Understanding Cataracts and Your Treatment Options

Cataracts are a common condition and a natural part of ageing. The lens in your eye helps you see clearly by focusing light. A cataract occurs when this lens becomes cloudy, usually due to ageing. This cloudiness can blur your vision or change your eye’s focus. The term cataract originates from the Latin word cataracta, meaning “waterfall,” reflecting how vision with cataracts may feel like looking through falling water.

Cataracts can also develop due to other factors, such as trauma, certain medications, such as orally taken steroids over long periods, and underlying medical conditions like diabetes. While ageing is the most common cause, understanding these additional risk factors can help you take preventive steps to safeguard your vision.

What Are the Benefits of Cataract Surgery?

Cataract surgery offers significant benefits, including improved vision and improved quality of life. The surgery restores clarity by replacing the cloudy lens with a clear artificial one, allowing you to see the world more vividly.  Many patients report life-changing improvements in their ability to read, drive, and enjoy daily activities.

In addition to improving vision, cataract surgery can reduce glare, improve depth perception, and enhance the ability to perceive colours.  This enhanced clarity of vision can make daily activities safer, particularly driving at night or in bright sunlight. 

Are There Any Alternatives?

In the early stages of cataracts, symptoms can often be managed with temporary measures:

• New Glasses: Updated prescriptions may help improve vision.
• Magnifying Aids: Useful for reading small print or detailed tasks.
• Anti-Glare Coatings: May help reduce sensitivity to bright lights, particularly when driving.
• Improved Lighting: Bright, focused lights can make reading and working easier.

These solutions are effective only temporarily. As cataracts progress and significantly affect vision, surgery becomes the most effective option. 

When Should I Consider Cataract Surgery?

Cataracts do not generally harm the eye, but they worsen over time.  One should consider surgery when reduced vision impacts life quality and daily activities and hobbies. For example, blurred vision may interfere with reading, sewing, watching television, or driving safely. These lifestyle challenges often signal that it’s time to explore surgical options.

While delaying surgery is not immediately harmful, untreated cataracts can eventually lead to severe vision impairment. It’s essential to have regular eye exams to monitor cataract progression and discuss when surgery is right for you.

What Does Cataract Surgery Involve?

Before the Surgery

Your journey begins with an initial consultation. During this visit:

• We will perform an in-depth examination of your eyes using dilating eye drops to check the severity of your cataracts.
• Necessary scans will determine if surgery is appropriate, the best type of lens implant, and the type of anaesthesia to be used.
• Our team will answer any questions or concerns you may have.

We will also discuss different types of intraocular lenses (IOLs) available, such as mono-focal, toric, or extended depth of focus (EDOF) lenses, and their benefits for addressing specific vision needs:

• Monofocal Lenses: These lenses provide clear vision at a single fixed distance, typically for distance vision. You may still need glasses for reading or close-up tasks. Monofocal lenses are the most common type covered by most insurance plans.
• Toric Lenses: Designed for patients with astigmatism, toric lenses correct uneven curvature in the cornea, ensuring sharper vision without the need for additional corrective lenses. These are particularly beneficial for those who previously relied on specialised glasses or contact lenses.
• Extended Depth of Focus (EDOF) Lenses: These advanced lenses provide a continuous range of vision, particularly from distance to intermediate tasks, such as using a computer or cooking. While they may still require glasses for very close work, EDOF lenses are an excellent option for individuals seeking greater visual freedom and clarity across various activities.

We will help you understand the differences between these lenses and guide in selecting the one that best suits your lifestyle, vision goals, and medical needs.

On the Day of Surgery

Cataract surgery is a quick, modern procedure performed using a technique called phacoemulsification:

• A small incision is made in the eye.
• An ultrasound probe is used to break the cloudy lens into tiny pieces, which are gently removed.
• A new, clear artificial lens (intraocular lens, or IOL) is implanted.
• The procedure typically takes 15–20 minutes and is performed under local anaesthesia.

You will be fully awake during the procedure. The surgery is generally painless, and most patients experience only mild discomfort, if any. Some individuals cannot tolerate cataract surgery under local anaesthesia, and in such circumstances, it can be done under general anaesthesia. 

After the Surgery

• After the operation, you’ll recover briefly in our recovery area. Most patients can return home after a few hours, though some may require an overnight stay.
• Vision usually starts to improve the next day, although, for some patients, it may take a little longer.
• Recovery is quick, and you’ll be given instructions on how to care for your eye, including using prescribed eye drops for about four weeks.

We will schedule follow-up appointments to monitor your progress and ensure your eye is healing properly.

Post-Surgery Precautions

• You cannot drive immediately after surgery, so arrange transport home.
• Avoid rubbing or pressing on your eye and protect it from dust and water.
• Avoid vigorous activities, swimming, or lifting heavy objects until your surgeon gives the go-ahead.
• Your healthcare team is always available to address concerns, ensuring a smooth recovery process.

Returning to Normal Activities

• Do not drive, operate machinery, cook, or engage in potentially hazardous activities until your eyes are tested. 
• Avoid signing legal documents or consuming alcohol for 24 hours.
• Avoid swimming or lifting heavy objects until cleared by your surgeon.
• Regular exercise is encouraged, but consult your healthcare team before resuming intense physical activity.
• Most patients return to their routine activities shortly after surgery. However, proper eye care, including regular use of prescribed eye drops, is essential to reduce the risk of complications.

After surgery, it’s normal for colours to appear brighter. This is a sign that the cataract’s dulling effect has been removed. Wearing sunglasses for a few days can help ease the adjustment. However, if you are colour-blind, the surgery will not alter your perception of colours, providing reassurance and relieving any anxiety.

What Are the Risks of Cataract Surgery?

Cataract surgery is highly successful, with a proven safety and effectiveness track record. It carries some risks like any procedure, but most complications are rare and treatable, ensuring your confidence and security.

Common but Minor Risks:

• Clouding of the Lens Capsule (1 in 10): The artificial lens’s capsule may become cloudy over time. This is treatable with a simple laser procedure called YAG capsulotomy.
• Corneal Abrasion (1 in 10): A surface scratch on the eye that is effectively treated with antibiotic drops.

Rare but Serious Risks:

• Infection (1 in 1,000): Redness, pain, and blurred vision within a week require immediate attention.
• Bleeding: While minor bleeding is normal, severe symptoms should be reported.
• Tear in the Lens Capsule (1 in 400): This may lead to additional procedures to remove lens fragments.
• Severe Bleeding Inside the Eye (2 in 10,000): Extremely rare but may result in vision loss.
• Retinal Detachment (1 in 300 after seven years): Symptoms include floaters, flashes, or shadows in your vision. Seek immediate help if these occur.
• Cystoid Macular Oedema (fewer than 2 in 100): Swelling in the retina’s central area, treatable with anti-inflammatory drops or steroids.

Understanding these risks can help you make an informed decision about your care. Rest assured, our experienced team takes every precaution to minimise risks and ensure the best possible outcome.

Have Questions?

If you have any questions or concerns, please don’t hesitate to contact our healthcare team. We are dedicated to your well-being and are here to support you every step of the way. You can reach us via phone or email during your scheduled follow-up visits. Your comfort and confidence are our top priorities.