Understanding Cataracts

A cataract is clouding of the part of your eye called the lens. Your vision becomes blurred because the cataract is like frosted glass, interfering with your sight. It is not a layer of skin that grows over your eye, despite what you may have heard.

If your Optometrist has told you that you have a cataract, don’t be alarmed. Many people over 60 have some cataract and the vast majority can be treated successfully.

How does cataract affect your sight?

Blurry Sight This is very common. You may notice that your sight has become blurred or misty, or that your glasses seem dirty or appear scratched.

Dazzled by light You may be dazzled by lights, such as car headlights and sunlight.

Change of colour vision Your colour may become washed out or faded.

What causes a cataract?

Cataracts can form at any age. Most develop as people get older but we don’t yet know why, although research is being done on a number of possible causes. In younger people, we know that they can result from conditions such as diabetes, certain medications and alongside other longstanding eye problems.

Your Driving Licence

If you are a driver you must reach the visual standard required by the Drivers and Licensing Authority (DVLA), and it may be necessary to have the cataract removed in order to keep your licence. Ask your Optometrist for details.

Cataract Operations

The most effective treatment for cataracts is an operation to remove the clouded lens. Diets or drugs have not been shown to slow or stop the development of cataract.

When should I have the operation?

In the past, eye specialists often waited until the cataract became ‘ripe’ and your vision was very poor before suggesting you had the cataract removed.

Now, with modern surgery, the operation is usually done as soon as your eyesight interferes with your daily life and your ability to read, to work, or to do the things you enjoy. You will probably consider surgery if this is the case.

Pre-Operative Assessment

Before the operation, you and your eye will be carefully checked to decide the details of the operation. This may require a separate visit before the operation.

Close up of eye with contact lens

What happens in the operation?

During the Operation

The lens containing the cataract is removed and replaced with a plastic lens, so that the eye can see clearly after the operation. This plastic lens is called an intraocular lens implant and remains permanently in your eye. A pad or shield will probably be put over your eye to protect it from accidental rubbing and bumping after the operation.

The eye specialist does the operation with the aid of a microscope, through a small incision on the eye. This incision is so small that stitches are usually not necessary.

We want to reassure you that your eye is not taken out of its socket during surgery. The operation is not painful and if stitches are used, they cannot be seen or felt.

Local Anaesthetic

Almost everyone has a local anaesthetic. With a local anaesthetic, you will be awake but will feel nothing in your eye.

Usually, the eye specialist will explain what is happening as the operation goes along, and someone will also be there to hold your hand if you wish and make sure you are comfortable and relaxed. You may vaguely see some movement but no details of the operation.

How long does it take?

The operation often takes about 15-20 minutes, although it can take longer.

After the Operation

Most people notice an instant improvement in sight, although complete healing may take several months. You will be given eye drops for use for up to two months after your operation. It is a good idea to have some help at home, especially if you find it difficult to put your eye drops in.

The eye specialist or nurse at the eye clinic will be able to answer any questions that you may have and advise you when to have an eye check when you can go back to work, drive and fly again.

Most people will have the operation and go home on the same day, and will probably be able to carry on with normal daily activities – but do think about the following:

  1. Avoid rubbing the eye; wear an eye shield if you are a restless sleeper.
  2. Don’t do any very heavy lifting, and avoid strenuous exercise and swimming.
  3. Take care if it is windy, in case anything blows in your eye, although you don’t need to stay indoors.

Possible Problems

Cataract surgery is one of the most successful operations. Fewer than two percent of patients have serious, unforeseen complications. If you have any concerns after the operation ring the eye clinic or the doctor on call in the eye unit.

One of the commonest, and easily correctable, complications is a thickening of the lens casing – the part of the eye that holds the lens in place. This can be easily corrected with laser treatment.