Cataract

PATIENT EDUCATION

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Cataract

Elsevier Interactive Patient Education ©2017 Elsevier Inc.
Last revised: May 22, 2017.

A cataract is cloudiness on the lens of your eye. The lens is the clear part of your eye that is behind your iris and pupil. The lens focuses light on the retina, which lets you see clearly.

When a lens becomes cloudy, vision may become blurry. The clouding can range from a tiny dot to complete cloudiness. As some cataracts develop, they make a person more nearsighted. Other cataracts increase glare. Cataracts can worsen over time, and sometimes the pupil can look white. Cataracts get bigger and they cloud more of the lens, making it difficult to see. Cataracts can affect one eye or both eyes.

CAUSES

Most cataracts are associated with age-related eye changes. The eye lens is mostly made up of water and protein. Normally, this protein is arranged in a way that keeps the lens clear. Cataracts develop when protein begins to clump together over time. This clouds the lens and lets less light pass through to the retina, which causes blurry vision.

RISK FACTORS

This condition is more likely to develop in people who:

  • Are 60 years of age or older.
  • Have diabetes.
  • Have high blood pressure.
  • Take certain medicines, such as steroids or hormone replacement therapy.
  • Have had an eye injury.
  • Have or have had eye inflammation.
  • Have a family history of cataracts.
  •  
  • Drink alcohol heavily.
  • Are frequently exposed to sun or very strong light without eye protection.
  • Are obese.
  • Have been exposed to large amounts of radiation, lead, or other toxic substances.
  • Have had eye surgery.

SYMPTOMS

The main symptom of a cataract is blurry vision. Your vision may change or get worse over time. Other symptoms include:

  • Increased glare.
  • Seeing a bright ring or halo around light.
  • Poor night vision.
  • Double vision in one eye.
  • Having trouble seeing, even while wearing contact lenses or glasses.
  • Seeing colors that appear faded.
  • Trouble telling the difference between blue and purple.
  • Needing frequent changes to your prescription glasses or contacts.

DIAGNOSIS

This condition is diagnosed with a medical history and eye exam. You may need to see an eye specialist (optometristorophthalmologist). Your health care provider may enlarge (dilate) your pupils with eye drops to see the back of your eye more clearly and look for signs of cataracts or other damage.

You may also have tests, including:

  • A visual acuity test. This uses a chart to determine the smallest letters that you can see from a specific distance.
  • A slit-lamp exam. This uses a microscope to examine small sections of your eye for abnormalities.
  • This test measures the pressure of the fluid inside your eye.

TREATMENT

Treatment depends on the stage of your cataract. For an early cataract, vision may improve by using different eyeglasses or stronger lighting. If that does not help your vision, surgery may be recommended to remove the cataract.

If your health care provider thinks your cataract may be linked to any medicines that you are taking, he or she may change your medicines.

HOME CARE INSTRUCTIONS

Lifestyle

  • Use stronger or brighter lighting.
  • Consider using a magnifying glass for reading or other activities.
  • Become familiar with your surroundings. Having poor vision can put you at a greater risk for tripping, falling, or bumping into things.
  • Wear sunglasses and a hat if you are sensitive to bright light or are having problems with glare.
  • Quit smoking if you smoke. If you need help quitting, talk with your health care provider.

General Instructions

  • If you are prescribed new eyeglasses, wear them as told by your health care provider.
  • Take over-the-counter and prescription medicines only as told by your health care provider.Do notchange your medicines unless told by your health care provider.
  • Do notdrive or operate heavy machinery if your vision is blurry, particularly at night.
  • Keep your blood sugar under control, if you have diabetes.
  • Keep all follow-up visits as told by your health care provider. This is important.

SEEK MEDICAL CARE IF:

  • Your symptoms get worse.
  • Your vision affects your ability to perform daily activities.
  • You have new symptoms.
  • You have a fever.

SEEK IMMEDIATE MEDICAL CARE IF:

  • You have sudden vision loss.
  • You have redness, swelling, or increasing pain in your eye.
  • You develop a headache and sensitivity to light.

Photorefractive Keratectomy

PATIENT EDUCATION

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Photorefractive Keratectomy

Elsevier Interactive Patient Education ©2017 Elsevier Inc.
Last revised: May 22, 2017.

The first procedure used to improve eyesight was called Radial Keratotomy (RK). RK is an operation to improve nearsightedness. It does this by changing the curve of the cornea over the pupil. The cornea is the clear covering in the front of the eye. RK is done with actual incisions (cuts) in the cornea.

A recent development in vision correction is a procedure called Photorefractive Keratectomy (PRK). PRK is done by laser, avoiding the need for incisions to be made. It is similar to RK, in that the cornea is changed to correct vision. PRK often takes less than one minute per eye. Although there is sometimes more discomfort and longer healing time than with LASIK (another common procedure, using a laser to correct vision), PRK can be performed on people who cannot have LASIK. This includes people with loose corneal surface cells or thin corneas.

The process for PRK is different, and it offers improvements in patient risk and correction abilities. Rather than making cuts in the cornea like RK, or destruction of tissue like LASIK, the PRK process uses an excimer laser to sculpt an area 5 to 9 millimeters in diameter on the surface of the eye. This means it cuts thin layers of cells off the cornea. This changes your vision.

RISKS AND COMPLICATIONS

Complications during or after surgery are rare, but can be serious. Some people can have a poor healing response. Most complications can be treated with medicines or more surgery. The following is a list of some of the potential short and long-term complications:

  • Changes in vision, especially in the first few months after surgery.
  • A weakened cornea that is more likely to rupture, if hit directly.
  • Need for additional surgery.
  • Contact lenses can be difficult to fit, if they are required.
  • Glare, sensitivity, or starbursts around lights (haze) may occur.
  • Sores (ulcers) on the cornea.
  • (This can usually be treated with antibiotics.)
  • Delayed surface healing.
  • Double vision. (You could see two of everything.)

BEFORE THE PROCEDURE

If you are a contact lens user, stop wearing contact lenses for several days before surgery.

AFTER THE PROCEDURE

Immediately after surgery, some people have discomfort. But the use of bandage contact lenses and medicines usually control this. Light sensitivity happens to almost everyone. Halos and other unusual light effects can happen. Vision can be reduced while healing. You must discuss with your surgeon and fully understand all of these possible side effects and problems prior to surgery.

HOME CARE INSTRUCTIONS

  • Do notrub your eyes.
  • You may experience slight discomfort in the first 24 to 48 hours following surgery.
  • Rest your eyes in a dark room for the first 48 hours.
  • A protective “bandage” contact lens on the eye may keep irritation to a minimum.
  • Drops may be prescribed to soothe the eye(s). Use as directed.
  • Do notwear eye make-up for one week.
  • Do notgo swimming, use hot tubs, saunas, whirlpools, or come into contact with possibly contaminated water for two weeks.
  • Do notplay contact or racquet sports for one month after your procedure, or as directed by your surgeon.
  • Do notdo anything that requires bending over (such as gardening) for the first two days after surgery.
  • You should stay home from work for at least two days.
  • Do notdrive (day or night) until your surgeon has approved this.
  • Wear good quality sunglasses when outdoors.
  • Attend all follow-up appointments scheduled by your caregiver.

SEEK IMMEDIATE MEDICAL CARE IF:

  • Your vision gets worse or does not improve after a time specified by your caregiver.
  • You have pain in or discharge coming from the repaired eye(s), or redness or swelling around your eyes.
  • An unexplained oral temperature above 102° F (38.9° C) develops.

PATIENT EDUCATION

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Photorefractive Keratectomy, Care After

Elsevier Interactive Patient Education ©2017 Elsevier Inc.
Last revised: May 22, 2017.

Refer to this sheet in the next few weeks. These instructions provide you with information about caring for yourself after your procedure. Your health care provider may also give you more specific instructions. Your treatment has been planned according to current medical practices, but problems sometimes occur. Call your health care provider if you have any problems or questions after your procedure.

WHAT TO EXPECT AFTER THE PROCEDURE

After your procedure, it is common to have:

  • Mild to moderate pain.
  • A feeling like there is something is your eye.
  • Watery eyes (tearing).
  • Bloodshot eyes.
  • Itching
  • Light sensitivity.
  • Blurred vision or other vision changes.
  • Distorted vision, especially at night. You may see halos or starbursts around lights.
  • Dry eyes.

HOME CARE INSTRUCTIONS

Medicines

  • Take over-the-counter and prescription medicines only as told by your health care provider.
  • Use eye drops as told by your health care provider. You may need to use them for several months.
  • Use liquid tears as told by your health care provider.

Activity

  • Do notdrive or operate heavy machinery until your health care provider approves. It may take several months for your vision to stabilize.
  • Do notdrive at night until your health care provider says you can do so.
  • Do notplay contact or racquet sports until your health care provider approves.
  • Rest at home until your health care provider says you can go back to work. Ask your health care provider when you can return to your usual activities.

General instructions

  • Do notput your contact lenses back in, even if your vision is blurry. Only start wearing your contact lenses once your health care provider approves.
  • Wear sunglasses when you are outside.
  • Avoid bright lights as told by your health care provider. Try to rest your eyes in a dark room as much as possible.
  • Do notwear eye makeup until your health care provider approves.
  • Keep all follow-up visits as told by your health care provider. This is important.
  • Do notrub your eyes.
  • Wear your protective contact lenses until your health care provider says they can be removed.
  • Do nottake baths, swim, or use a hot tub until your health care provider approves.

SEEK MEDICAL CARE IF:

  • You continue to have significant pain, blurred vision, or light sensitivity after several days.
  • You have new symptoms.
  • Your symptoms get worse.

SEEK IMMEDIATE MEDICAL CARE IF:

  • You have severe eye pain.
  • You have any sudden vision loss.