Cataract Surgery in Fresno

A cataract is a clouding of the eye's natural lens, the clear lens behind the iris that focuses light. It's a normal part of aging: according to the National Eye Institute, by age 80 more than half of Americans have had a cataract or cataract surgery. As the lens clouds, the world looks blurry, dim or washed out, and glasses can only help so much.

Cataract surgery removes the clouded lens and replaces it with a clear artificial lens, called a lens implant or IOL (intraocular lens). It's one of the most common operations in the country, and one of the most successful. Our surgeons use phacoemulsification and offer premium lens implants, including multifocal, toric and extended-depth-of-focus lenses, which can reduce your need for glasses after surgery.

Signs of a cataract

Cataracts develop slowly, so the changes are easy to miss at first. Common signs:

• blurry, cloudy or dim vision
• glare and halos around headlights, making night driving harder
• needing more light to read
• colors that look faded or yellowed
• frequent changes to your glasses or contact lens prescription
• trouble seeing a computer or phone screen clearly

A comprehensive eye exam shows whether a cataract is the cause, and how far along it is. What cataracts are, in more detail.

When to have surgery

There's no need to wait for a cataract to "ripen". The usual time for surgery is when the cataract starts getting in the way of your life: driving, reading, working, or doing the things you enjoy. Your eye doctor will examine your eyes, talk with you about what's bothering you, and help you decide. Early on, a new glasses prescription and brighter lighting may be enough. When to have cataract surgery.

How cataract surgery is done

Cataract surgery is an outpatient procedure: you go home the same day. The surgery itself usually takes 15 to 30 minutes.

1. Numbing. Your eye is numbed, and you're kept comfortable and relaxed throughout.
2. Removing the cataract. Through a tiny incision, the surgeon uses phacoemulsification, gentle ultrasound energy, to break the cloudy lens into small pieces and remove them.
3. Placing the new lens. A folded lens implant goes in through the same incision and unfolds inside the thin, clear capsule that held your natural lens.
4. Finishing. The incision is so small that it usually seals on its own, without stitches.

Many people notice brighter, clearer vision within a day or two. If both eyes have cataracts, they're done on different days, usually a few weeks apart, so the first eye can heal. How long to wait between eyes.

Choosing your lens implant

Your lens implant is permanent, so choosing it is one of the most important decisions you'll make with your surgeon. The measurements of your eye, the way you use your eyes every day, and how much you'd like to depend on glasses afterward all play a part.

Multifocal and EDOF lenses can cause some halos or glare around lights at night, which most people get used to. Your surgeon will help you weigh it up. Types of cataract lenses.

Recovery

• The day of surgery: someone needs to drive you home. Your eye may feel scratchy or irritated, which is normal.
• The first few weeks: you use prescription eye drops to prevent infection and inflammation, and avoid rubbing your eye, swimming and heavy lifting until your surgeon says otherwise. You may be asked to wear an eye shield while you sleep.
• Follow-up visits: usually the day after surgery, and again over the following weeks, to check that your eye is healing well.
• About a month later: most eyes have settled, and if you need glasses, that's when your new prescription is measured.

Tips for a smooth recovery.

Later on: a clouded capsule

Months or years after surgery, the capsule that holds the lens implant can turn hazy. It's common and is called posterior capsule opacification. It can feel as if the cataract has come back, but it's easily treated: a quick, painless YAG laser treatment in the office clears it, usually for good. Can cataract surgery be done twice?

Refractive lens exchange (RLE)

Refractive lens exchange is the same procedure, done before a cataract forms, to correct vision rather than clear it. Your natural lens is replaced with a lens implant chosen for your prescription, which can correct nearsightedness, farsightedness and astigmatism, and, with a multifocal or EDOF lens, reduce the need for reading glasses after 40. It's often a good choice for people over 40 with a strong prescription, or who aren't good candidates for LASIK. And because the natural lens is gone, a cataract can never form in that eye.

RLE is elective, so insurance doesn't usually cover it. CareCredit financing is available. More about refractive lens exchange.

Cost and insurance

Medicare and most private insurance plans cover cataract surgery when it's medically necessary, with a standard monofocal lens implant. Your deductible and copays apply. Premium lens implants, such as toric, multifocal and EDOF lenses, cost extra, and that part isn't covered. We'll explain your coverage and give you an exact estimate before surgery, and CareCredit financing can spread out what you pay yourself.

Cataract surgery questions

Is cataract surgery painful?

No. Your eye is numbed and you're kept comfortable throughout. Mild scratchiness or irritation for a day or two afterward is common. More about what it feels like.

How soon will I see clearly?

Many people see better within a day or two. Your vision keeps improving over the first few weeks as the eye heals.

Can a cataract come back?

No. Once the natural lens has been removed, a cataract can't form again. What can happen is the clouded capsule described above, which a quick laser treatment fixes.

Can I have cataract surgery if I've had LASIK?

Yes. Bring any records you have from your LASIK: they help your surgeon choose the right lens power. LASIK vs. cataract surgery.

Where is the surgery done?

Our surgeons operate at Fresno Surgical Hospital and Chestnut Surgical Center. Your consultation and follow-up visits are at our offices.