David Litoff, MD.

According to the Centers for Disease Control and Prevention (CDC), more than one million cataract surgeries are performed each year and more than half of Americans over the age of 80 are living with cataracts. Cataract is the leading cause of vision loss in the U.S., as well as the leading cause of blindness worldwide, the CDC said. Cataract surgery is one of the most common operations in the U.S.—an average of 4 million cataract surgeries are performed in this country every year, according to the American Academy of Ophthalmology (AAO).

VMAIL Weekend recently sat down with Dr. David Litoff, a corneal specialist and surgeon specializing in both cataract surgery and refractive surgery. Dr. Litoff is the chief medical officer of ICON Eyecare, located in the Front Range/Greater Denver area of Colorado, and is a Diplomate with the American Board of Ophthalmology and National Board of Medical Examiners.

Here’s what he had to say about the early signs of cataract, how patients can protect themselves from developing cataracts and what's involved in cataract surgery and choosing the right IOL.

Question 1: What are the early signs of cataracts and what can patients do to protect themselves from developing the disease in the first place?

Early signs of cataracts are blurred or cloudy vision, increased sensitivity to glare, decreased night vision and frequent changes in eyeglasses or contact lens prescription. I have heard that glare with night driving is one of the first things that people notice with cataracts.

Cataracts develop in everyone as they get older. Genetics play a role in the development of cataracts, however, there are some preventive measures that one can take to help protect against cataracts. Wearing sunglasses can help protect your eyes from UV radiation and can help prevent cataract formation.

Smoking has been linked to an increased risk of cataracts and is another factor that contributes to cataract formation. Maintaining a healthy diet also helps eye health. Managing any chronic conditions can also help decrease cataract formation. Diabetes is one condition that contributes to cataract formation so controlling your blood sugar may help prevent cataract formation.

Lastly, some medications have been associated with cataract formation—steroids are the medication most strongly linked to cataracts.

Question 2: What is the profile of a typical cataract patient and how much does a family history of the disease play into one’s chances of developing cataract?

Aging is the primary cause of most cataracts, as one gets older the chance of cataract formation increases. In my practice, the typical cataract patient is in their 60s and 70s and has noted a progressive decrease in their vision. Genetics play a role in developing cataracts and it is not uncommon to hear that the patient has relatives that have had cataract surgery.

Question 3: Are you seeing younger patients presenting with cataracts?

Cataracts are primarily caused by the natural aging process of the eye and other underlying factors such as genetics, exposure to UV light, eye injuries or certain medications.

Cataracts are commonly associated with aging and the risk of developing cataracts increases as we get older. However, I do see cataracts in younger patients. The occurrence of cataracts in younger patients can be due to a variety of factors including congenital cataracts, secondary to trauma, secondary to certain medical conditions such as diabetes, and lifestyle factors such as smoking and poor nutrition. I have noticed that cataracts are appearing in younger individuals.

Question 4: What advice can you give our readers for identifying and treating patients with cataracts? And since early detection is key, how can ECPs encourage high-risk patients to get screened on a regular basis?

Cataracts can appear at all ages, so it is important to think about cataracts in everyone. Performing a comprehensive eye exam can help detect the presence and severity of cataracts. Dilating the pupil can provide a clearer view of the lens and aid in the diagnosis of cataracts.

Educating patients is important on what cataracts are and how they can impact their vision. Providing information about available treatment options and lifestyle modifications can help slow down the progression of cataracts. ECPs should consider a referral for surgery when the cataracts start to interfere with the patient’s daily activities.

Question 5: Can you talk a little bit about what's involved in cataract surgery and what's the process for choosing the right IOL?

Cataract surgery involves outpatient surgery generally with topical anesthesia and some mild sedation. The procedure can usually be performed in under 10 to 15 minutes. The recovery is usually very quick with patients often noting improvement in their vision within 24 to 48 hours.

The choice of the intraocular lens is a process that involves several factors including the patient’s visual needs, lifestyle, ocular health and any pre-existing refractive errors. There are several different types of IOLs available including Monofocal, Toric, Extended depth of focus, Multifocal, and Light adjustable IOLs. It is important to discuss the different options with the patient and explain the benefits, risks and potential trade-offs with each option.


Prevent Blindness Shines the Spotlight on Cataract Awareness

Prevent Blindness, the nation’s leading nonprofit eye health and safety organization, has once again declared June as Cataract Awareness Month in an effort to provide patients, care partners and professionals with information on topics related to types of cataract, risk factors, symptoms, cataract surgery and available financial assistance resources.

In the video above, Prevent Blindness features the “Understanding Cataract” episode of its “Focus on Eye Health Expert Series.” Prevent Blindness president and CEO Jeff Todd discusses cataract and cataract surgery with Albert Cheung, MD, Cataract, Cornea, Anterior Segment Specialist with Virginia Eye Consultants and assistant professor at Eastern Virginia Medical School, Department of Ophthalmology.

The group offers a dedicated web resource at PreventBlindness.org/cataract, and free materials in English and Spanish, such as fact sheets and social media graphics. Read more about the organization’s efforts in the fight against cataracts in the feature titled Prevent Blindness Declares June as Cataract Awareness Month, Providing Educational Resources on Eye Disease that Affects Millions.

And for a look at how ECPs across the country are stepping up to spread awareness of cataracts through online and in-person initiatives, check out this story, Indies’ Ideas for Cataract Awareness Month, from VM’s most recent edition of The Independent Eye.