Cataract does not cause pain or headache. The most common symptoms can be any one or a combination of the following:

• blurring of vision; 
• glare and sensitivity to light; 
• diminished night vision; 
• altered color perception;

These symptoms can interfere with normal daily activities such as reading, working or driving a car (especially at night).

Cataract most commonly occurs as a "normal" aging process in the eye. It is not caused by "overusing" your eyes. Cataract may also occur in younger individuals. Some of the factors that contribute to the development of cataract are:

• A family history of cataract; 
• Diabetes and other medical problems; 
• Injuries to the eye; 
• Medications, such as steroids; 
• Smoking 
• Exposure to ultraviolet light (such as sunlight). 

In the early stages of cataract development vision can usually be improved by changing the spectacle prescription. We recommend that a patient with cataract see their eye doctor every six to twelve months to monitor their vision and "fine tune" their eyeglasses prescription.

Eventually, changing the eyeglass prescription is no longer sufficient to maintain good vision. Surgical removal of the cataract may be indicated if blurring of the vision interferes with normal daily activities (reading, driving, etc.).

A cataract is removed using microsurgical techniques. A small (3.0 mm) incision is made into the eye. This incision is so small that, in most cases, it is self-sealing and sutures are not required. 

Once the cataract (clouded lens) has been removed it is replaced with a new, clear lens. This lens is called an intraocular lens implant. This lens (with a diameter of approximately 6 mm) is folded in half and then inserted into the eye through the original (3 mm) incision. The implant enables patients to see well without having to wear thick, heavy eyeglasses. 

The cataract procedure is most frequently performed under local anesthesia in an outpatient surgery facility. It does not require a stay in the hospital. Sedation is given to most patients to help them relax. The procedure is performed in about 30 to 45 minutes. Thanks to the anesthetic, patients do not feel or see the surgery.

After the procedure patients are instructed to spend a day relaxing at home. Most patients return to normal activities the day following the surgery.

Cataract removal with insertion of an intraocular lens implant is performed over one million times each year in the United States. A success rate of 98% makes this one of the safest surgical procedures known to modern medicine. As with any type of medical procedure there is always the possibility of complications. The rate of complications is approximately 2%. This includes the following:

• infection; 
• hemorrhage; 
• retinal tear or detachment; 
• glaucoma; 
• clouding of the cornea; 
• loss of the vision.

This is a very common misconception. The most advance technique for removing a cataract (phakoemulsification) uses ultrasound, not laser. Currently, there are clinical trials being done to determine whether the laser can be used to remove a cataract. As of this writing, it appears that the laser technique has no advantages over the ultrasound technique. In fact, laser may not work as well as ultrasound at removing more advanced cataracts.

• Will a cataract recur after surgery?

A cataract does not recur. However, behind the pupil there is a thin, clear membrane called the lens capsule. In approximately 30% of patients this membrane can become clouded. This may occur anytime from several weeks to many years following the cataract procedure. If the membrane becomes clouded it can be opened using a laser. This painless, outpatient procedure is usually performed in the office.

• When is a cataract "ripe"?

The term "ripe" is obsolete. The last couple of decades have seen a tremendous improvement in the results of cataract surgery. Before these advances were made, patients had to be hospitalized for a week to ten days for a cataract procedure. The complication rate was higher and there were no intraocular lens implants. After the surgery patients had to wear thick "Coke bottle" type spectacles. 

In the past, "ripe" was a term used to describe a cataract that had become so advanced that the patient was nearly blind. In those cases the risks and inconveniences of cataract surgery were justified. 

With the modern techniques that we now use to remove a cataract the term "ripe" has become outdated. Patients are no longer hospitalized and the complication rate is one of the lowest in all of medicine. With the advent of intraocular lens implants, patients are no longer required to wear thick, heavy eyeglasses. Many patients are now able to see well (for most activities) without wearing any spectacles.

• How do I know when my cataract is ready to be removed?

Thanks to recent advances in cataract surgery, we no longer have to wait until a patient is nearly blind before removing a cataract. We now let the patient decide when they would like to have their cataract removed. 

In most cases we recommend waiting until the vision has become blurred to the point where it is interfering with work, reading, driving or other daily activities. This will be different for each patient. For instance, an airline pilot may want to undergo the procedure at a much earlier stage than someone whose daily activities are less visually demanding.