What exactly is a cataract? The human lens in the eye is normally crystal clear, but when it becomes opaque, we call it a 'cataract'. A cataract is NOT a film or growth that occurs in the eye. It is simply a cloudy lens. As the opacity worsens, it prevents light from properly focusing 
on the retina, the light sensitive tissue lining the back of the eye. Early lens changes or opacities may not disturb vision significantly. But as the lens continues to change, the vision becomes blurred and the person notices glare, haziness, and difficulty with seeing street signs or reading, for example.
The cornea is the clear dome of tissue at the front of the eye that helps focus light. The lens is located behind the iris, the blue, green, or brown part of the eye. The lens has three parts: the capsule, the cortex, and the nucleus. All parts of the lens are normally clear.
HEALTHY LENS 
CATARACT LENS
What are the symptoms of cataracts?
- Blurry or hazy vision, or dim vision that requires brighter lights in order to read small print
- Increased glare and sensitivity to light, especially in bright sunlight or while driving at night
- A yellowing of the vision
- Increased nearsightedness, requiring frequent changes in your glasses prescription
Who gets cataracts?
For nearly all patients, the cataracts are related to age, lifetime sun exposure, and genetics. In the other patients, the cataract may be related to diabetes, steroid use (for asthma, allergies, or immune problems), or trauma. Everyone who lives long enough will end up with a cataract, and this is why it is the number one surgery performed in the USA, with nearly 2 million performed yearly.
How are cataracts diagnosed and treated?
A thorough dilated exam is needed. When you feel that your vision affects your daily activities or your lifestyle and you desire better vision, cataract surgery should be considered. Cataracts can only be treated with surgery.
At what point do I need cataract surgery?
There is no single objective test to determine the need for cataract surgery. The final decision for cataract surgery is made by the patient and depends on how much the decreased vision from the cataract is bothersome. Doing cataract surgery at an earlier stage makes for a quicker recovery and a technically easier surgery. Waiting until the vision is very poor can often make the surgery and the recovery more involved. Cataract surgery is an elective surgery and it's up to the patient to decide when to undergo surgery.
The Maryland Motor Vehicle Administration requires that drivers have 20/40 vision (with or without glasses) in their better eye to qualify for a license. However, many active patients who still work, drive, and use computers have higher demands for their vision.
Some patients choose to have surgery even before they develop vision-blocking cataracts. In this instance, the same procedure is referred to as Refractive Lens Exchange (RLE). In clinical trials the vast majority of these patients we capable of distance, intermediate, and near, well enough to perform activities of daily living without the assistance of spectacle. If you want and need better vision for your activities right now, and would like to see more clearly, then schedule a consultation today.
How is cataract surgery performed?
Cataract surgery is a way to replace the cloudy lens with a clear lens, thereby restoring vision. In modern techniques, the scaffolding of the anatomic lens is left in place to support the artificial replacement lens that is later implanted.
Micro-incisional Clear-corneal phacoemulsification is the most advanced version of cataract surgery. In this technique, the eye is anesthetized with eye-drops and the patient is given a mild intra-venous relaxing medication by the anesthesiologist. The entry into the eye is a micro-incision created with a diamond-blade. This delicate incision is so fine
there are no sutures required as it is self-sealing. The man-made lens is one of the top-of-the line models that can be folded or compressed during insertion, and then opened once inside the eye. The name "clear-corneal" refers to the incision, which is made at the edge of the clear tissue named the cornea. Due to the location of this incision, there is typically no bleeding (not even one drop), and the day after the surgery, the eye won't be red at all. The recovery for this surgery is very quick, with good vision within a day or two. When combined with astigmatism management, (Astigmatic Keratotomy vs. Toric Lens) the pre-existing astigmatism can be lessened and further post-operative astigmatism can be prevented.
Alcon SN60-Toric IOL
So why don't all surgeons perform this Advanced Clear-Corneal method?
Cataract surgery is not an easy surgery to perform, and requires constant training and refinement. The surgery is performed while the surgeon looks through an operating microscope that greatly magnifies the view of the eye. This also means that a very steady hand is important. It is easier to perform the older techniques of cataract surgery, rather than learning the newer technique.
How is my surgical technique better?
No Pain. The vast majority of my patients report no pain and don't even take a single Tylenol afterwards. I am able to numb the eye with eye-drops, while the anesthesiologist gives a small amount of sedation in the intra-venous line to help you relax. Some other surgeons need to inject medications behind the eyeball with a 3 inch needle.
No Stitches and No Bleeding. Since my incision is so tiny and since it is made with a gem-quality knife, it seals by itself. It is placed in such a manner that not even one drop of blood comes from the incision. Other techniques require incisions 2x to 5x larger than this, using a large steel blade or even scissors in the eye. In these older techniques, the surgeon would then place multiple stitches. These nylon stitches are sometimes felt when you blink, and they are often left in the eye for years or even permanently. Recovery after this less advanced type of surgery is months, versus just a week or two after my surgery.
The Best Optics. The best vision requires the best optics. I only implant the best lenses, including Bausch & Lomb's SofPort Advanced Optics IOL, Alcon's SN60WF, and AMO's Technis Z9000. In addition, I perform exacting calculations to determine which power lens to place in the eye. I take the extra time to incorporate as much of your glasses prescription as possible, into the power of the implanted lens. I analyze your eye and place my tiny incision in such a manner as to help to reduce your astigmatism. Ultimately making you less reliant on spectacles. In fact, the majority of patients don't wear glasses for distance vision, such as driving.
My research interests include improvement of surgical instrumentation and refinement of outcomes associated with the most advanced lens implant designs. This in effect, leads to the best possible outcome for my patients.
To explore your options for the most advanced lens options, Check out Crystalens and ReZoom/ReSTOR
Lou
Mary