What is a cataract?

A cataract is a clouding of the lens in the eye that may reduce your vision. The structure of the lens also changes as the cataract develops.

 

There are different types of cataract but the two main types are (1) age- related cataract (the most common) and (2) congenital cataracts (present at birth). The latter are uncommon but important to diagnose early as - if undiagnosed - the eye may not learn to see, which can result in poor vision even if the cataracts are removed later in life.

 

It is not known why age-related cataracts develop but there are certain factors which increase your chances of developing them:

  • Diabetes
  • Smoking
  • Medications - such as long term use of steroids
  • Exposure to ultraviolet light from sunlight (use of sunglasses which block out UVA and UVB rays may help prevent this)
  • Family history of cataracts

 

Symptoms include:

  • Worsening of vision -which may appear cloudy, fuzzy or filmy
  • Spots in your vision
  • Glares and haloes from light
  • Difficulty driving at night
  • Difficulty in differentiating between colours especially shades of blue
  • Double vision
  • Frequent changes in prescription as eyesight worsens
  • Second sight-your close up vision may improve temporarily as the lens changes shape

 

For many people, use of glasses and/or contact lenses are sufficient to improve vision. However, cataracts are likely to worsen over time and so at some point it may be appropriate to consider surgery. Essentially, this means surgically removing the cataract(s) and replacing the cloudy lens with an artificial one. The most common technique being phacoemulsification (small incision surgery).

Who needs cataract surgery?

You do not need to wait until the cataract is "ripe" or "mature" anymore. In fact, you can have surgery as soon as your cataract is interfering with your quality of life. You do not have to have a cataract removed just because it is there, but if it is causing you some problems, for example poor vision when it is bright, or difficulty reading road signs when driving, then it would be reasonable to have it removed.

Cataract surgery

A high frequency ultrasound probe is inserted into the eye through a tiny incision. The probe "mines" out the cataractous lens.

A clear plastic artificial lens is folded up and inserted into the eye through the same tiny incision.

 The lens unfolds within the eye to lie in the same position as the old cataractous lens. The strength of the implant is calculated before the operation to ensure that it will suit your eye. The operation is usually carried out through a tiny cut in the eye that seals without any stitches. We can also treat your astigmatism at the same time, if you wish.

How successful is the surgery?

The operation is one of the most successful operations around, with more than 95% getting an improvement in the vision. Note that you may have other eye disease(s) that may cause the outcome not to be as good as some patients you may have talked to. However, the operation should still give you improved eyesight.

 

What are the risks of the surgery?

Cataract surgery, like any other major operation, carries with it the risk of complications although fortunately serious ones are uncommon. The risk of losing one's vision completely, from infection or haemorrhage at the time of surgery, is extremely rare, affecting about 1 case per 500-1000 procedures. In general terms modern cataract surgery is rightly regarded as being one of the most succesful and safe procedures carried out in hospitals today. 

 

What type of anaesthetic is used?

Most cataract surgery is carried out under local anaesthetic. 

 

How long is the hospital stay?

Most cases can be done as a day case procedure, allowing you to go home on the day of surgery.

 

How long is the recovery period?

Within the first week much of the visual improvement from surgery has already been obtained. The vision may alter slightly over the next four weeks or so, but there is very little change after this. For most people a return to full activity is possible within four weeks of surgery, but it is important to discuss this with your surgeon. It is likely you will have to change your spectacles.

 

What are the do's and don'ts after surgery?

The main thing you should not do after surgery is rub the eye. With modern surgery techniques, bending over, and heavy lifting are not strictly forbidden anymore. Wash your hair with care, making sure that the water does not go into the eye.

 

What can you expect after surgery?

For a few days the eye may feel slightly gritty, but this is usually mild. Painkillers are not usually necessary, but drops are used for a few weeks. The eye may be slightly red, but this usually settles over one to three weeks.

 

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This website exists to provide further information about ocular conditions to patients, and their families, optometrists and GPs.

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