When your focus and eyesight deteriorate suddenly, it may be because you've developed cataracts. That means you need to have the lenses inside your eye replaced. But not to worry. With laser surgery and other technologies, replacement is a breeze, and your sight will improve immediately.
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"Healthy Living in the Four Corners"
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is brought to you by
Southwest Eye Consultants.
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Are you experiencing blurry vision
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or seem to be seeing double?
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Do you have trouble seeing well at night?
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You may be experiencing the
development of cataracts,
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a condition that affects
one out of every two people
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after the age of 60.
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We asked Dr. Moss Fenberg
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with Southwest Retina
Consultants of Durango
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about cataracts and
the latest technologies
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that are available to replace
them and improve your vision.
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So as we age, there is a
natural clouding that happens
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in your lens inside your eye.
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Your lens is a clear crystalline
protein that helps to,
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of course, focus light inside your eye.
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As the birthday candles come,
we tend to have less ability
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for that crystalline
lens to focus or move,
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which changes our focal point,
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meaning our arms are
not long enough anymore.
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We can't quite bring
images as close as we want,
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and also there's a general
clouding that occurs.
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So that light is no longer distributed
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through the lens equally,
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and we start to develop
opacities there in the lens
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and we go see our optometry
colleagues who make our glasses
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and do our comprehensive evaluations,
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and they say at some
point, "Well, I'm sorry.
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I can't get you back to 20-20 any longer.
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You need to go see an ophthalmologist
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and consider cataract surgery."
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Cataract surgery is the removal of that
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hard, cloudy crystalline lens in your eye
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and the replacement of it with
an acrylic or plastic implant
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that is designed to focus
light where it should,
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and so although that may
seem strange to think about,
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an implant inside your eye,
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it's a lot like an implant to replace
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a different part of your
body that isn't working well.
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Your eye is essentially measured
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like a fitting for a shoe,
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and all of the angles and curves
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and length of the eye are
brought into consideration,
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and then a lens is chosen
that is right for you,
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and that new lens
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then focuses light
properly in the eye again.
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Cataract surgery traditionally
has been performed
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by hand with surgeons magnifying
the eye with a microscope.
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Dr. Fenberg also employs laser technology
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to ensure the finest precision possible.
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With laser assisted cataract surgery,
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before the physician does anything,
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the laser makes that incision
with a laser, essentially.
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The laser then opens
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with a perfectly round capsulotomy
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here on the center of
the lens in the capsule,
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and then the laser sculpts
this lens into multiple pieces.
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You imagine cutting a
pie into multiple wedges.
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It's all broken into those
pieces, but not removed.
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So then the patient is moved
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under the microscope with the physician.
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These incisions that have been
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perfectly made with the laser are opened.
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The capsulotomy is essentially removed,
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because it's already been
placed perfectly in the eye,
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and then with much less power
and much less manipulation,
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each of these little quadrants is removed
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from the eye of the lens,
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and then you began the process of,
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on the table, measuring
the patient one more time
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to ensure that the lens you've
chosen is the proper lens.
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So the lens is essentially
loaded by my assistant
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on the table into this very
thin profile, like a scroll,
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and so it's smaller than
that two millimeter size.
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It goes in the eye like
a scroll, all rolled up,
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and then once it gets into your eye,
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your body temperature starts to heat up.
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Well, it doesn't.
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Your body temperature isn't hot.
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It's just hotter than the operating room.
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Once the lens goes into the eye,
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and your normal body temperature
starts to impact that lens,
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it then rolls and opens into
its own natural configuration,
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which is much larger, of
course, then that incision,
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and it has two little arms
that hold it out and stretch it
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and keep it in a centered
position where it should be.
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Most health insurance
covers cataract surgery
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for traditional lens replacement,
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but if you're willing
to spend a little more
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on out-of-pocket expenses,
you may be a candidate for
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one of two types of specialty lenses.
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The multiple focal lens
can give you both close-up
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and long distance vision,
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and the more common toric
lens can correct astigmatism.
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Patients who have large
levels of astigmatism
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who may have had to have worn
a contact or a rigid contact
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and gas-permeable, scleral
lens, things like that.
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Those patients are amazed,
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because they're out of their contacts.
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They've now corrected their astigmatism
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with something inside their eye
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and their distance vision is excellent.
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Now, they don't have near
vision with that lens,
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but many of them are okay with that.
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And they want what we refer
to as custom distance.
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They want the clear,
beautiful distance vision
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and they're okay having near vision.
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Some of them are okay
wearing glasses still
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with almost no correction
above, but with a bifocal below,
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and they just like the ability
to take those glasses off
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when they need to, to ski or do whatever,
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and still have great distance vision
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and put them on for their near work.
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With a multifocal,
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or what's called an enhanced
depth of field lens,
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you now bring in your world
much, much, much closer.
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You can pick up the things
in the grocery store,
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or read the price tag.
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You can read most things
that you need in your world.
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If you're doing something like tying flies
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or reading the fine print
on a pill bottle, well,
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you may need to put a pair
of readers on for fine work,
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but for most of your activity,
you're able to do that.
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These lenses work by essentially
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casting multiple images onto the retina,
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and your brain then
learns to ignore the image
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that's out of focus for the
given distance that you're in.
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Dr. Fenberg warns that patients
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who elect to have one
of the specialty lenses
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implanted in their eyes will
need to be evaluated first
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to ensure that they're a good candidate,
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both physically and emotionally.
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Adjusting to the new lenses can take time.
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I tell patients, we change
your visual system instantly
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when we do cataract surgery,
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and it takes some time to adapt to that.
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So if I go and get a new pair of glasses
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from my favorite local optometrist,
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no matter how well I actually
see when I put them on
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and they tell me I'm 20-20,
I'm still not adjusted yet.
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I don't like them initially,
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because the astigmatism
is a little different,
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and the focal point and the size,
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and it just takes a little bit to adapt,
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and so they always tell
you, you know, I'm sorry.
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You got to give it a couple
of weeks and see how you do
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before we make an adjustment.
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With surgery, we do that
permanently and instantly,
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and we take your patch off the next day,
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and for most patients,
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they're not quite certain
how great it is initially,
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but by a few days to a few
weeks, they're loving it.
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They are loving their
spectacle independence.
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If you'd like to know more
about cataract surgery
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and the options available to you,
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contact SWEyeConsultants.com.
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I'm Deborah Uroda for Healthy Living.
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