Cataracts

Cataracts and cataract operations

What are cataracts?

A cataract is when the eye’s lens develops cloudy patches. Over time, these increase in size, causing blurry vision and eventual blindness.

Our lenses are perfectly clear when we’re young, but as we get older, they become frosted and impede the vision. Cataracts are more common in older adults and will affect daily activities such as driving.

It is also possible for babies and children to suffer with cataracts. Click to read about children’s eye problems.

When should I seek medical advice?

If you have any of the following symptoms, you should seek the advice of an optician in the first instance. They will then either refer you to your GP or a specialist.

• Blurry or misted eyesight.
• Finding it harder to see in low light.
• Find lights too bright.
• Colours appear faded.
• Glasses wearers – you may feel like your glasses need cleaning when they’re not dirty.

You don’t experience any pain with cataracts or notice any redness or irritation except in rare cases of hypermature cataracts.

What are the tests for cataracts?

Your optician will carry out a number of eye tests, including a visual acuity test, which looks at how well you can see at varying distances.

What causes cataracts?

We still don’t exactly know why some people develop cataracts, but here are some things that can increase your risk:

• Family history of cataracts.
• Diabetes.
• Eye injury.
• Smoking.
• Long-term steroid use.
• High alcohol consumption.

What is the treatment for cataracts?

In the early stages, cataracts can be helped with stronger prescription glasses and brighter reading lights. As they deteriorate over time, you will eventually require surgery to remove and replace the affected lens or lenses. This is currently the only proven treatment to be completely effective and is one of the most common surgeries performed in the UK.

This surgery is usually offered by the NHS, or you can opt to have this carried out privately in order to gain a quicker cataract operation date.

What happens during the cataract operation?

Before the surgery, you will be referred to a specialist eye doctor, or ophthalmic surgeon, who will assess your condition. They will carry out a number of tests and take various measurements of your eyes.

This assessment will be the time for you to ask any questions and also for the surgeon to understand the outcomes that you would like. These questions can include:

• Whether you would like your lenses to be near or long sighted (NHS options), or if you would like any existing sight issues to be rectified with multifocal lenses (Private option).
• Any risks and benefits of the surgery.
• Immediate and ongoing aftercare.
• Recovery time.

The operation itself is relatively straightforward and only takes approximately 20 to 30 minutes. It is usually carried out as a day procedure and under local anaesthetic but sedation or general anaesthetic are also an option. During the operation, the surgeon makes a microscopic cut into your eye to remove the affected lens and replace it with an artificial lens implant.

Currently the NHS will only offer a monofocal lens, meaning that you choose to have distance vision. The majority of people who choose monofocal lenses will still need to wear glasses for near tasks, such as reading. If you choose the private option, you will be able to choose either monofocal lenses or a multifocal lens – the multifocal lens allows you to have unaided vision for near, mid-range and distance.

If you have cataracts in both eyes, you will need two operations. These are usually carried out 1 to 2 weeks apart, in order to give the first eye time to heal and for your vision to return.

What are the benefits of having cataract surgery?

Cataract surgery should give you the following benefits;

• See things in focus.
• Not suffer as much glare.
• Be able to look into bright lights.
• Correctly identify different colours.

If you have other eye conditions such as diabetic eye disease or glaucoma, you may still experience limitations to your eyesight, even after successful cataract surgery.

Are there any risks associated with cataract surgery?

Cataract surgery comes with a very low risk of serious complications. Most common complications can be treated with medications or additional surgery.

There is a very small risk (1 in 1000) of permanent loss of vision in the eye that is treated by cataract surgery.

What is the cataract operation recovery procedure and timescale?

You can usually go home on the same day as your cataract operation. You may have to wear a pad and plastic shield over the eye, but this will be removed the next day.

Feeling in your eye should return after a few hours, but it may take a few days for the vision to be fully restored.

The following side effects are very normal and should go away in a few days, but it can take up to 6 weeks to recover fully.

• Watering.
• Blurred or double vision.
• Red/Bloodshot eye.
• A ‘gritty’ feeling.

If you need to order new glasses, you will have to wait until your eye is fully recovered to ensure the prescription is correct.

After the recovery period, you should be able to return to all normal activities.

When should I be worried about side effects?

If you experience any of the following side effects, you should contact your eye surgery department:

• Decreased vision.
• Increased pain and/or redness.
• Increased discharge or stickiness.

What can I do, or not do after my surgery?

In order to aid recovery and ensure the best outcome, it is important to ask your surgeon’s advice on aftercare. This will include such things as:

• Using your eye drops as instructed.
• Rest for the first 2-3 days.
• Use your eye shield at night for at least 1 week.
• Take painkillers if required.
• Wear your eye shield when washing your hair and don’t allow soap or shampoo to get into your eye.
• Read, use electronic devices and watch TV as normal.
• When outdoors use your shield or sunglasses.
• Avoid strenuous exercise or other activities.
• Avoid swimming, usually for 4-6 weeks.
• Don’t drive until given the all-clear.
• Avoid wearing eye make-up for a minimum of 4 weeks.

Depending on your work situation and the circumstances involved with your surgery, your surgeon will advise when you can return to work.

If you have poor vision in your other eye also, it may be a good idea to have someone take care of you until the vision in your treated eye improves.

If you have cataracts and would like to discuss your options for treatment, please contact me.