Blog

By Kerline Marcelin, M.D. — Hudson Ophthalmology, Cortlandt Manor, NY 10567

In my practice at Hudson Ophthalmology in Cortlandt Manor, one of the most common conversations I have with patients involves explaining what a cataract actually is. Many people come in worried, assuming a cataract is a film growing over the eye or something that needs to be burned off.

The reality is much simpler: a cataract is the natural lens inside your eye becoming cloudy over time. As we age, the clear proteins in that lens clump together, making your vision feel like you are looking through a foggy window. Colors look dull, driving at night becomes stressful because of glare, and fine print gets harder to read.

My primary goal as a cataract surgeon serving Cortlandt Manor, Peekskill, Yorktown Heights, Ossining, Croton on Hudson, and communities throughout northern Westchester and Putnam County is to educate my patients so they feel completely confident and informed about their choices. Here is what I want every patient to understand about modern cataract surgery.

Cataract Surgery Is Quick, Safe, and Everyday Medicine

Cataract surgery is one of the most frequently performed and successful medical procedures in the world. The process itself takes only about 15 to 20 minutes. During the procedure, we gently remove your cloudy natural lens and replace it with a crystal clear artificial lens, called an intraocular lens implant.

You remain comfortable with local numbing drops and light sedation, and most patients are amazed at how quick and painless the entire experience is. Recovery is typically fast, with most people returning to their normal light activities within a day or two.

The Precision of Femtosecond Laser Cataract Surgery

While traditional cataract surgery uses manual instruments to open the lens capsule, modern technology allows us to offer femtosecond laser cataract surgery here in Cortlandt Manor.

Using a computer guided laser, we can create precise micro incisions and soften the cloudy cataract before it is removed. This level of exactness allows us to use significantly less ultrasonic energy inside the eye.

In my experience, the benefits of laser cataract surgery are consistent and meaningful:

• Greater precision and reproducibility than manual instruments alone

• Less physical manipulation of the delicate tissues inside the eye

• Less inflammation and swelling after surgery

• Quicker healing and visual recovery for many patients

There is another point that patients rarely hear about. The laser portion of the procedure is performed at the very beginning of the case, which means several of the most delicate and precise steps are already completed before the rest of the surgery is carried out. That sequence is part of why the technology appeals to me as a surgeon.

What I find remarkable is that patients were asking for this long before it existed. For as long as I have been in practice, people have walked into my office and asked whether their cataract could be removed with a laser. They intuitively understood the benefits of laser precision years before femtosecond laser cataract surgery was ever invented. The request has been steady and consistent, both before the technology arrived and ever since.

In my experience, many of my patients are candidates for femtosecond laser cataract surgery. If this is something you are curious about, ask your surgeon directly whether you are a candidate. I particularly recommend it for patients who are making an investment in a premium lens implant, and for patients who want accurate astigmatism correction, where laser precision is an essential part of the result.

Choosing the Right Lens Implant for Your Life

Replacing your natural lens gives us a unique opportunity to customize how you see the world after surgery. Depending on your visual goals, we can choose specialized lenses designed for your eye shape and your daily routine.

The Basic Monofocal Lens

A standard monofocal lens is set to provide clear vision at one distance, usually far away, so you will typically still need reading glasses for close up tasks. This is the lens that is included with routine cataract surgery, and it is a genuinely good choice for many people.

I find the basic lens is a good option for patients who do not mind wearing glasses for distance and near, for patients without significant astigmatism, for those who are less active, and honestly for those who simply like the way they look in their glasses.

Toric Lens Implants for Astigmatism Correction

Astigmatism is one of my favorite things to correct, and I will tell you why.

Astigmatism comes from an oval shape of the cornea rather than a round one, and it blurs vision at every distance. For many of my patients, astigmatism is the single component standing between them and good long distance vision. Without correction, these patients have to wear glasses just to see across the room, in addition to the reading glasses that nearly everyone their age already needs.

Correcting the astigmatism at the time of cataract surgery changes that. It allows my patients to be in line with the general age population, meaning they can go about their day seeing distance on their own, and reach for a simple pair of over the counter readers for close work, just like their friends and neighbors who only ever needed help with reading.

I enjoy correcting astigmatism with the femtosecond laser, with a toric astigmatism lens implant, or with a combination of both, depending on the eye. For patients who are on the fence about whether to invest in astigmatism correction, this is the option I recommend most often, because the payoff in daily independence is so tangible.

Toric Lens Implants for Astigmatism Correction

Multifocal lens implants are designed with multiple focus zones so you can see at near, intermediate, and far distances. In my experience, patients who choose a multifocal lens end up relying on glasses somewhere between zero and twenty five percent of the time.

Patients frequently ask me whether they will be able to throw their glasses away. I am always honest about this. That is not necessarily true for everyone. What is true is that a predominant amount of your daily activities will be done without glasses.

Some patients truly never pick up a pair again. Others find they want readers in specific situations, such as dim lighting, very small print, or long stretches of sustained continuous reading, especially if they also have dry eyes. Some keep a pair in the glove compartment to sharpen their vision for night driving. All of this is normal, and none of it means the lens is not working.

Is a Multifocal Lens Right for You?

I think of multifocal lens implants as a lifestyle choice more than a medical one. They suit people who move between many different distances throughout the day: fishing, golf, bowling, gardening, cooking, and travel. Cruises are the example I use most often, because you can take in the sunset and the water around you while reading a book in your lap, and never once reach for your glasses.

This is an excellent option for younger, highly active seniors. It is also a thoughtful option for patients who are more forgetful, since it minimizes how much they depend on a pair of glasses they may misplace, and for patients in assisted living or nursing home settings who otherwise rely on those around them for help.

There are patients for whom I do not recommend a multifocal lens, and it is important to be candid about that. Multifocal lenses can produce halos around lights. If you do a predominant amount of nighttime driving, discuss this openly with your surgeon before you decide. Patients who are intolerant of halos, patients who are sensitive to spherical aberration, and patients with other eye conditions causing significant vision loss where the lens simply will not deliver its benefit are all better served by a different choice.

And if you genuinely love your glasses, that is a perfectly good answer too. You will need a different prescription after cataract surgery, but feel free to hold onto your frames. This is a personal choice, not a test you can fail.

What Insurance Covers and What It Does Not

This is a point of confusion for almost every patient, so I want to be very clear about it.

Cataract surgery itself involves removing the cloudy, opacified lens and placing a new standard lens implant in the eye. That is what medical insurance covers.

Femtosecond laser cataract surgery and premium lens implants, including toric and multifocal lenses, are considered refractive surgery. They are elective enhancements that go beyond the cataract procedure itself, and they are not covered by insurance. Patients with a health savings account can often apply funds they have already set aside toward these options, and our office is happy to walk you through the details.

For patients who cannot make up their mind, I always bring the decision back to two questions. How much vision do you want to have independently, without help? And how do you feel about depending on glasses to see? There is no universally correct answer. It is a personal decision, and your physician should help guide you through it.

That is difficult when the surgeon is new to you and does not know who you are.

How I Counsel Patients Before Cataract Surgery

In my practice, I do my own cataract surgery counseling. I do not delegate it to staff members, because there are critical components of this conversation that a patient needs to hear directly from the surgeon who will be operating on their eyes.

During that visit I go over:

• The risks and benefits of cataract surgery

• The full range of lens implant choices and what each one realistically delivers

• Realistic expectations for vision after surgery and during recovery

• The anesthesia being used, which is typically IV sedation rather than general anesthesia

• A careful look at whether enhancements such as femtosecond laser cataract surgery or a premium lens implant would actually benefit you

I do my best to get to know my patients before their cataract surgery, so that I can help them make the right choice for their own lives rather than a generic one.

How I Counsel Patients Before Cataract Surgery

Hudson Ophthalmology is a community based practice, and we know most of our patients personally. Many of them come from right here in Cortlandt Manor and Peekskill, and a great number arrive as referrals from other patients who have been through surgery with us.

We are an independent practice, and that independence shapes how we practice medicine. I regularly receive requests for second opinions on cataracts, both from other physicians and surgeons and from patients who seek us out on their own. Patients often tell me they wanted an opinion from a practice that is not part of a larger optical or corporate network.

Within large multi specialty groups and networks, there can be understandable pressure to keep care inside the organization, or long standing professional relationships that shape where a patient is sent. We have no such arrangements. There are no kickbacks, no bonuses, and no network affiliations attached to the recommendations we make. Our obligation is to our patients, not to our professional relationships.

As an independent practice owner, I am one phone call away. There is no corporate structure or call center standing between us. If you have a question about your cataract surgery, you can be confident that the answer is coming directly from me.

Cataract Surgery for Northern Westchester and Putnam County

Our office sits at 2050 East Main Street, Route 6, in Cortlandt Manor, New York, 10567. That location puts advanced cataract surgery within a short drive of most of northern Westchester and southern Putnam County, and patients regularly tell me the trip is easier than they expected.

Cortlandt Manor and Peekskill (10567, 10566). We are your local practice. Most Peekskill patients reach us in under ten minutes by way of Route 6 or Route 9.

Yorktown Heights, Mohegan Lake, Jefferson Valley, and Shrub Oak (10598, 10547, 10535). A straight run down Route 6 or Route 202. Many of our Yorktown and Mohegan Lake cataract patients have been with the practice for years.

Croton on Hudson, Ossining, Briarcliff Manor, Buchanan, Montrose, and Verplanck (10520, 10562, 10510, 10511, 10548). An easy drive south on Route 9. Croton, Ossining, and Briarcliff Manor patients often come to us for a second opinion on cataract surgery and stay for the surgery itself.

Somers, Mahopac, Putnam Valley, Carmel, and Brewster (10589, 10541, 10579, 10512, 10509). Putnam County patients frequently find that fellowship trained cataract care with premium lens implants and femtosecond laser technology is closer than the options within their own county. Mahopac and Somers patients reach us directly by way of Route 6, and Brewster patients by way of Interstate 84 to the Taconic or Route 6.

Katonah, Bedford, Bedford Hills, Goldens Bridge, North Salem, and Amawalk (10536, 10506, 10507, 10526, 10560). A short trip east on Route 35 or Route 202. Many patients from the Bedford and Katonah area specifically seek out an independent practice rather than one of the larger networks.

Chappaqua, Millwood, Pleasantville, Briarcliff Manor, and Mount Kisco (10514, 10546, 10570, 10549). A straightforward drive by way of the Taconic State Parkway or Route 100. Patients from these communities frequently choose us for premium lens implants and femtosecond laser cataract surgery because the surgeon they meet at the consultation is the surgeon who performs the procedure.

Cold Spring, Garrison, Philipstown, Fort Montgomery, and Highland Falls (10516, 10524, 10922, 10928). Just across the Hudson by way of the Bear Mountain Bridge or Route 9D, and a genuinely scenic drive. Fort Montgomery and Highland Falls patients are often surprised that we are closer than heading south toward Rockland.

If you live in any of these communities and have been putting off a cataract evaluation, distance should not be the reason. Cataract surgery is an outpatient procedure, and most patients need only a handful of visits from consultation through final follow up.

Taking the First Step Toward Clearer Vision

If you notice blurry vision, frequent changes in your eyeglass prescription, or halo rings around headlights when driving at night, a comprehensive cataract evaluation is the best place to start. Cataracts develop slowly, and you do not have to wait until your vision is severely impaired before taking action.

Understanding your eye health empowers you to make the best decisions for your lifestyle. If you have questions about whether laser cataract surgery or a premium lens implant is right for you, we are always here to sit down, examine your eyes, and talk through your options together.

To schedule a cataract evaluation at Hudson Ophthalmology, call our Cortlandt Manor office at (914) 737-6360. We welcome patients from Peekskill, Yorktown Heights, Ossining, Croton on Hudson, Mohegan Lake, Somers, Katonah, Mahopac, Brewster, Cold Spring, Fort Montgomery, and throughout the Hudson Valley. You will be speaking with a practice that knows you by name.