At Insight Eye Center, we believe that every patient deserves treatment that revolves around their unique situation. Dr. Rom meets patients’ needs by drawing on a strong educational background coupled with over two decades of clinical experience focused on the diagnosis and treatment of cataracts. Throughout his career as a board-certified ophthalmologist and cataract surgeon, Dr. Rom has successfully performed over 25,000 cataract and glaucoma procedures. He continues to work intently on improving the standard of care for his patients. The use of cutting edge technologies is one example of how he does so.
What Are Cataracts?
The natural lens of the eye sits behind the pupil. This lens is made of proteins, just as the hair and nails are. Until later in adulthood, the proteins in the lens support flexibility and transparency that provide the full range of vision. With time, the proteins in the lens begin to denature. This prompts the process of what is called lenticular dysfunction. We all experience this at some point.
This first indication of lenticular dysfunction, a change to the lens of the eye, may occur sometime around age 40, around the same time when many people need to use reading glasses or bifocals. This initial stage of dysfunction involves a loss of flexibility in the lens; the human lens no longer zooms in and out like the lens of a camera.
As dysfunction progresses to its second stage, night vision may decline. People notice that they need more light to read or perform certain tasks. Fine print may be difficult to read even with glasses. During this stage, the lens is not only more rigid than it once was, but it also loses some degree of its clarity. What used to be clear and sharp may now be slightly blurry due to optical aberrations and the scattering of light through the eye.
The final stage of lenticular dysfunction is the development of a cataract. A cataract is a cluster of proteins that have become somewhat sticky. Over time, the accumulation of proteins worsens, causing various symptoms. A mature cataract can be visualized as opacity in the pupil. Most people undergo cataract surgery before their condition worsens to this degree.
Symptoms of Cataracts
The increase of protein clumps inherent in cataracts leads to yellowing and hardening that scatters light through the eye. This can affect the perception of colors, night vision, and visual clarity. People with cataracts may initially find that colors are not as vibrant as they once were. When driving at night, they may notice glare or halos around light sources. As cataracts worsen, both central and peripheral vision may become impaired due to significant clouding, like looking through fogged glass.
Indications that cataracts may be worsening include:
- Vision feels blurry or dim
- Night driving becomes increasingly difficult
- Sensitivity to light occurs
- Halos appear around lights
- Reading and other activities require brighter light
- Eyeglass or contact lens prescriptions change frequently
What is Cataract Surgery?
Cataract surgery is one of the most frequently performed ophthalmic procedures in the United States today. Meaningful advances in technology and surgical technique have made cataract surgery one of the most successful procedures in the history of medicine. The objective of this procedure is to replace the clouded lens with an ultra-thin artificial lens that is free of protein clusters. The artificial lens is referred to as an intraocular lens, or IOL. The selection of the most appropriate IOL is an important aspect of cataract surgery, as the new lens may decrease the future need for corrective eyeglasses.
Choose Dr. Rom As Your Cataract Surgeon
Dr. Michael Rom is a Board-Certified Ophthalmologist and has performed over 25,000 cataract surgeries. He has a reputation for great patient care and service. Here are what some of his patient’s say about their experience with cataract surgery.
“For as long as I can remember I have had poor vision. There was nothing more to be done , but Dr. Rom did cataract surgery on both of my eyes and I now have crystal clear vision. I will need a simple contact or glasses for reading. I am so excited because for the first time in such a long time I can SEE. Every aspect of the process was clearly described. All my questions were answered. Dr. Rom , and all of his staff were knowledgeable , kind and supportive. It was a no stress event that had a superb outcome. Thanks to all.” – Ginny T.
“The professionalism of Dr. Rom and his staff is refreshing. The communication regarding the surgery was excellent. Most important to me was that my cataract surgery was completely painless. I will highly recommend Dr. Rom to my friends.” – B. Buckman
Cataract Surgery Candidacy
If you have been diagnosed with cataracts, you may be a good candidate for cataract surgery. In the majority of cases, cataracts are not removed until they interfere with vision to such an extent that quality of life is affected. Once visual difficulties become apparent, a comprehensive consultation and examination with an ophthalmologist should be scheduled.
Cataract Surgery Options
Many modern cataract procedures are conducted with the assistance of high-frequency ultrasound waves. These break up the protein clusters into small pieces so they can be gently extracted from the eye with suction.
More recently, device manufacturers have developed various refinements for use in cataract surgery. Additionally, pre-operative diagnostic testing such as biometry provides important data related to refractive error such as astigmatism. This data influences both the selection of the most appropriate intraocular lens and also the surgical technique utilized during cataract surgery to reach targeted refraction.
To ensure patient satisfaction after cataract surgery, Dr. Rom chooses the optimal intraocular lens that will correct the patient’s refractive error along with cataract treatment. With modern technical and operative options, intraocular lenses can facilitate this with high safety and probability. These options include the use of toric lenses for the correction of corneal astigmatism or other premium lenses designed to treat corneal aberration. Incision options also contribute to a reduction in pre-existing astigmatism.
Cataract Surgery Procedure
Cataract surgery is one of the safest and most common refractive procedures performed today. The procedure lasts only about 10 minutes. If cataracts are present in both eyes, each is treated independently, with at least a few weeks in between.
The steps of cataract surgery include:
- A local anesthetic is administered in the form of eye drops to prevent pain during the brief procedure. A mild sedative may also be provided to help the patient relax.
- The lens is accessed through an extremely small incision.
- A tiny instrument is used to achieve phacoemulsification, which breaks proteins into tiny pieces. The lens may also be softened using laser energy.
- The dismantled lens is removed using a small device that is inserted through the corneal incision.
- Finally, a folded IOL is inserted into the sac/pocket that held the natural lens. Once in place, the surgeon carefully unfolds the IOL which then acts as a replacement for the removed lens.
- The small size of the incision needed for this procedure enables it to seal naturally over time.
How Long Does Cataract Surgery Take?
Cataract surgery typically takes only 10-15 minutes, but you should plan on being at the surgery center for about 2 hours to include preoperative preparations and post-op instructions.
Recovery After Cataract Surgery
When you undergo cataract surgery, your pupils will be dilated and you may receive a mild sedative before your procedure. Patients are generally able to drive the day after surgery.
Post-operatively, you may experience mild discomfort and itching. The use of anti-inflammatory eye drops prescribed by the doctor facilitates optimal comfort. These or other medicated eye drops will need to be used several times a day for a few weeks. A protective eye shield will also be worn for 2 days after surgery just at bedtime. A special pair of post-operative sunglasses may also be provided to protect the eyes from bright light during recovery, although the sunglasses are generally for comfort and not medically necessary.
While the eye heals, it is not unusual to experience mild blurriness and redness. Expect to avoid strenuous activity and lifting objects over 30 pounds. It is also necessary to avoid hot tubs and swimming for two weeks or longer after cataract surgery. Additional instructions and recommendations may be provided depending on the particulars of your case.
When will I see clearly after cataract surgery?
Vision is often slightly blurry for a few days after cataract surgery. However, as healing progresses, you can expect to notice improvements in vision at all distances. The results of cataract surgery often enable patients to drive or read a book or newspaper without reading glasses and to perform better on vision tests. The degree of vision improvement is influenced by the patient’s choice of intraocular lens implant. We provide assistance in this area based on the findings of our eye exam and on each patient’s lifestyle and preferences.
Can I correct astigmatism with cataract surgery?
Dr. Rom performs limbal relaxing incisions for qualified patients. This technique coincides with cataract surgery to correct mild degrees of corneal astigmatism. Limbal relaxing incisions are placed at precise positions on the eye to reshape the cornea. In many cases, this reshaping can reduce astigmatic error. More significant errors may respond better to a Toric IOL.
Is cataract surgery permanent?
Intraocular lenses are considered permanent due to the elimination of the stimulus that initially caused lenticular dysfunction.
Is surgery the only option for cataracts?
There is no non-surgical treatment for cataracts at this time. Surgical treatment is the only option available to restore clear, sharp vision.
Does cataract surgery require stitches?
No. Incisions made to remove the clouded lens are so small that they naturally seal over time.
Will the cataract return after surgery?
Cataracts are proteins on the natural lens of the eye. By removing the entire lens, the risk of future cataracts is eliminated.
Preparing for Cataract Surgery
Prior to cataract surgery, expect to undergo a comprehensive eye exam. This evaluates the overall health of the eyes and rules out risk factors that may affect the predicted outcome of your procedure. Refraction is also commonly performed before cataract surgery to determine the degree of refractive error, if any, is present. Refractive errors include nearsightedness, farsightedness, and astigmatism. Additionally, the cornea is measured to determine its curvature. The various measurements obtained assist in the selection of your intraocular lens.
Several IOL options may be considered, depending on your specific needs. Based on the findings of your eye exam, our team will discuss the options that will provide the clearest vision.
Necessary measurements are obtained by incorporating the latest technology into pre-operative vision testing. Modern technologies include optical biometry, corneal topography, integrated wavefront aberrometry, and more. This sounds like a lot, but our selection of diagnostic devices makes the process convenient and comfortable.
Diagnostics such as the IOLMaster 700 and the OPD-Scan III Wavefront Aberrometer provide a no-contact approach to scanning ocular structures. A brief examination taking approximately 10-seconds per eye completes multiple diagnostic metrics that assist us in fine-tuning refractive results for cataract patients.
What are the potential complications?
Although cataract surgery is the most common ophthalmic procedure performed today and is considered extremely safe, there are risks to any surgery. For cataract patients, these include infection, bleeding, and retinal detachment. In addition to details about the procedure and recovery, we also educate patients about the risks of the cataract procedure during their consultation.
Approximately 3 million cataract surgeries are performed annually in the U.S. Approximately 98% of those procedures achieve favorable outcomes. Based on these statistics, cataract surgery is deemed very safe and effective.
What happens if I don’t have my cataracts removed?
One or both eyes may develop cataracts. Until treatment is performed, the clouding of the natural lens will continue to worsen. This eventually disrupts the ability to drive at night, read, and engage in many everyday activities.
Schedule A Consultation
If you are interested in cataract surgery, contact Insight Eye Center today to schedule a consultation with Dr. Michael Rom. Call our Mentor office at (440) 205-5840 or our Chardon office at (440) 286-1188.