What are cataracts?
In a healthy eye the lens is clear or transparent. Cataracts are when the lens becomes cloudy, stopping light from reaching the back of the eye, which in turn causes blurred or reduced vision.
Over time cataracts can become worse and your vision gradually gets cloudier. A simple procedure can be carried out to remove the cloudy lens and replace it with an artificial one, this normally allows you to regain good vision once again.
What causes cataract?
Cataracts cannot be delayed or prevented and are very much a normal part of growing older, however there are some other causes such as:
Other eye conditions and previous eye surgery
Injury to the eye
Certain medications such as steroids
There are other factors which may cause cataract such as:
Having a poor diet, with the lack of specific vitamins and minerals.
Exposure to sunlight
Symptoms of having a cataract
Although cataracts tend to develop in both eyes then can affect one eye more than the other causing a difference between them. Symptoms vary among people but there are some common complaints like, general clouding of vision, things being “washed out” and you may struggle to carry out normal tasks such as reading smaller print. You also might find colours not being as bright and things may appear slightly yellow. Another common complaint is struggling with bright lights (glare), either with low sunlight or oncoming car headlights.
The only effective treatment for cataracts is surgery to remove the cloudy lens and replace it with a artificial lens implant. (Types of lens implant) This is carried out by highly trained eye specialists (ophthalmologists) at a hospital or clinic. Cataracts can be removed at any stage and don’t need to be “ripe” as they used to several years ago. As with any surgery there is a small risk so it is often advised to wait until you are having some problems with your vision before going ahead. This can be discussed in detail with your ophthalmologist or optometrist who will advise you on the options as circumstances can vary from person to person.
Once you decide you are ready for an assessment you can be referred into the clinic to meet with one of the surgeons. You will be asked various questions about your eye and medical history and a detailed assessment of your vision and eyes will be carried out. Some drops will be used to widen your pupils, giving the surgeon a larger window to look through (with a slit lamp / microscope) allowing them to check the overall health of your eyes. An ophthalmic nurse will measure the length and curvature of your eyes to help identify what size of lens implant is best suited to you. The assessment should be a relaxed time for questions to be answered, allowing you to go home and consider what options are available. Your surgeon will normally suggest you have cataracts removed one at a time, usually the worse one first.
Types of lens implants
Where possible our surgeons aim to customise your cataract surgery specific to your eyes and lifestyle. A part of this decision process is choosing the most appropriate lens implant. There are many on the market but can be placed in the following categories;
Monofocal lens implants
These are fixed strength lenses that are set for a certain level of vision. This is normally set for distance with glasses being required for near tasks such as reading. These lenses don’t correct significant astigmatism, so if you suffer from this then glasses or contact lenses may be needed afterwards for all levels of vision
In some cases you can deliberately aim for good distance vision in one eye and useful near vision in the other, trying to reduce the need for glasses at all levels. Your optometrist and surgeon can advise if this is possible and may require you to have a trial of contact lenses first to simulate this scenario.
Toric lens implants (for atigmatism)
These lens are made from the same material as the monofocal lenses but are used to correct corneal astigmatism. The aim is to reduce the need for glasses for distance but you would still need glasses of reading. Toric lenses may not suitable if you have other eye conditions. These lenses are not commonly available on the NHS
Multifocal lens implants
These lenses aim to allow you to see at several distances without wearing glasses and are becoming increasingly popular. There is however a level of compromise with some patients reporting mild halo around lights and some reduction in the contrast of vision. These lenses may not be suitable if you have other eye conditions. They are also not commonly available on the NHS.
Cataract surgery is a reasonably straightforward procedure that takes around 30 mins. It is most commonly carried out as a day procedure under Local Anaesthetic, however options of sedation and General Anaesthesia can be discussed if you are anxious about having the surgery.
You will asked to lie relatively flat and once you are comfortable and the eye is numb, a very small cut is made on the surface of the eye. A probe using ultrasound energy breaks up the cataract into small pieces, which is then removed through a small tube. The new lens implant is then inserted.
Your eye will be covered with a protective pad or shield and you will be allowed to rest before going home.The nursing staff will run through the recommended advice following your procedure, including how and when to use your drops and what symptoms to look out for. Your surgeon may wish to check your eye within the first week or so, and you will also be required to visit your own optometrist around 4-6 weeks afterwards.
Most people’s eye sight will improve quite soon after surgery, although it may take several weeks for things to settle down and your vision may be out of focus during this time