Cataracts

The most common cause of curable blindness in the world.

Diagnosis is made by the detection of a decrease in visual acuity that cannot be corrected by refractive correction, and an eye exam that is otherwise normal apart from opacity in the crystalline lens.

Treatment is with surgery involving an incision into the eye and removal of the opacified crystalline lens. In most cases the cataract is replaced by an artificial lens made of polymethyl methacrylate, acrylic, or silicone.

If an implant lens is not used, or there is remaining refractive error (e.g., astigmatism that is uncorrected by the implant lens), the patient may need to wear either a contact lens or spectacles to achieve good postoperative vision. Adjunctive procedures may be done at the time of surgery or afterward to correct residual refractive error.

Over time, some patients will develop an opacification of the posterior capsule behind the implant lens after the cataract has been removed. This condition is treated with the neodymium-doped yttrium aluminum garnet (Nd:YAG) laser, which creates an opening in the opacified membrane to restore vision.

Cataract is the opacification of the crystalline lens that results from the normal aging process, trauma, metabolic disorders (hereditary or acquired), medications, or congenital problems. This topic mainly addresses acquired cataract.