ophthalmologist will examine and test your eyes to make a cataract diagnosis. This comprehensive eye exam will include dilation. This means eye drops will widen your pupils. Slit-lamp exam: Your ophthalmologist will examine your cornea, iris, lens and the other areas at the front of the eye. The special slit-lamp microscope makes it easier to spot abnormalities. Retinal exam: When your eye is dilated, the pupils are wide open so the doctor can more clearly see the back of the eye. Using the slit lamp, an ophthalmoscope or both, the doctor looks for signs of cataract. Your ophthalmologist will also look for glaucoma, and examine the retina and optic nerve. Refraction and visual acuity test: This test assesses the sharpness and clarity of your vision. Each eye is tested individually for the ability to see letters of varying sizes.
A small incision is made on the side of the cornea, the clear, dome-shaped surface that covers the front of the eye. Your doctor inserts a tiny probe into the eye. This device emits ultrasound waves that soften and break up the lens so that it can be removed by suction. Most cataract surgery today is done by phacoemulsification, also called “small incision cataract surgery.”
Your doctor makes a longer incision on the side of the cornea and removes the cloudy core of the lens in one piece. The rest of the lens is removed by suction. Prior to cataract surgery, antibiotic eye drops may be prescribed to prevent infection. Cataract surgery is most often done as an outpatient procedure with local anesthesia (a numbing gel is placed in the eye) and light intravenous sedation. You should not see instruments coming toward your eye and you should not feel pain in your eye during surgery. The incision made to remove the cataract is so small that it usually does not require stitches. Phacoemulsification (a type of ultrasound) is the most common method used to remove the cataract. After the natural lens has been removed, it often is replaced by an artificial lens, called an intraocular lens (IOL). An IOL is a clear, plastic lens that requires no care and becomes a permanent part of your eye. Light is focused clearly by the IOL onto the retina, improving your vision. You will not feel or see the new lens. Some people cannot have an IOL. They may have another eye disease or have problems during surgery. For these patients, a soft contact lens, or glasses that provide high magnification, may be suggested.