Progressive Vision Loss

Cataracts don’t go away on their own. In fact, they continue to worsen with time. As the lens becomes cloudier, your vision becomes more blurred, colors appear duller, and sensitivity to light increases. You may also notice halos around lights and difficulty seeing at night. Eventually, these symptoms can interfere with daily tasks like reading, driving, or recognizing faces. The result is a loss of independence and reduced quality of life.

Increased Risk of Falls and Injuries

Untreated cataracts are a leading cause of preventable blindness in older adults. Poor vision caused by cataracts has been linked to an increased risk of falls and fractures, especially when navigating stairs or uneven surfaces. These accidents can have long-term health implications, particularly for seniors. Timely cataract surgery can restore visual clarity and help reduce these risks.

Potential for Complete Vision Loss

While cataracts are treatable, ignoring them for too long may allow the condition to reach a stage where surgery becomes more complex. In extreme cases, the cataract can become hypermature (hardening and swelling), which increases the chance of complications during removal. Though rare, permanent vision loss is a risk if the cataracts contribute to glaucoma, inflammation, or lens dislocation.

Delaying Treatment Doesn’t Help

Some people wait to address cataracts because they feel their symptoms are manageable or believe glasses will improve their vision. However, glasses can only help to a certain extent. Once a cataract significantly impacts your vision, surgery is the only effective treatment. Fortunately, cataract surgery is one of the safest and most successful procedures in modern medicine.

Don’t Let Cataracts Steal Your Sight

If you’re experiencing cloudy or blurry vision, frequent prescription changes, or difficulty with night vision, it’s time to have your eyes evaluated. Dr. Pamel, a recipient of the American Academy of Ophthalmology Lifetime Education Award, and the team at Pamel Vision & Laser Group provide comprehensive cataract diagnosis and customized surgical care. Contact (212) 355-2215 today to schedule a consultation at our NYC or Astoria office and take the first step toward restoring your vision.

Cataracts

The Subtle Toll of Cataracts

Cataracts develop gradually as the natural lens of your eye becomes clouded. Initially, you may adapt to early symptoms like dim vision, glare, or trouble reading small print without realizing how much you are compensating.

Eventually, night driving becomes stressful. Colors appear dull. Hobbies like knitting, painting, or golfing may lose their appeal. These limitations can lead to reduced activity levels, social withdrawal, and a higher risk of depression.

Beyond lifestyle impacts, cataracts are also linked to increased fall risk in older adults. Impaired depth perception and contrast sensitivity can affect mobility and safety, especially in low-light environments or on stairs.

Why Waiting Isn’t Always Best

In the past, cataract surgery was often delayed until vision was considered legally impaired. Today, advances in lens implant technology and surgical precision mean that surgery can be done safely and effectively much earlier in the disease process. Our cataract surgery patients report significantly improved vision, brighter colors, and less dependence on glasses or contacts.

Choosing early surgery often leads to better outcomes and a smoother recovery. It allows patients to resume daily activities with confidence and reduces the mental and emotional toll of gradual vision decline.

The Personalized Approach to Cataract Care

Dr. Pamel tailors each cataract surgery to the individual’s visual goals and lifestyle. Premium intraocular lenses (IOLs) offer a range of options, from correcting astigmatism to minimizing the need for reading glasses. Our team takes the time to evaluate your current vision, discuss your daily habits, and determine whether early cataract surgery could help you regain visual freedom sooner than expected.

If you’ve noticed subtle changes in your vision or feel like you’re no longer seeing life in full color, it may be time to consider a cataract evaluation. There is no need to wait until cataracts become a serious problem to seek treatment. The team at Pamel Laser Vision is here to guide you through every step of the process with experience, advanced technology, and personalized care. Contact our Astoria, NY office at (212) 355-2215 today to schedule your consultation.

Benefits of Monofocal Lens Implants

Monofocal IOLs are the standard lens implant used for cataract surgery. They are focused for a single focal point so you may have sharp near or distance vision but not both. Most patients choose to have excellent distance vision with a monofocal lens so they can drive, recognize faces from far away, and watch TV without wearing glasses or contact lenses. Monofocal lenses are a cost-effective option for cataract surgery patients because they are covered by insurance, though you are still responsible for your co-pay and other costs. People with hyperopia who struggle to see faraway objects clearly may not need to use their glasses with a monofocal lens focused for distance vision. You may still need corrective eyewear for close-up tasks. Patients with monofocal lenses may have better eyesight in low lighting circumstances than those with multifocal IOLs.

Monofocal IOLs could be a good fit for someone with nearsightedness who enjoys spending time outdoors or driving, or someone with farsightedness who likes to read, sew, or do other detailed tasks. However, monofocal lenses will not correct for astigmatism or presbyopia, and you will likely still need to wear glasses or contact lenses in some situations.

Monofocal lenses can also be used for monovision, which focuses one eye for near vision and the other for distance. The monovision approach reduces your dependence on corrective eyewear, allowing you to drive and read without wearing glasses. This method may decrease your depth perception and near vision, and cause glare or haloes around lights at nighttime. Some patients may have trouble adapting to monovision.

Benefits of Multifocal Lens Implants

Multifocal IOLs are advanced or premium lens implants that correct your eyesight at multiple focal points, so you can see clearly at all distances. These lenses are ideal for people with an active lifestyle who enjoy reading, traveling, golfing, and other activities that require switching from near to intermediate and distance vision.

Unlike monofocal lenses, multifocal lenses can correct for astigmatism and presbyopia in addition to nearsightedness and farsightedness. Most people with multifocal IOLs have little to no need for corrective eyewear. These premium options can offer complete visual freedom, so you don’t need to remember your “readers” when you leave the house or deal with the hassles of contact lenses. These lens implants are often preferable to monovision with monofocals because they offer more flexibility and don’t limit your near vision, depth perception, or night vision.

Multifocal IOLs offer more convenience and a better quality of life. You can enjoy excellent vision after cataract surgery or refractive lens exchange with these advanced lens implants.

While there is an added cost and a small risk of halos or glare around lights, most patients are satisfied with multifocal IOLs and do not require corrective eyewear after the procedure.

Discuss your intraocular lens implant options with Dr. Gregory J. Pamel during your consultation at Pamel Vision & Laser Group in Astoria, and New York, New York. Schedule a consultation by calling (212) 355-2215 or complete our online contact form.

Diabetes Can Lead to Early Cataract Formation

Cataracts form when proteins inside the natural, transparent eye lens clump together, causing an opaque appearance as the cataract grows denser. Most people will have cataracts by their 70s. However, those with diabetes may develop them much earlier in life because high glucose (sugar) levels in the blood can alter the structure of the eye lens and accelerate cataract development. 

High blood sugar affects your body in many ways. In your eyes, the extra glucose affects the fluid filling the front of the eye (aqueous humor), which provides nutrients to the eye lens, including oxygen and glucose. Elevated blood glucose also increases the sugar levels inside the aqueous humor and, ultimately, the lens. The excess sugar may cause swelling in the lens and lead to vision changes. 

The lens also contains an enzyme called sorbitol that is converted from glucose. Too much sorbitol can cause what’s referred to as sugar cataracts or diabetic cataracts. The sorbitol accumulation causes osmotic stress, leading to the breakdown of the lens integrity and triggering cataract formation. 

The longer you live with diabetes, the more likely your eye health will suffer. You may not notice the cataract at first because the clouding of the eye lens is gradual until it reaches the center of the lens and growth speeds up. Keeping your blood sugar within your target range (typically 80-180mg/dL) can help you avoid vision loss and eye disease. 

You May Have Additional Risk Factors for Early Cataracts

Diabetes may not be your only risk factor for cataracts; your cataract risk increases if you have a family history of cataracts, previous eye surgery or injury, or repeated eye injections. People taking corticosteroids and other medications may be more likely to have cataracts early in life. Cataracts are also linked to UV exposure, so be sure to wear UV-blocking sunglasses when you’re outside. 

Discuss your risk factors with Dr. Gregory Pamel during your comprehensive eye exam at Pamel Vision & Laser Group. Regular eye exams are crucial for people with diabetes to diagnose problems early — before they cause vision loss. While diabetic cataracts are cured with cataract surgery, other eye diseases linked to diabetes cause irreversible vision impairment before you notice symptoms, including glaucoma and diabetic retinopathy. 

Laser cataract surgery removes the clouded lens and replaces it with an artificial lens implant. Dr. Pamel offers advanced intraocular lens (IOL) implants that correct refractive errors, such as nearsightedness, farsightedness, astigmatism, and presbyopia. 

Learn more about diabetes and eye disease by scheduling an eye exam with Dr. Pamel. Contact our Astoria and New York, New York, offices at (202) 355-2215. 

At Pamel Vision & Laser Group, Dr. Gregory Pamel offers traditional and laser-assisted cataract surgery. Both methods can restore clear eyesight and involve two incisions, but the laser approach may offer more advantages. 

Traditional Cataract Surgery Vs. Laser Cataract Surgery

Traditional cataract surgery is called phacoemulsification. The eye surgeon makes a tiny incision in the clear dome at the front of the eye (cornea) with a handheld scalpel and inserts a small instrument to reach the lens capsule behind the pupil that houses the cataract (clouded natural lens). The second incision is a circular opening also made by hand. The surgeon inserts a pen-shaped probe that emits ultrasound waves to break up the cataract, and the broken pieces are suctioned out and replaced with an IOL. 

Laser-assisted cataract surgery uses a computer system to map the eye’s surface and lens and programs the laser with these measurements. The laser makes precise incisions at the necessary depth and size, and its energy softens the cataract, making it easier for the ultrasonic probe to break it into pieces. 

Both surgical techniques can correct astigmatism with specific incisions in the cornea to improve the corneal shape for better vision. However, laser cataract surgery offers more precise cuts and may be preferred for astigmatism correction and premium IOL placement. 

What Are the Benefits of Laser Cataract Surgery?

Laser-assisted cataract surgery offers exact incisions every time, eliminating human error. The laser’s precision combined with the computer mapping system provides a more accurate and consistent procedure and may be faster than the traditional approach. The heat from the laser energy helps to soften dense cataracts, making it easier to break them apart and remove the pieces. The laser is also useful for exact positioning of multifocal lens implants, which provide for clear vision at several focal points and can correct astigmatism. 

Laser cataract surgery requires less ultrasound energy to soften the lens for removal, which may reduce corneal swelling and lead to better vision right after the procedure. 

Ultimately, the outcome of cataract surgery, whether traditional or laser-assisted, depends on the eye surgeon’s experience. Dr. Gregory J. Pamel is a board-certified ophthalmologist with extensive training and more than 20 years of experience in cataract and refractive surgery. He is the recipient of the Lifetime Education and Achievement awards from the American Academy of Ophthalmology. 

If you’re ready for clear vision with cataract surgery, contact Pamel Vision & Laser Group to schedule your eye exam. Contact our Astoria and New York, New York, offices at (212) 355-2215.  

Cataracts

Cataracts are clouding of the eye’s natural lens. Over time, patients develop blurred vision, which makes them feel as if they are looking through a foggy window. The ability to read and drive is affected. Eventually, many people decide to undergo cataract surgery, a relatively safe procedure.

Laser Cataract Surgery

As per its manufacturer, Johnson & Johnson, “The CatalysTM  system uses 3D OCT Imaging and Integral Guidance technology with automatic surface mapping and guided delivery to generate precise and accurate laser incisions that are key to accurate incisions.” It is used in patients undergoing removal of the crystalline lens.

The system forgoes the traditional handheld blades and ultrasound probes for the efficiency and efficacy of a computer-guided laser offering extreme accuracy. It is used for the following steps of cataract surgery:

• Anterior capsulotomy: removal of the anterior lens capsule
• Phacofragmentation: lens removal technique in cataract and refractive surgery
• Creation of single-plane and multi-plane arc cuts or incisions in the cornea

While cataract surgery has long been very safe, this technology makes it even safer and more precise. The result is better surgical outcomes for patients. For surgeons, the technology is easy to learn and use.

The technology features a Liquid Optics Interface. This optimizes the optical path to the eye. The proprietary Integral Guidance mapping system is designed so that femtosecond laser pulses are delivered to the intended location safely and precisely. Patients spend less time in surgery than with traditional cataract surgery methods.

Contraindications

While most people can benefit from the Catalys system, there are some for whom the procedure is contraindicated. That includes those with:

• Corneal ring or inlay implants
• Severe corneal opacities
• Corneal abnormalities
• Severe corneal edema
• Descemetocele with impending corneal rupture

Contact Us

If you would like more information about laser correction technologies for cataract surgery and whether you are a candidate for the procedure, contact Pamel Vision and Laser Group and schedule a consultation with Dr. Gregory Pamel. He is one of the first New York City cataract eye surgeons offering laser refractive cataract surgery using the Optimedica Catalys Precision Laser Platform femtosecond cataract system.

Dr. Gregory Pamel suggests waiting at least a week or two before resuming any exercise, and adds the following advice:

No Swimming

If swimming is your favorite form of exercise, you should probably find a substitute activity for a while. In the first two weeks, your eye will be irritated by exposure to water. In the subsequent weeks, you need to avoid lakes, oceans and other bodies of water because they often have bacteria that could infect your eyes. Similarly, you should avoid pools and hot tubs because the chlorine can burn your ailing eyes.

Dodge Potential Injuries

Part of the reason to lay off exercise for a period is the increased potential for an eye injury. Any sport where there is a chance of a ball, elbow or any foreign object hitting your eye can cause serious and permanent damage to your eye post-surgery. It is best to play it safe while you recover.

Be aware that exercise risks go beyond aggravating your eyes. Because your vision is diminished for some time after your surgery, that makes you more liable to, say, jog into a tree or cycle into a car. Keep yourself safe by resting and relaxing for the prescribed amount of time.

Do Not Get Strenuous

After a couple of weeks you may be ready to resume some physical activity, but avoid pushing too hard. While moderate exercise should have no effect on your eye health, overexertion puts additional pressure on your eyes, which can do damage. In particular, lifting heavy weights increases ocular pressure, so you will want to avoid that for a month or two.

Mind Your Stretches

Admittedly, yoga is not usually considered strenuous exercise, but you should be mindful of what poses you choose. It is important to keep your head above your waist during recovery since bending too low will put added pressure on your eyes. For that reason, temporarily skip the downward dog and child’s pose — the same goes for toe touches.

Ask Dr. Pamel

Since many factors depend on the type of eye surgery you undergo, Dr. Pamel will discuss the specifics of physical activity ahead of your treatment. At your follow-up appointments, Dr. Pamel will check on your progress, and you may ask questions about potentially adjusting your exercise timeline based on that assessment.

To schedule a consultation to discuss any issues regarding eye surgery, call the team at Pamel Vision & Laser Group at 212-355-2215.

It is virtually impossible to avoid getting cataracts. However, the more you educate yourself about cataracts, the more likely you are to be able to detect them in their early stages. Early detection offers the best chances at avoiding devastating vision loss to cataracts.

Read on as Dr. Gregory Pamel of Pamel Vision & Laser Group discusses the different types of cataracts.

Nuclear Sclerotic Cataracts

The most common type of cataract is a nuclear sclerotic cataract. These cataracts develop in the center of the lens, called the nucleus. The nucleus hardens, yellows and becomes cloudy, which interferes with the amount of light entering the eye. Gradually, the hardening and yellowing effect spreads to the other layers of the lens. Nuclear sclerotic cataracts develop very slowly and take years to cause noticeable symptoms.

All cataracts, including nuclear sclerotic cataracts, can cause blurry or cloudy vision, impaired night vision, sensitivity to light, difficulty discerning between colors, increased glare and halos around lights.

Nuclear sclerotic cataracts are sometimes associated with a brief improvement in near vision called “second sight.” This improvement is short-lived, and as the cataract progresses, near vision deteriorates.

Cortical Cataracts

Cortical cataracts affect the cortex, or the periphery or outside edge of the lens. The yellow and cloudy areas of the cortex slowly spread to the center of the lens, like the spokes on a wheel. Individuals with diabetes have the highest risk of developing cortical cataracts.

Posterior Subcapsular Cataracts

A posterior subcapsular cataract forms on the back surface of the lens, beneath the membrane or “capsule” that holds the lens in place. Posterior subcapsular cataracts develop faster than other types of cataracts. They are most likely to affect individuals who take steroid or diabetes medications or who have extreme nearsightedness or retinitis pigmentosa.

Expert Cataract Treatment at Pamel Vision & Laser Group

If you are experiencing symptoms of a cataract, Dr. Pamel encourages you to schedule an evaluation at our office. Cataracts are corrected with a routine surgical procedure. During the procedure, the natural lens is removed from the eye and an intraocular lens (IOL) is placed to restore clear vision. Some patients do not need glasses to see clearly after surgery; this will depend on the type of IOL that is placed.

To learn more about cataracts or cataract surgery, please contact Pamel Vision & Laser Group today.

Perfect Timing

Not long ago, patients were commonly advised to wait until a cataract was said to be “ripe” — mature enough to be easily removed from the surface of the eye. Now cataracts can be removed at any stage of development.

In general, a conservative approach is prudent. If a patient has normal vision, and doesn’t experience some of the activity-limiting symptoms such as cloudy vision, trouble reading or glare during nighttime driving, there is no need to remove the cataract quickly.

It is also true that patients should not ignore cataracts. As a cataract develops beyond the “ripe” stage, it becomes harder, making it more difficult to remove in a surgical procedure. Left untreated long enough, cataracts can inflame the eye or cause elevated eye pressure. High intraocular pressure often leads to glaucoma, the serious condition that damages the optic nerve and may result in total loss of vision.

Record of Success 

Although important to your quality of life, the timing of cataract surgery is not a life-or-death decision. Removal of cataracts and replacement with an intraocular lens implant (IOL) is a routine procedure with an astronomically high success rate. There are no real negatives to replacing your clouded cataract with an IOL. The implant is designed to become a permanent part of your eye. It will not be rejected by your body or wear out. And because it is made of a special material, it will remain clear for life.

Originally performed with the use of a miniature blade, cataract removal can now be done using a femtosecond laser to make incisions. Dr. Pamel uses the the Optimedica Catalys Precision Laser Platform femtosecond cataract system, an ultra-precise instrument that makes possible greater precision for the surgeon and faster recovery for the patient. In fact, he was among the first laser cataract eye surgeons in New York City to master this advanced technology, and make it available to patients.

Lens Choices

Once you’ve made the decision to schedule your cataract surgery, the choices have just begun. Gone are the days when surgeons implanted the same type of lens for every patient. New varieties not only replace clouded cataracts, but also feature the ability to focus the field of vision from near to far.

These advanced lenses may reduce or eliminate a patient’s need for glasses or contacts after cataract surgery. For example, the ReSTOR and Tecnis Multifocal lenses provide a full range of vision, using a special surface design that brings close and distant objects into focus without eye muscle assistance. The Crystalens performs this same function by using your eye’s natural muscle.

To learn more about cataract surgery, schedule an appointment with Dr. Pamel at his Manhattan or Astoria office by contacting Pamel Vision & Laser Group today.

These plastic implants, originally designed only to efficiently imitate the eye’s natural lenses, now provide capabilities that transcend the limitations of the cataract-clouded lenses they replace. New IOLs allow patients to reduce and even eliminate reliance on prescription lenses. Below, experienced Manhattan and Astoria ophthalmologist Dr. Gregory Pamel explores the exciting new world of IOL choices.

Beyond Monofocal

Multifocal IOLs represent the most dramatic improvement in IOL technology. As the name suggests, these lenses are able to focus on objects at various distances. Most offer two set fields of vision, but a new trifocal option allows clear vision at near, far and intermediate distances. Patients who receive these new trifocal IOLs can read a book, watch TV and look up to enjoy a sunset, all with the same permanent and resilient implanted lenses.

Among the many choices are the ReSTOR and Tecnis Multifocal lenses that bring close and distant objects into focus without eye muscle assistance. Crystalens provides this same full range of vision by using your eye’s natural muscle. The Visian Toric Implantable Collamer Lens is the first implantable lens that corrects for myopia and astigmatism at the same time.

One of the most impressive innovations is the AcrySof IQ PanOptix intraocular lens. It is the first IOL to offer trifocal vision, providing clear focus at near, intermediate and far distances. PanOptix works by splitting light into three focal points: The intermediate focal point for these exceptional lenses is 60 cm, which is within the optimal range for performing tasks using digital screens. This is more practical than the 80 cm focal point used by some other lenses. The near vision focal point is 40 cm, an ideal distance for reading and other close-range tasks. The third focal point is infinity, allowing clear, panoramic views of the world around you.

Sharper Image

Although adults who needed glasses or contacts before cataract surgery may not achieve 20/20 vision with these advanced IOLs, almost all patients who receive these lenses will see a real improvement in their vision. An estimated 80 percent of advanced IOL patients will have no need to rely on glasses or contacts, and nearly all will be able to pass a driver’s license exam without corrective lenses. In addition, the vast majority will not need reading glasses.

To learn more about IOL innovations, schedule an appointment with Dr. Pamel at his Manhattan or Astoria office by contacting Pamel Vision & Laser Group today.