1. Do cataracts and presbyopia affect only older people?

Though they can be found in younger patients, cataracts generally start forming after 40. About half of the population can expect to have cataracts by age 65, and nearly everyone over 75 has a cataract in at least one eye. Presbyopia, too, is another one of life's inevitables that can begin after 40 and may require the use of bifocal lenses or reading glasses.

2. Is there any risk to lens replacement surgery?

All surgery involves some risk; however, this surgery is the most commonly performed surgery in the United States, and is considered one of the safest and most effective of all surgical procedures. Choosing a surgeon who has performed thousands of successful procedures will help reduce the risk of complications. Dr. McMann will discuss pertinent risks, benefits and possible alternatives with you during your consultation.

3. Does cataract or lens replacement surgery hurt and how does it work?

You can expect to feel virtually no pain during the surgery and usually only mild discomfort (scratchiness and irritation) afterward. The procedure takes 10 to 20 minutes per eye. You can be given a sedative to help you relax if you like.

4. What happens after the surgery?

You will be provided with a protective shield for your eye, and after a short period in the outpatient recovery area, you will be ready to go home. Someone will need to drive you home after surgery. You will be given a prescription for eye drops to be used for a few days prior to and following the procedure. While the eye is healing during the following week, it is recommended you wear your protective eye shield while sleeping or napping. Strenuous activity or lifting, swimming and exposing your eye to dust or grime should be avoided for at least two weeks after surgery.

5. My doctor says I have a cataract, but her recommends I wait before removing it. Why?

When a cataract begins forming, it is often unnoticeable, but as it grows larger and cloudier, it can begin to interfere significantly with your vision. Some cataracts never reach the stage where the lens has to be removed; however, regular visits to your ophthalmologist to monitor progress of the cataract are definitely recommended. Because of the modern advances in cataract surgery, it is no longer necessary to wait until a cataract is "ripe" before removing it. It is necessary, though, that the cataract has progressed to the point where it starts to affect your lifestyle before insurance will consider it a medical necessity and cover its removal.

6. When should I consider having IOLs?

The short answer is whenever you are ready to enjoy excellent vision without glasses or contacts. Cataract surgery may become necessary sooner or later as you get older and your vision declines, so you may just choose to wait to have lens replacement surgery. Whether you choose to wait until the cataracts are developed or to electively do a Refractive Lens Exchange (replacing your lens before cataracts develop) is dependent on your immediate goals for reducing your dependency on glasses or contact lenses. The earlier in life you choose to do cataract surgery or a Refractive Lens Exchange with a multifocal or accommodating IOL, the sooner you can improve your vision and see clearly and comfortably well into your future. With the advancements now available from Lifestyle IOL technology, the real decision to be made is how long you wish to wait before significantly raising your quality of life.

7. Will I ever need to wear glasses after the cataract is removed and IOLs are inserted?

This depends on your goals. Most patients who choose multifocal or accommodating IOLs can expect to enjoy excellent vision for almost every activity, including reading without glasses. However, not every Lifestyle IOL works well for every patient's situation and there are some visual problems that are the result of irregularities of the cornea that cannot be corrected by replacing the lens in cataract surgery.

LASIK or another procedure may be recommended by your surgeon to correct refractive error such as nearsightedness, farsightedness or astigmatism due to these corneal irregularities. If you are planning to have Lifestyle IOLs fitted, inquire as to the additional fees of having LASIK or another procedure, should they be needed.

8. How much does cataract surgery cost?

The costs will vary depending whether the procedure is medically necessary or is done electively. Prices can fluctuate and are dependent on the cost of the Lifestyle IOL used and additional testing and follow-up care that may be needed. Medicare and most private health insurance plans usually cover most of cataract surgery and standard (monofocal) intraocular lens implants, as these are considered medical necessities. You are typically responsible for co-pays and deductibles. Upgrading to a Lifestyle IOL or doing RLE electively to correct presbyopia or astigmatism, though, is not covered by Medicare or any insurance.