Cataract: If you are having trouble with night driving, glare from headlights, golf, reading, watching TV or any of the things you like to do and feel your lifestyle has been impaired due to these issues, you may be experiencing the early stages of developing cataracts. The natural lens inside the eye is normally transparent and a cataract is the clouding of this natural lens. Glasses or contact lenses cannot sharpen your vision if a cataract is present. Cataracts are a normal part of the aging process. Most people will develop cataracts if they live long enough. There is no medical treatment to reverse or prevent the development of cataracts. Once they form, the only way to see clearly again is to have them removed and replaced with an intraocular lens (IOL). In general, when your vision starts to interfere with your daily activities and lifestyle, it is time to think about having cataract surgery. Cataracts will typically not damage the eye while growing, so you can decide when the time is right for you to have cataract surgery. Cataract surgery is a very successful operation. Three million people have this procedure every year and greater than 95% have a successful result. As with any surgical procedure, complications can occur during or after surgery and some are severe enough to limit vision. But in most cases, vision, as well as the quality of life, improves.

• Secondary Cataract: A laser for secondary cataracts (posterior capsulotomy) is a surgical laser procedure that may be necessary after cataract surgery.

  During cataract surgery, part of the front (anterior) capsule that holds the lens is removed. The clear back (posterior) capsule remains intact. As long as that capsule stays clear one has good vision. But in 10 to 30% of people, the posterior capsule loses its clarity. The symptoms from this may be very similar to those that occurred prior to the cataract surgery. Some patients may feel like the cataract is “coming back.” Even though the symptoms are similar, it is much easier to treat this scarring of the posterior capsule. An opening is made in the capsule with a laser (posterior capsulotomy) to restore normal vision.

  A posterior capsulotomy is painless and takes five minutes. Eye pressure is taken an hour after the operation in your physician’s office to make sure it is not elevated. Potential but rare complications following laser posterior capsulotomy are increased intraocular pressure and retinal detachment. Symptoms typically improve within a day following the procedure. Once performed, it is unusual to have to perform a laser posterior capsulotomy a second time on the same eye.

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• Macular Edema: Macular edema is swelling in part of the retina (the light-sensitive layer of tissue at the back of your eye). People with macular edema may have blurry vision, but treatment can help reduce the swelling and prevent vision loss. The macula is surrounded by many tiny blood vessels, anything affecting them, such as a medical condition affecting blood vessels elsewhere in the body or an abnormal condition originating in the eye, can cause macular edema. Retinal blood vessel obstruction, eye inflammation, diabetes, and age-related macular degeneration have all been associated with macular edema. The macula may also be affected by swelling following cataract extraction, though typically this resolves itself naturally. Treatment seeks to remedy the underlying cause of the edema. Eyedrops, injections of cortisone around the eye or laser surgery can be used to treat a macular edema. Recovery depends on the severity of the condition causing the edema.

  Retinal Tear / Detachments: In general, retinal detachments are classified based on the cause of the detachment: rhegmatogenous, tractional, or exudative. Rhegmatogenous retinal detachments are the most common type. They are caused by holes or tears in the retina that allows fluid to pass through and collect underneath the retina, detaching it from its underlying blood supply. Retinal tears can develop when the vitreous gel separates from the retina as part of aging or in patients with abnormal thinning in the peripheral retina (lattice degeneration) or occasionally from trauma. Retinal tears often present with acute onset of flashes and floaters. Untreated retinal tears may progress to a retinal detachment. Tractional retinal detachments are caused by scar tissue that grows over the retina and pulls the retina off the back wall of the eye. This type of retinal detachment may occur from diabetes or other conditions. Exudative retinal detachments form when fluid leaks out of blood vessels and accumulates under the retina. This type of retinal detachment is uncommon and can occur in eyes with abnormal inflammation, tumors, or excessive leakage from abnormal blood vessels. The goal of treatment is to reattach the retina to the back wall of the eye and seal the tears or holes that caused the retinal detachment. Several methods can be used to repair a retinal detachment:

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