more cloudy and blue light does not pass through quite as easily. Pediatricians recommend that young children under the age of two should get ZERO screen time.   They have much better ways of developing their eyesight with activities requiring hand eye coordination with high contrast physical objects.

Technology is advancing the world, and our jobs and daily lives will only continue to rely upon it. Don’t let technology get in the way of your vision and your health. Ask us about the best solution for you. 

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