Can Cataracts Really Explode In Your Eye?
Part 1 of a 3 part series on cataracts
I have heard many stories from patients about what they have been told about their cataracts over the years. I have been told that they needed cataract surgery immediately as the cataract is going to explode inside their eye. If the cataract remains in their eye any longer, it is going to ruin their eye. The cataract is just starting but it should come out now as it is easier to do the surgery now. Unfortunately, there are too many doctors who are more interesting in making money than taking care of their patients.
What do You Really Need to Know About Cataracts?
What is a Cataract?
Nearly 100 percent of people that have cataracts believe that a cataract is a film growing over their eye. A cataract is not a film or piece of tissue growing over the eye that is causing their vision to be blurred. There is a lens inside of the eye behind the pupil and iris (colored portion of the eye) that the eye uses to focus the light that passes through the pupil onto the retina (retina is like the film of a camera as its receives the image that you are looking at). The information that the retina receives is transmitted through the optic nerve and all the way through the brain to the back portion of the brain. This is called the occipital lobe and is the vision center inside the brain. This lens behind the pupil loses its clarity over time and becomes hazy or cloudy. As the lens becomes progressively cloudier, the vision begins to blur. It would be like the windshield of your car fogging up. The foggier the windshield, the more difficult it is to see through the windshield. As you can see this is not a growth growing over the eye.
What Causes Cataracts?
In most cases, it is just that the lens loses its clarity secondary to aging. There are genetic factors that can lead to the development of cataracts. On a rare occasion, a child is born with cataracts. There is good evidence that sun exposure or ultraviolet light causes cataracts to develop at a faster rate and the cataract can blur the vision earlier in life. Smoking can also lead to the development of cataracts at a younger age. People with diabetes develop cataracts younger as well.
Usually, cataracts develop slowly over years of time and many times a person just needs to get a new prescription for glasses as some cataracts cause the eye to become more nearsighted from the eye’s original state. There are different types of cataracts as there are different portions of the lens that can become cloudy. These are some of the different types of cataracts:
Posterior subcapsular cataracts
Combination of the different types of cataracts
Mature or hyper mature cataracts
A ripe cataract is an old term used to describe a hyper mature cataract. The term ripe cataract was used as far back as Aristotle’s time. A ripe cataract is when the lens in the eye becomes white and the tissues of the lens start to degenerate. The lens melts like when an apple or other fruit becomes overripe and begins to liquefy. You can see the cataract as the pupil of the eye is white. The vision with a ripe or hyper mature cataract is usually only light perception. That is the person can only see light when a bright light in shown into the eye. The term ripe cataract was used years ago by eye surgeons when the cataract had advanced to a stage when cataract surgery would be indicated. Most of the time the cataract had not advanced to the real stage of being ripe. It was just an easy way for the surgeon to explain how far the cataract had advanced. This was before the time of the more advanced surgical techniques of today when people had to be admitted to the hospital for several days following cataract surgery. There are very few people who let their vision and cataract advance to that level in the United States today. Hypermature or ripe cataracts are common in third world countries where access to health care is limited. So, if your eye doctor is telling you that you have a ripe cataract, ask them to explain what they mean.
When Should Cataract Surgery be Performed?
If you remember nothing else in this article, you need to remember this section. This is the most important thing you need to know about having cataracts. There is almost never a medical reason for having your cataracts removed. There are very few medical indications for you having to have your cataract removed. Cataract surgery is an elective operation. Unfortunately, I see people nearly every week who have been told that they have to have cataract surgery or that if they don’t do it right away, it is going to harm their eye. Or I see people who come in for a second opinion after their surgery because they don’t see any difference in their vision after the surgery. The surgery was done well and their vision is good. It is my opinion that these people probably didn’t have any cataract at all or a very minimal level of cataract formation. A Significant number of people are being told to have cataract surgery with no cataract or a minimal cataract. I have been told stories that the eye surgeon told them that their cataract was at a level 1 now but would advance to a level 4 within a year and harm their eye. I am not sure what the doctor means by a level 1 or 4 as I have never seen cataracts referred to in this manner.
So, why or when should you have cataract surgery. The first thing that needs to be done is to see if just changing your glasses will improve your vision. If with your best possible corrected vision, you are having significantly blurred vision, then you should consider having cataract surgery. You decide to have cataract surgery if your blurred vision is interfering with your lifestyle. You are having trouble seeing at night driving, reading vision is not good, distance vision is blurred to the point you are not happy with the quality of your vision, or you having trouble seeing the things you need to see at work. Your eye is healthy and it is the opinion of your eye surgeon that cataract would improve your vision. Sometimes it can be difficult to know if surgery would improve the vision if you have macular degeneration as well. It can be difficult to know if most of a person’s vision trouble is related to their macular degeneration or the cataract. This is where you need to depend on your doctor’s opinion. Otherwise, the decision of when you are going to have surgery is up to you. You know better than anyone else how much trouble you are having with your vision.
How is Cataract Surgery Performed?
Now that you have decided you need to see better, what is next? As you now know, a cataract is the lens inside of your eye that becomes cloudy. That cloudy lens needs to be removed so you can see clearly. If that is all that is done, your vision would be very blurred. Since your lens has been removed, it needs to be replaced so that you can see again. Without replacing the lens that was removed from your eye, you would have very poor vision. You have lost a significant part of the focusing system for your eye and it needs to be replaced. Prior to surgery, your eye will be tested so that the eye surgeon can choose a lens power to replace your lens. The lens power is determined by the measurements of your eye and the eye surgeon will choose the strength of lens that will correct your vision. So, if you are near-sighted, far-sighted, or have astigmatism, your vision can be corrected with the insertion of an intraocular lens that can correct your refractive error or glass prescription.
This is part 1 of a 3-part series on cataracts. Part 2 will go into more information about how cataract surgery is performed and the options that you have in how the surgery is performed.
The reason you decide to have cataract surgery is that you are unhappy with the quality of your vision. Your lifestyle is being altered because of your blurred vision. There is almost never a medical reason to have your cataracts removed. Your eye surgeon should assist you in making the best decision for you and the health of your eyes. But, the bottom line is you are the final decision maker on when to have your surgery. You know how much your vision is bothering you more than anyone else. There is almost never a need or requirement to have your surgery done. Cataract surgery is an elective operation that you choose to have performed because you decide that you need better vision, period.