A cataract is an opacification or cloudiness that develops within the lens of the eye. This is a normal part of the aging process that most people experience at some point. The lens is the part of the eye that focuses light on the retina and allows us to see things sharply. The lens functions best when we are younger because it is crystal clear. As we age, the lens slowly turns yellow, then brown, and sometimes becomes opaque and white. An analogy is a window that is never washed. As dirt accumulates, the window loses its clarity, and it is no longer possible to see through it. Similarly, sometimes a cataract progresses to the point that vision decreases.

Age is not the only cause of cataracts. Trauma or injury to the eye, certain medications such as prednisone or cortisone, diabetes and other less common medical conditions may also cause cataracts. Sometimes people are even born with cataracts. Cataracts present at birth may be small and harmless or may be large enough to interfere with vision.

A person with a cataract may notice problems such as blurred or distorted vision, glare from sunlight, headlights, or other lights, or trouble focusing on things. When these symptoms begin to interfere with activities of daily life, removal of the cataract may be recommended.


Cataract surgery is a precise and technically demanding procedure. Cataract surgery is micro-surgery, which means that it is performed under a high-powered operating microscope. This surgery is one of the most commonly performed surgical procedures in this country and at Chelsea Eye. It is also one of the most successful procedures. It is usually performed as an outpatient procedure, which means that you do not have to stay in the hospital overnight.

Dr. Coad will first numb the eye with topical anesthetic drops. Sometimes an anesthetic injection is required. Your doctor will make a tiny incision, approximately 1/5" in or next to the cornea of your eye. This is called a "clear cornea" incision. The doctor will then use an ultrasound-powered needle to liquify and remove your cataract. This part of the procedure is called phacoemulsification. Researchers are experimenting with lasers to remove cataracts, but laser cataract removal currently offers no advantage over phacoemulsification.

When the cataract has been removed, your doctor will implant a new lens into your eye. This new lens (refractive multifocal lens or conventional monofocal lens) is made of plastic. Sometimes a foldable plastic lens is used so that the initial incision does not have to be enlarged. The advantage of keeping the incision small is a more rapid healing time and a quicker recovery from the procedure. Once placed into the eye, the lens is unfolded and placed in proper position.

Usually, no stitches are needed to close the incision in the cornea. Your doctor will place a shield or protective glasses over the operated eye before you go home. In most cases you can resume normal activity as early as the next day. Drops will be prescribed to prevent infection and inflammation in the eye, and your doctor will give you detailed instructions regarding postoperative follow-up examinations. Dr. Coad is a recognized expert in no stitch cataract surgery and is available to answer questions about this exciting procedure.

Presbyopia and Cataract/Lens Surgery

Patients who have cataracts may have, or will eventually develop, an age-related condition known as presbyopia.  Presbyopia is the reason that reading glasses become necessary, typically after age 40, even for people who have excellent distance and near vision without glasses.  Presbyopic individuals require bifocals or separate (different prescription) reading glasses in order to see clearly at close range.  There are several options available to achieve distance and near vision after cataract surgery.

• GLASSES  You can choose to have a monofocal (single focus) IOL implanted for distance vision and wear separate reading glasses, or have the IOL implanted for near vision and wear separate glasses for distance.
• MONOVISION  IOLs with two different powers, one for near vision, and another for distance vision, could be implanted.  This combination of a distance eye and a reading eye is called monovision, and it would allow you to read without glasses.  It has been employed quite successfully in many contact lens and refractive surgery patients.  Dr. Coad will discuss and demonstrate this option.
• MULTIFOCAL IOL  (ReSTOR and ReZoom) A multifocal IOL could be implanted.  These IOLs, more recently approved the FDA, provide distance vision AND restore some or all of the focusing (accommodating) ability of the eye.  Depending upon the technological features of the IOLs, they may be described as "accommodating", "apodized diffractive" (ReSTOR®) or "presbyopia-correcting".  All of these lenses are "multifocal", meaning they correct for both distance vision and other ranges, such as near or intermediate.