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What is a cataract?

A cataract is a clouding of the eye's naturally clear lens. The lens focuses light rays on the retina — the layer of light-sensing cells lining the back of the eye — to produce a sharp image of what we see. When the lens becomes cloudy, light rays cannot pass through it easily, and vision is blurred. 

What causes cataracts?

Cataract development is a normal process of aging, but cataracts also develop from eye injuries, certain diseases or medications. Your genes may also play a role in cataract development.

How can a cataract be treated?

A cataract may not need to be treated if your vision is only slightly blurry. Simply changing your eyeglass prescription may help to improve your vision for a while. 

Light Rays Entering Eye - Normal Lens

There are no medications, eyedrops, exercises or glasses that will cause cataracts to disappear once they have formed. Surgery is the only way to remove a cataract. When you are no longer able to see well enough to do the things you like to do, cataract surgery should be considered. 

Usually with cataract surgery, a small incision is made in the eye. The front of portion of the covering of the lens is opened to allow removal of the cataract inside. The cataract is then gently broken up and vacuumed out. Then a permanent intraocular lens (IOL) implant is inserted through the small incision and into the capsule where it unfolds and permanently takes the place of the clouded natural lens.

With the cataract removed, the new lens implant clearly focuses light rays onto the retinal. The power of the lens implant is selected for each individual's eyes.

small incision cataract surgery

What can I expect if I decide to have cataract surgery?

Before Surgery

To determine if cataract surgery is indicated, you will have a comprehensive eye examination (with dilation) to establish the degree of the cataracts and to screen for the existence of any other eye pathology. Before the surgery, another pre-operative appointment will be scheduled at the office to measure and determine the proper power of the intraocular lens that will be placed in your eye. Additionally, pre-operative instructions, required physical assessments, and necessary paperwork will be completed. An antibiotic and non-steroidal anti-inflammatory eye drop will be prescribed to begin three days prior to your surgery date. 

The Day of Surgery

Dr. Busch performs cataract surgery on Wednesday mornings at MEDARVA Stony Point Surgery Center. 

When you arrive for surgery, you will be given eye drops and perhaps a mild sedative to help you relax. A local anesthetic will numb your eye. The skin around your eye will be thoroughly cleansed, and sterile coverings will be placed around your head. Your eye will be kept open by an eyelid speculum. You may see light and movement, but you will not be able to see the surgery while it is happening. 

Under an operating microscope, a small incision is made in the eye. In most cataract surgeries, tiny surgical instruments are used to break apart and remove the cloudy lens from the eye. The back membrane of the lens (called the posterior capsule) is left in place. A plastic, acrylic, or silicone intraocular lens is implanted in the eye to replace the natural lens that was removed.

Your eye will be patched at the end of the procedure, and you will need to make arrangements for someone to drive you home after the surgery. 

Following Surgery

You will need to:

  • Wear the patch until it is removed in the office the next morning
  • Use the eye drops as prescribed and directed on your instruction sheet
  • Be careful not to rub or press on your eye 
  • Avoid strenuous activities for the first week following surgery
  • Wear dark or tinted lenses/sunglasses in bright light
  • Take over-the-counter pain medicine as needed
  • Report any unusual pain or other problem

Richmond eye doctor

During cataract surgery, tiny instruments are used to break apart and remove the cloudy lens from the eye.


Intraocular lens Richmond eye doctor
An intraocular lens (iol) implant
Intraocular lens replacing natural lens 
In cataract surgery, the intraocular lens replaces the eye's natural lens.

Is a laser used during cataract surgery?

Laser surgery is not used in cataract removal surgery. However, the lens capsule (the part of the eye that holds the lens in place) sometimes becomes cloudy several months or years after the original cataract operation. If the cloudy capsule blurs your vision, your ophthalmologist can perform a second surgery using a laser. During the second procedure, called a posterior capsulotomy, a laser is used to make an opening in the cloudy lens capsule, restoring normal vision. 

Posterior capsulotomy

Posterior capsulotomy: a laser is used to make an opening in the cloudy lens capsule. 

Will cataract surgery improve my vision?

The success rate of cataract surgery is excellent. Improved vision is achieved in the majority of patients. Only a small number of patients continue to have problems following cataract surgery. 


Complications After Cataract Surgery

Though they rarely occur, serious complications of cataract surgery are:

  • Infection 
  • Bleeding 
  • Swelling
  • Detachment of the retina

Call your ophthalmologist immediately if you have any of the following symptoms after surgery:

  • Pain not relieved by nonprescription pain medication
  • Loss of vision 
  • Nausea, vomiting or excessive coughing 
  • Injury to the eye

Even if cataract surgery is successful, some patients may not see as well as they would like to. Other eye problems such as macular degeneration (aging of the retina), glaucoma or diabetic retinopathy may limit vision after surgery. Even with these problems, cataract surgery may still be worthwhile. 

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