Cataract
What is a cataract?
A cataract is usually part of the ageing process, but it can be caused by other conditions including diabetes and trauma. The cataract usually causes blurred vision, but other symptoms include glare from bright lights (for example, car headlights) or seeing a double image.
What is the treatment?
The treatment for cataracts is surgery to remove the cloudy lens. This is done in an operating theatre with the help of an ultrasound machine. Although some parts of cataract surgery can be done with a laser, there is little evidence so far that this improves results and so it is not widely available on the NHS. This is not an urgent procedure and is usually carried out when the cataract is affecting the patient’s quality of life. You do not need to have surgery just because you have been told you have a cataract. There is always the option to leave things alone. You should only proceed when you feel your eyesight has become bad enough to justify having an operation. This may vary according to your lifestyle, occupation, or hobbies.
What happens during cataract surgery?
During surgery a small incision is made into the front of the eye through which the cloudy lens is removed. The capsule which contained the cloudy lens is left in place to support the artificial lens, which is then put into the eye through the small incision. Stitches are not usually needed as the incision is so small and seals itself. The operation usually takes around twenty minutes but may take longer. Most patients have this surgery under local anaesthetic. You will be awake, but the anaesthetic will numb your eye. You will not be able to see what is happening, but you will be aware of bright lights. You may also feel some movement and pressure, as well as cold water around the eye from time to time. You should not feel any pain, but you should tell your surgeon if you are in any discomfort.
During your operation, your face will be covered with a drape, so it is important that if you are claustrophobic, you tell someone before the day of surgery.
In some circumstances, sedation or a general anaesthetic is appropriate, and your doctor will discuss this with you if this is the case.
The implanted artificial lens
NHS cataract surgery aims to provide clearer vision, but you are likely to need glasses afterwards for some or all tasks. Your glasses prescription will change after cataract surgery but should usually be a less strong prescription than you needed before.
The artificial lens is a fixed focus lens, usually made of acrylic. This lens will normally last a lifetime.
The focus of the lens will be chosen for your needs and your surgeon will discuss this with you. Although we take great care to measure the eye accurately and perform precise calculations based on these, we cannot guarantee a specific outcome in terms of what kind of glasses you will need after cataract surgery. You may still need distance and reading glasses after the procedure.
Variable focus lenses and toric lenses, which are specially shaped to correct astigmatism, are available privately. The benefit of these is to reduce your need to wear glasses. If this is something you might be interested in, you may choose to explore this in the private sector.
How long will I need to stay in hospital for?
Most cataract operations are carried out as a day case, which means you will not have to stay in overnight. You will be in the hospital for up to six hours. If you have a general anaesthetic you may have to stay in hospital overnight, particularly if you live alone.
