Cataract

What are the symptoms of cataracts?

Early on, it is quite possible to have a cataract and yet be symptom-free. With time, you may develop some or all of the following symptoms:

• Increasingly blurred vision for distance
• The edges of objects becoming increasingly indistinct
• Glare in sunlight
• Glare from the headlights of oncoming cars
• Rapid change in prescription of glasses and contact lenses
• Alternatively, it may be that your optician or optometrist is the first to notice a change in your glasses prescription and may recommend cataract surgery.

Causes of cataract

• Age
• Diabetes
• Inflammation
• Injury or trauma to the eye
• Ultraviolet light damage
• Steroids either taken orally or as a drop
• Familial causes

What treatments are available?

If you haven’t changed your glasses for a long time, we may recommend that you simply update your current glasses prescription.

Surgery

Not all people who are symptomatic require surgery. However, there are a number of surgical options available, if you chose to proceed with surgery:

• Monofocal Lens implantation
• Monofocal lens implantation with blended vision
• Multifocal lens implantation

Your cataract is removed and a new permanent artificial lens is implanted inside the eye.
The focal length after surgery  is usually set for distance vision. As a result, one would enjoy good vision for distance without glasses but would need glasses to help focus at intermediate distances, for example when working on a laptop or reading.

Some people, for example those who are highly short sighted, choose monofocal lens implantation but prefer to be left so that they can continue to read at short distances without glasses (i.e. myopic). In this case, one would need to wear glasses for computer use and for distance vision.

Premium Intraocular lenses

Some individuals wish to be left spectacle independent following surgery

This can be achieved with a variety of specialist premium lenses which include extended focus lenses, multifocal lens implants and planning for surgery with blended vision.

Monovision with blended vision

With blended vision, cataract surgery is undertaken with monofocal lens implantation in either eye.

One eye is set for near vision and the dominant eye is set for distance. The aim is to help the individual become spectacle independent after cataract surgery.

Multifocal lens implantation

In some instances, patient can undergo cataract surgery with implantation of a multifocal lens implant. There are a variety of such implants available to suit each individual. The intention is to render the individual with good distance, intermediate and reading vision.

Multifocal lens implantation is most effective when undertaken in both eyes.

The cataract surgery procedure

Having had your consultation, it is important to decide what type of cataract surgery suits you best.
Once a final decision has been made, a pre-operative assessment is conducted and a date for cataract surgery that suits you is organised.

What to expect on the day of surgery

It’s a good idea to come with a friend or relative, bring sunglasses and organise a taxi or someone to take you home. Ideally, avoid wearing make up on the day. Once in the clinic or ward, our nurse will admit you, dialte your pupils, discuss your after-care and prepare you for theatre.

We ask you to bring your signed consent form but we will take you through the consent procedure again. It’s a good idea to assume you will spend 2 to 3 hours in the hospital in total. Your cataract surgery itself will roughly take 20 – 30 minutes but some procedures can take longer.

Immediately after surgery

You may be able to see very well immediately after surgery but equally your vision may be blurred for 48 to 72 hours. This is often because the pupils remain dilated following surgery.

Driving

We advise that you refrain from driving for at least 48 to 72 hours after surgery. This will also depend upon your driving vision in your fellow unoperated eye. It is best to discuss driving options with your surgeon prior to surgery.

Travel

We review most patients the day after surgery and again two weeks following surgery. Depending on the individual, it would be sensible to defer flying for one week following surgery.

Working after surgery

Most people can resume work within a couple of weeks following surgery. Please discuss this with your surgeon

Risks of surgery

Cataract surgery is safe and effective  and is associated with a very small risk of complications. The potential risks of surgery include tearing of the capsular bag, infection or bleeding, retinal detachment, loss of vision 0.1%. Your individual risk will be discussed with you at your consultation.

Posterior Capsular Opacification (PCO)

This occurs in a small percentage of patients within a few years, following cataract surgery. PCO involves some clouding of the back of the natural bag that houses the new lens implant. Symptoms can include blurred vision and glare. This is easily treated with laser treatment. This is conducted in clinic, is safe and effective. It is usually a one off treatment.