Understanding Cataracts Today

Published by: Dr. Robert Castrovinci

When my grandmother had cataract surgery many decades ago, she was in the hospital for a week, returned home and was required to stay in bed in a dark room for several weeks and then, finally after a couple of months, was able to get cataract glasses.  How things have changed!  Today cataract surgery is an outpatient procedure and most patients can return to their usual activities within 24 hours.

How did this occur?

Over the last 25 years remarkable changes in microsurgery and lens implant technology have taken the very common problem of cataract and allowed many people to enjoy better vision without serious interruption in their daily life.  Today all cataract surgery is done through tiny incisions from which the cataract is extracted and a permanent lens implant displaced.  Typically, no sutures are required.  Most people are surprised that there is no discomfort from the operation or the healing process itself. 

Cataracts can be part of the normal aging process of the eye, affecting 80% of people over age 60.  What causes cataracts?

Cataracts can be part of the normal aging process of the eye, affecting 80% of people over age 60.  Although cataracts can occur in people who are younger with certain chronic diseases, on certain medications or due to injury, this is a less common cause. 

Technically any cloudiness of the human lens is considered a cataract. Cataracts are not growths over the eye. Most people over age 40 do have some slight cataract formation which often causes no difficulty with their vision. However when the cataract increases to the point where vision is distorted or blurred, most people will elect to have cataract surgery.

Does everyone get cataracts?

No, not everyone will develop a visually significant cataract in their lifetime. However if you have cataracts that impair your ability to drive, work or read then no treatment other than surgery would be helpful in correcting your vision.

What are some of the symptoms that cataracts cause?

The earliest symptoms of cataracts are troublesome glare or decreased vision for night driving.  Often trouble with driving under bright or sunny conditions occurs.  Some people describe their vision like "looking through a film or veil".  Sometimes people have difficulty with vision in general including near tasks and reading.  So many of my patients complain about their inability to see the printing on their TVs that I often quip "Maybe it's time for a bigger TV".  Although none of the symptoms necessarily mean you have a cataract, you should consult with your eye care doctor to make sure it is nothing more serious.

There are over two and a half million cataract operations performed annually in the United States. In fact, with the number of people over 65 increasing in the United States over the next few years, the number of operations will continue to increase. Typically once a cataract is removed it does not return. Since cataracts are a medical condition, it is covered by insurance including Medicare. This surgery, in the hands of an experienced cataract surgeon, has a success rate of about 99%.

Why are lens implants used?

The normal lens of the eye provides a high degree of focusing power. Once it is removed from the eye it becomes very difficult to see. In the United States, after the late 1970s, cataract surgery was typically done with a lens implant. With current technology, the power of the lens implant that is used for a person's eye can be calculated fairly closely to what is needed for good vision.

Today's lens implants are made of a special surgical plastic which allows it to be folded and inserted through a tiny incision.  Once inserted in your eye, the lens implant is permanent, never requiring replacement.  Since they are within the eye itself, touching or rubbing your eye will not cause the lens implants to move.

What can I expect to happen when I go for cataract surgery?

On the day of surgery, you would report to the outpatient surgery center approximately an hour and a half before your operation.  The nurses would put special dilating drops in the eye that will be having surgery.  An anesthesia specialist will go with you to the operation.  Typically most patients receive only mild sedation for their surgery.

The actual cataract operation typically takes about 15-20 minutes.  After the operation is completed, you return to the recovery area and, when directed by the nurses, a friend or relative can take you home.  During the healing process, you will be using eyedrops several times a day. On the day of surgery it is advised that you stay indoors, preferably with your eyes closed.  You would be checked the following day by your doctor.  Most people can resume their usual activities within 24 hours of their surgery.  If you will require glasses after your operation, those would be prescribed a few weeks after your eye is healed.

In summary, modern cataract surgery is not only safe but typically pain-free and within 24 hours you would be able to resume your usual activities. In the hands of an experienced cataract surgeon, cataract surgery has a success rate of over 99%.  If your blurred vision is caused by cataracts, please speak with your eye doctor about appropriate treatment.

To schedule an appointment with Dr. Robert Castrovinci, contact Divine Savior Healthcare Ophthalmology Clinic at:       

Phone: 608 745-5919
All News Items


Experiencing a dull pain in the pit of your stomach

Stomach PainGastroesophageal reflux disease, or GERD, and gallbladder disease are two very common disorders. Knowing which one you have may be trickier than you think. Symptoms may be vague, such as a “dull pain in the pit of your stomach”, making it hard for you to explain to your doctor what’s exactly going on.

At Divine Savior Healthcare, General Surgeons, Dr. Eric Anderson and Dr. Joshua Pogorelec, have seen many patients with these symptoms and after further examination are able to help  diagnose and treat both diseases.

What is GERD?
Gastroesophageal reflux disease GERD refers to stomach contents moving into the esophagus causing a burning sensation commonly referred to as heartburn. Other symptoms may occur as well, such as pain in the upper abdomen, bloating, nausea and an acid taste in your mouth.  If this continue, prolonged exposure of the esophagus to stomach contents can result in damage to the lining of the esophagus.  This in turn can result in difficulty swallowing, pain with swallowing or permanent damage to the esophagus.

Although not all reflux results in symptoms or damage to the esophagus, common symptoms include:
• Heartburn
• Acid regurgitation
• Belching
• Difficulty or pain when swallowing
• Waterbrash sudden excess of saliva
• Dysphagia the sensation of food sticking in the esophagus
• Chronic sore throat
• Laryngitis
• Inflammation of the gums
• Erosion of the enamel of the teeth
• Chronic irritation in the throat
• Hoarseness in the morning
• A sour taste
• Bad breath
• Coughing at night

What is gallbladder disease?
The gallbladder is located below the liver on the upper right side of the abdomen. The main function of the gallbladder is to store bile, which is made in the liver and allows fat-soluble vitamins and nutrients to be easily absorbed into the bloodstream. Any condition that affects the gallbladder is considered a disease, and there are many different scenarios that fall under gallbladder disease:
• Inflammation
• Gallstones
• Common bile duct stones
• Biliary Dyskinesia
• Infection
• Perforated gallbladder
• Gallbladder polyps
• Porcelain gallbladders
• Gallbladder cancer

Dr. Anderson and Dr. Pogorelec share "the most common disease of the gallbladder is gallstones. Most people with gallstones do not even know they have them.  Once they cause problems, the gallbladder may need to be removed. Symptoms include pain below the right rib cage or in the “pit” of the stomach. This pain may radiate to the right upper back, chest, or shoulder. Other symptoms may include, bloating, nausea or vomiting, fever or chills, chronic diarrhea, jaundice yellow-tinted skin, or unusual lighter-colored stools or dark urine.”

After taking a closer look at GERD and gallbladder disease, Dr. Anderson and Dr. Pogorelec are able to provide helpful insight on common distinguishing factors between the two diseases.

Common distinguishing factors:
• Location: Although both may feel like a “pit in your stomach”, if you experience symptoms located closer to your throat or in your chest it is more likely to be GERD related. Symptoms located near your right lower rib radiating into your right upper back, chest and shoulder are more likely to be associated to your gallbladder.
• Pain: Unlike GERD, gallbladder pain usually begins suddenly, and changing positions, belching, passing gas or taking medications rarely helps pain symptoms go away.
• Timing: With heartburn being the most common symptom of GERD, symptoms of reflux are likely to occur shortly after eating, where symptoms of gallbladder disease usually occurs several hours after eating and have more consistent patterns of reoccurrence the same time each day.

What does treatment look like?
The symptoms of GERD are commonly and effectively treated with over-the-counter medications such as anti-acids and proton pump inhibitors. However, if relief does not go away from these medications your provider may recommend you be evaluated by one of our surgeons at Divine Savior.

After a thorough history and physical, our surgeons may recommend further evaluation of the esophagus and stomach with endoscopy.  Similar to colonoscopy, but without the need for prep, upper endoscopy allows the surgeon to visualize the esophagus, stomach and intestine to evaluate for damage to the esophagus, infection and a hiatal hernia.  Depending on the findings, further testing may be indicated to evaluate the function of the esophagus. 

Patients with severe GERD benefit from surgery to prevent reflux from occurring.  This procedure is commonly performed by both Dr. Anderson and Dr. Pogorelec, is minimally invasive, and very effective at treating GERD.  In fact, most patients no longer require any antacid medications after the procedure.

If you are found to have stones in the gallbladder causing symptoms, the best course of action is to have the gallbladder removed.  Leaving the stones in place will continue to cause pain and may result in serious infection of the gallbladder and bile ducts, jaundice or pancreatitis. 

Both Dr. Anderson and Dr. Pogorelec routinely perform minimally invasive removal of the gallbladder.  This is most often an outpatient procedure and very successful.  After a short recovery, most patients will find their symptoms are gone and they are able to live a normal life. 

If you experience symptoms related to GERD or gallbladder disease, or have concerns about either, it is best to consult your provider for further examination. Treatment for either disease varies person to person, but taking action immediately and being properly treated can help you prevent problems from worsening.

To schedule an appointment with Divine Savior Healthcare General Surgeons, Dr. Anderson or Dr. Pogorelec, call 608-745-5176.

All News Items