Cataracts Chat Transcript

Dr. Mitchell:  Welcome to all!

Moderator:  Welcome, Dr. Mitchell.

Moderator:  Welcome to our chat about cataracts with Dr. Tom Lyle Mitchell. As a reminder, information presented is for information only. Please contact your personal eye care specialist before undergoing any eye care procedures.

Moderator:  Dr. Mitchell,  please tell us a little bit about yourself.

Dr. Mitchell: I've been practicing general ophthalmology with a special interest in cataract and eyelid surgery since 1987 with Montgomery Eye Physicians.

Moderator: Dr. Mitchell, August is dedicated to getting out information about cataracts. What is the most important thing people should know about cataracts and the signs to watch for?

Dr. Mitchell:   Cataracts usually develop gradually and cause a variety of visual symptoms. The early symptoms usually involve needing more light for reading and noticing glare and haloes around lights. Often, cataracts cause a loss of color vision and sensitivity to contrasts. These findings may be present even when patients are unaware of their visual loss. That's why it's important for routine eye exams.

Moderator:  Dr. Mitchell is there any particular age at which people should begin to worry about cataracts? Is it a disease that mainly occurs in an older population or is anyone susceptible?

Dr. Mitchell:  Cataract formation is a part of the normal aging process. If we live long enough, we will all have cataracts and need cataract surgery. However, cataracts can develop at any age. Some children are born with congenital cataracts and it is not uncommon to see cataracts associated with medical diseases such as diabetes in younger patients.

Moderator:  Dr. Mitchell, tell us about a typical eye examination for someone who thinks they may have problems. Is it a long preliminary examination?

Dr. Mitchell:  A routine complete examination involves a measurement of visual function with refraction. The eyes are then examined with a microscope. The pupils are dilated with drops and the inside of the eye is examined thoroughly. The complete examination usually takes about one hour.

Moderator:  If someone is found to have cataracts after this exam, what treatment or procedure will they have to undergo next?

Dr. Mitchell: If cataract surgery is found to be necessary, we would measure the eye for the proper implant power. Cataract surgery involves removing the natural lens and replacing it with a lens implant.

Len: Dr. Mitchell, A lady friend of mine had surgery about a month ago on one eye and the other a week later. She now claims that headlights, streetlights, etc. are not round and they have wings protruding from the sides. Is this common?

Dr. Mitchell: That complaint is not typical; however, it is not unusual to have some glare from the implant, especially under night driving conditions. Usually, the cataract produces much more bothersome symptoms.

CatEyes: How safe are the procedures involving the new implants?

Dr. Mitchell: Can you be more specific about the new implants to which you are referring?

Len: Dr Mitchell, I am 71 yrs old. On my last eye exam, the Dr. told me I had the start of cataracts. Does this mean I should expect to have surgery soon or do they develop at different speeds in different people?

Dr. Mitchell: I have learned not to try to predict the speed of cataract development. There is considerable variation from patient to patient. Generally, patients are usually aware of cataract progression by the change in their visual function. Fortunately, with the new techniques available, cataract surgery is a much safer and easier procedure.

v-girl: My mother has hypertension and is nearsighted. Should I be worried about her developing cataracts because of her high blood pressure?

Dr. Mitchell: High blood pressure is not related to an increased risk of cataracts, but it is related with other serious conditions. A control of the high blood pressure is essential to minimize the risk of eye complications.

Moderator: Just a second ago, I accidentally cut out CatEyes' response to your response on implants. The response is they just heard something about implants and cataracts on the news but didn't know the specifics. Do you have any idea if implants of any kind are used to treat cataracts?

Dr. Mitchell:   Cataract surgery is better thought of as lens replacement. The old lens or cataract is removed and replaced with an artificial plastic lens or implant. Prior to implant development, the focusing power was replaced with thick glasses or contact lenses. The first implant was used in England in 1948. It was very controversial but opened a new era in cataract surgery.

Since that time, the implants have been continually modified and updated. The current implant technology is very advanced and it is rare to have a complication related to the lens implant. The latest development in implants involves a flexible implant that allows us to insert the device through a small incision. We can't wait to see what the future holds.

Len: Will cataract surgery have any effect on floaters and flashers?

Dr. Mitchell: Floaters and flashes usually indicate a disorder of the vitreous or retina in the back of the eye. These symptoms may be present before and after cataract surgery. Some patients are temporarily more aware of their floaters after cataract surgery due to the increased illumination.

v-girl: I have been wearing contacts for ten years. Am I at a greater risk to develop cataracts later on?

Dr. Mitchell: Fortunately not.

David S: I have had a transplant and later the lens was removed to try to improve my vision but with no improvement. would a lens implant like the cataract surgery help me. plus I have a lot of floaters also in that eye.

Dr. Mitchell: Was an implant not placed when your lens was removed?

David S: No. there was some lazer work done

Dr. Mitchell: I would check with your surgeon on that possibility due to the unique nature of your case.

David S: The implant is super clear. but my vision is so bad.

JW: Dr Mitchell, My wife has developed floaters since her cataract surgery. Is there anything she can do to reduce or get rid of them?

Dr. Mitchell: Unfortunately, there is no easy solution for floaters. The good news is that most patients become much less aware of the floaters over time. In extreme cases, vitreous surgery can be performed.

Moderator: I want to thank Dr. Mitchell and all our chatters for an informative chat. For more information log on to and go to Ask the Expert or call the Experts at Montgomery Eye Physicians. Good night all!

Dr. Mitchell: Thanks to everyone who logged on tonight. We'll be SEEING you!