What is a cataract?
If you have a cataract the lens is no longer clear but has become cloudy
This is a natural ageing change of the lens that happens to everyone as we get older and pass our 60s. The cloudy lens causes misty, blurred vision and sometimes lots of glare in the sunlight or with night driving due to scattering of the light as it passes through the misty lens.
The first step is to remove the cloudy lens
Cataract surgery is the most commonly performed operation in the UK and one of the most successful. The operation is quick and takes around 10 minutes and is done under a local anaesthetic as a day case procedure, so you only need to spend a short time in the hospital. During the operation we break up the old lens with ultrasound energy and remove the fragments.
After the old, cloudy lens has been removed it is replaced with a new one
A new, artificial, lens is placed in the eye, taking the place of the old lens, this is clear and will allow light to focus at the back of the eye unobstructed. The lens can be different powers to correct sight at the same time for distance, near or both.
The new lens is completely clear and will never go cloudy.
The new lens is clear and does not degrade over time.
What is a cataract?
The lens of the eye that becomes misty, often due to age but sometimes related to other medical conditions or medicines that we take.
If I have a cataract, what do I see?
Things look misty and blurred, difficulty in seeing in the distance and sometimes reading also, glare on bright sunny days and when driving at night headlights cause a lot of glare.
What can be done about it?
The cataract can be removed with a short operation and a new replacement lens implanted which will correct the vision.
What are the benefits?
Vision clears, often vision can be corrected such that glasses are not needed for either distance vision, near vision or for all tasks. Everything looks brighter and more colourful.
Do cataracts need to be ‘ripe’?
No, this is an old fashioned term that used to apply 25 or more years ago when the surgery was done in a very different way, now the outcomes are so good that we can do the surgery when you feel you need the surgery to improve your vision and help your lifestyle.
Am I asleep during the operation?
The majority of patients have the surgery awake, in a short operation that takes around 15 minutes. There is no pain with the operation at all. Some patients can have a general anaesthetic and be asleep but this is usually not needed.
Do I need to stay overnight after the surgery?
No, the operation is quick and usually you can go home within an hour of coming out of the theatre.
Can I see what you are doing in the operation?
No, patients often don’t see anything, or see only colours and shapes in front of their eyes. You can hear what is going on, I will play some music in the background.
What do I do during surgery, can I fall asleep?
Yes you can fall asleep though most people just need to lie still for around 15 minutes, it’s best not to move, cough or talk during the surgery as the head can move.
What are the risks of surgery?
The most important but rarest risk is loss of vision which is extremely rare, in 1 in 1000 cases. The vast majority, around 98% get a dramatic improvement in vision.
What happens after the operation?
Your vision will be very blurred for a few hours as the eye recovers from the anaesthetic and surgery, and you will be asked to wear an eye shield until the next morning, to protect your eye. You will be given eye drops to use for a few weeks to help the eye recover.
How long until I can drive again?
There’s no rule about this, but I recommend leaving things for a week at most. If you can see a number plate at 20m you are safe to drive, with one eye. If the other eye has good vision, you may be able to return to driving straight away.
Do I need to take time off work?
Depending on your job I recommend taking at least a week off work and if you do any heavy lifting or bending forward, then 2 weeks off would be best.
When will I be seen again after the operation?
I will see you 2 weeks after the surgery by which time the vision usually has improved tremendously, it takes 4 weeks to entirely heal and settle down.
Will I need glasses afterwards?
There are a variety of different lenses available to correct the vision in different ways. Most commonly patients choose a monofocal lens which fixes the vision for distance. This means patients can see to watch TV, drive, do most activities beyond an arms length without glasses, but for reading may need glasses. This can be used to correct nearsightedness or farsightedness. It does not however correct astigmatism, which is a condition where the window of the eye is steepened in one direction compared to the other.
Some patients choose to have premium lenses. These lenses can correct astigmatism and some can correct distance, intermediate and near sight with one lens. These lenses have some advantages but it is important to have a detailed discussion about the benefits and risks of these lenses at the consultation.
Why should I have surgery as a private patient?
The biggest benefit is that you choose the surgeon that does your operation, at a time that is convenient for you. Secondly in order to have surgery within the NHS you may have to wait 18 weeks or more to have one eye done, so this may be inconvenient for you. In some areas there are restrictions for patients to be eligible for cataract surgery on the NHS.
Case Studies
Mrs SP 74 year old lady found her vision deteriorating for a year.
The Problems:
- Inability to drive as vision was not meeting legal standards to drive
- Glare from oncoming headlights and low sunlight
- Struggling to read and do hobbies
The Solution:
She sought Mr Qureshi’s opinion and cataracts were identified in both eyes. Surgery was arranged very quickly after an initial consultation. Straight after surgery Mrs SP noted a huge difference in her vision. She noted everything looked brighter and more colourful. She also noted that everything appeared sharper and clearer.
After having both eyes operated on, separated by a few weeks, she reported she had her vision was improved dramatically back to what she was like as a young woman. She did not require glasses for all tasks apart from reading
Mr SJ 65 year old HGV driver
The problems:
- Difficulty reading road signs
- Glare from headlights
- Wore glasses most of his life due to astigmatism
The Solution:
Mr SJ had cataract surgery on both eyes with toric lenses implanted to correct his astigmatism, he no longer needs glasses for nearly all tasks and can drive his lorry confidently. Mr SJ absolutely delighted with the result and for the first time in his life has not needed to wear glasses. He does not need to worry about them when driving or losing them when travelling.
Mrs SGR 57 year old contact lens wearer
The problems:
- Becoming intolerant to her lenses and vision deteriorating
- Struggling to see the PC screen at work
- Unable to wear contact lenses any more as cornea suffering from their use
- Eyes very tired when working as struggling to focus
The Solution:
Mrs SGR had bilateral cataract surgery and trifocal intraocular lenses implanted, these allowed Mrs SGR to work and not need glasses for any tasks at all. She also did not need to wear contact lenses again which allowed the cornea to recover from the damage inflicted by the contact lenses.