Cataracts are a common cause of gradual deterioration of vision and are a normal part of ageing. Some of the symptoms you may experience are:
- Objects are no longer clear.
- Colours appear dull.
- Driving, especially at night, is more difficult.
- You are more sensitive to light and glare.
Fortunately, cataract surgery is one of the most common procedures in the world and The Medical Eye Clinic in Exeter, Devon has highly experienced surgeons to ensure extremely successful outcomes.
We are registered with Bupa and AXA PPP Healthcare.
What is a Cataract?
There is an internal lens which sits inside your eye and focuses light on to your retina. This system provides you with clear vision. A cataract is a normal part of your eye’s ageing and occurs when the structure of this internal lens becomes cloudy. With age, our lens becomes thicker and less transparent resulting in a loss of vision.
The condition is progressive so over time vision will become dull and blurry, similar to looking through a dirty window. A cataract should be treated when it begins to impact on your everyday quality of life.
- Gradual deterioration in the quality of vision.
- Hazy or cloudy vision.
- Faded colour perception.
- Increased sensitivity to bright light.
- Frequent changes to your spectacle prescription.
How are Cataracts treated?
There are no medical treatments to delay or prevent the formation of a cataract. The only option is to remove the cloudy, natural lens and replace it with an artificial, intraocular lens. Once this is done both your vision and your quality of life should improve.
Cataract surgery is one of the most common, safest and the most effective types of surgery in the world. The cloudy natural lens is removed and the artificial intraocular lens is installed via a tiny incision at the edge of the eye. This incision is usually self-sealing, with no stitches required, allowing for a fast and easy recovery.
The entire procedure takes between 15 and 30 minutes and with the use of anaesthetic it is totally pain-free.
What are intraocular lenses?
The intraocular lens is an amazing piece of technology. Made of an acrylic-type material, they mimic the refractive properties of your natural lens, focusing the light on the retina and providing clear vision after surgery. The intraocular lens is inserted during the surgery through a micro incision only about 2mm in size.
At The Medical Eye Clinic, we can accurately calculate the exact power of intraocular lens your eye requires to focus light correctly, often providing fantastic distance vision without glasses. It is normal that with standard intraocular lenses reading glasses may still need to be needed. However, with improved technology we can now supply multi focal lenses by ZEISS, that can also help combat these near vision difficulties as well. We can also supply a specialist “Toric” lens which helps correct the vision of those patients who have astigmatism in their prescription.
What is Cataract Surgery?
Cataract surgery is an operation to remove the cloudy lens and replace it with a clear artificial one. This will allow you to see more clearly. You can have cataracts removed at any stage, you do not need to wait until your eyesight is badly affected. However, the NHS in your area may impose certain criteria that mean cataract surgery may not be available, on the NHS, at the early stages of the problem. You can develop cataracts in one or both eyes.
If you do have cataracts in both eyes it is usually advisable to have surgery performed one eye at a time, beginning with the most severely affected eye.
What are the potential complications?
Modern cataract surgery consistently achieves good outcomes and is amongst the safest operations that are frequently performed today. However, all surgical procedures can have potential complications. It is possible for a cataract operation to leave you worse off than you are now. One person in every 1000 will have a sight threatening problem in that eye as a direct result of the operation. One in 10,000 will lose the eye. There is virtually no risk to the other eye.
The most common specific complications are:
- Complications DURING the operation: Posterior capsule rupture with or without vitreous loss 1 in 100; Dropped nucleus 1 in 500; Suprachoroidal haemorrhage 1 in1000; Bruising of the eye and eyelids.
- Complications AFTER the operation: Corneal decompensation; Detached retina 1:1000; Endophthalmitis (severe intraocular infection) 1:1000; Dislocation of the implant 1:1000; Post-operative raised intraocular pressure; Posterior capsule opacification 30%; Cystoid macular oedema 2%; Refractive surprise 1%; Allergy to post-operative eye drops.
What are the alternatives?
When cataract first develops, a change in glasses prescriptions or other visual aids (e.g. magnifying glass) may help you to see better in the short-term. However, as the cataract advances, glasses and magnifiers will not be able to overcome the deteriorating vision. Surgery to remove the cloudy lens from inside your eye and replace it with a new artificial one is the only way to restore your vision.
Preparing for Cataract Surgery
During your consultation and pre-operative assessment appointment regarding your cataract, your surgeon will:
- Perform a thorough examination of your eyes. This includes measurement of your vision, Biometry readings to take measurements of the size and shape of your eyes, detailed examination of the cataract and the health of the back of your eye (Macula).
- Confirm that the cataract is the cause of your visual symptoms.
- Discuss with you the risks and benefits of surgery.
- Discuss the different types of artificial lens implants available in order to find one that would be best suited for your eye and your lifestyle.
- Certain types of ‘Premium’ artificial lens implants such as Toric, Multifocal and Toric Multifocal are not available on the NHS.
- Your surgeon will discuss with you what will happen before, during and after your procedure and advise you about any pain you might experience. This is your opportunity to understand what will happen, and you can help yourself by preparing questions to ask about the risks, benefits and any alternatives to the procedure. This will help you to be informed, so you can give your consent for the procedure to go ahead.
- You will be given a consent form to take home and read.
- You will be asked to give your consent by signing a consent form on the day of surgery.
What happens during Cataract Surgery
Cataract surgery is usually done as a day case. This means you have the procedure and go home the same day.
The operation usually takes around 30 minutes.
You will have eye drops put in to widen your pupil and relax the muscles in your eye. This makes it easier for your surgeon to examine your eye and remove the lens.
The operation is carried out under eye drops or a Local Anaesthetic given by your surgeon.
Once the anaesthetic has taken effect, your surgeon will place a clean drape over your face. The drape will make a small tent over your face so you can still breathe and speak easily.
A small speculum is used to keep your eye open during surgery. Your surgeon will make tiny cuts on the surface of your eye to carry out the cataract surgery. Although you may see some lights and movements during surgery, you will not be able to see the instruments being used or feel any pain.
Your surgeon will use a special instrument to break up the cloudy lens. You may hear a soft buzzing sound when it is being used. The cataract will be removed from your eye. The new artificial lens is then inserted, where it will remain permanently.
Your surgeon will usually leave your eye to heal naturally without stitches.
What to expect afterwards
After the local anaesthetic, it may take several hours before the feeling comes back into your treated eye. Your eye is covered with a protective pad, which you will need to wear overnight. You may need pain relief to help with any discomfort as the anaesthetic wears off. You will be given a combined steroid and antibiotic eye drops to use at home to help control inflammation and prevent an infection in your eye.
You will usually be able to go home when you feel ready. However, you will need to arrange for someone to drive you home. Try to have a friend or relative stay with you for the first 24 hours.
Recovering from Cataract Surgery
It is important to complete the whole course of the prescribed combined steroid and antibiotic eye drop medication.
If you need pain relief, you can take over-the counter painkillers such as Paracetamol or Ibuprofen. Always read the patient information leaflet that comes with your medicine and if you have any questions ask your pharmacist for advice.
You should start to get feeling back in your eye after a few hours. Your vision should start to improve within a few days, however it may take a number of weeks to heal completely.
There are some important instructions to follow for the first 10 days after cataract surgery. The main ones are listed below:
- Try to avoid touching or rubbing your eye. If you are a restless sleeper you can wear an eye patch at night to protect your eye.
- Try to avoid heavy lifting or strenuous exercise for the first few weeks after the operation, as this can increase the pressure in your eye and could put strain on your healing scar.
- Try to avoid wearing eye make-up, driving or going swimming until your surgeon tells you it’s safe to do so.
- If you go out when it is windy, please protect your eye from grit and dust.
It is not unusual to experience some of the following symptoms in the early days after cataract surgery:
- An itchy or sticky eye
- Mild pain, discomfort and bruising to your eye or eyelid
- Sensitivity to bright light
- Mild blurring of vision that usually returns to normal
However, if you experience any of the following symptoms, please contact The Medical Eye Clinic urgently:
- Severe pain
- Loss of vision
- Redness in your eye that continues to get worse
It usually takes between two and six weeks to make a full recovery from cataract surgery, but this varies between individuals so it is important to follow your surgeon’s advice. A follow-up appointment will be arranged 4–6 weeks after your surgery. Once your eye has healed, you may need to have an eye test and new prescription glasses.