Q&A With Dr. Mary Davidian: Taking a clear look at treatable cataracts


"Cataracts are the leading cause of visual loss in Americans 65 and older," says Mary Davidian, M.D., founder and medical director of Highland Ophthalmology Associates in New Windsor.

But there's good news: Cataracts are very treatable.

To increase awareness, Highland Ophthalmology is offering free cataract screenings in its new, full-service vision center during August, which is Cataract Awareness Month.

GO Healthy asked Davidian for an overview on symptoms, causes and treatments.

Q. What is a cataract?

A. A cataract, like a wrinkle, is part of the natural aging process. If we live long enough, we'll have both wrinkles and cataracts.

Some people begin to wrinkle earlier than others, based on factors such as smoking, unprotected sun exposure and genetics.

It's the same with the many types of cataracts. Genetics play a role in how quickly they'll develop. The sun can also hasten their development, as can the use of certain medications such as prednisone, or eye injury or surgery. There are congenital cataracts as well, meaning the person is born with them, although this condition is not common.

Q. Can anything be done to prevent cataracts?

A. Wearing sunglasses with ultraviolet light protection when outdoors, eating a healthy diet rich in antioxidants and avoiding smoking might help stave off the development of cataracts. Regular visits to your eye-care professional will help detect cataracts early in their development.

Q. What are the symptoms of cataracts?

A. Decreased, cloudy or blurry vision is a common complaint. Colors don't seem as bright, and there might be double vision. Eyeglass and contact lens prescriptions might be changed frequently. People also might notice that they need more illumination to perform daily tasks such as reading, and there can be more sensitivity to light in general.

Many people are unable to drive at night because the glare of headlights is unbearable. That is because cataracts are typically not homogenous or a uniform level of clouding across the lens; rather, there are usually spokes of opacification that disburse the light in patterns.

Q. What is the treatment for cataracts?

A. Right now, there is no medication to prevent cataracts or to decrease their density. When the decrease in vision is such that daily activities are limited, then surgery is the only course of action available. Contrary to popular belief, lasers are not used to remove cataracts. The most modern method available utilizes ultrasound, and is called phacoemulsification.

Q. How is the surgery performed?

A. The technology has really advanced in the last decade or so to minimize side effects and maximize results.

Small, approximately 3mm self-healing incisions are made. The small probe of the phacoemulsification machine is inserted into the eye, which breaks up the lens into tiny pieces that are essentially vacuumed up while irrigating the fluid-filled anterior chamber of the eye.

Next, a foldable lens is inserted through that small incision and implanted. The implant opens and is positioned on the lens capsule.

Q. What type of lens is implanted?

A. Each patient is measured to determine the appropriate lens power for his eye. The goal is to get the patient as close to 20/20 vision as possible. Most patients who wore distance glasses before cataract surgery may not need to wear any distance correction after cataract surgery. This is because much of their previous eyeglass power can be incorporated into the implant that goes in their eye. If a monofocal lens implant is used, glasses will generally still be required for reading.

If the patient desires minimal to no dependence on glasses at all, then new generation multifocal lenses may be considered. These lenses have rings of different powers for distance, near and intermediate ranges. The brain learns to focus on the proper ring for each range to bring objects into focus. It's similar to having a progressive lens in the eye.

Barring any unforeseen complications, many patients return for follow-up care the next day with outstanding vision.

Q. What are the potential side effects?

A. All surgical procedures carry the potential for risks. Because there is an incision, however small, there is always a risk for infection or bleeding.

If there is underlying pathology, such as glaucoma or macular degeneration, because the cataract is superimposed on those conditions, the patient might not get optimum results. However, there is generally a noted improvement in vision, despite these conditions, when the cataract is removed.

Q. Who can perform cataract surgery?

A. While an optometrist, or eye doctor, will frequently make the diagnosis, only an ophthalmologist, who is also a surgeon, can perform the surgery. Cataract surgery is not an in-office procedure; it must be done at an ambulatory surgical facility or hospital, but is generally conducted on an outpatient basis, with the patient returning home shortly after the procedure. The cost of surgery is covered by major medical insurances.

For more information please call us at (845) 562-0138.