Patient information: Cataract

What is cataract? Cataract is an opacity or clouding of the lens of the eye. The lens is located just behind the pupil and focusses light on the back of eye, where the retina forms an image of the outside world.  When the lens is opaque is degrades the quality of light entering the eye and blurs the vision.  
What causes cataract? The exact cause of cataract is not known but in most cases it is part of the normal aging process. Conditions such as diabetes may cause cataracts to develop earlier in life.  Rare causes include injury, eye surgery, or prolonged use of medications such as steroids.   Childhood cataracts are uncommon.   

What happens if I have cataract? Opticians may pick up a cataract before it causes any visual symptoms, but with time most cataracts progress and eventually affect vision. Patients notice that the clarity of their vision reduces, that colours seem washed out, or bright lights such as car headlamps cause glare.  

Do I need surgery?  When the cataract progresses to the point that it prevents normal vision and affects your quality of life, then that is the most appropriate time to consider surgery.

What does surgery involve? Cataract is one of the commonest eye diseases and most eye surgeons perform cataract surgery. Operations are usually performed under local anaesthesia, meaning that you will be awake, however an injection around the eye ensures that surgery is not painful.   Modern cataract surgery uses an ultrasound (phakoemulsification) to remove the abnormal lens material and the surgeon then inserts a clear artificial lens (intraocular lens) into the eye.  The wound is usually closed without stitches. Surgery takes about 15-45 minutes and is usually very safe and effective; the risk of a serious complication is less than 2%.

What happens after surgery? Most patients have surgery as a daycase and return home the same day.  The next day they remove the pad that covers the eye, and start taking the eyedrops as prescribed.  A plastic shield is used to cover the eye at night for two weeks and a follow-up appointment is arranged for 2-3 weeks after surgery. The eye may feel a bit gritty for a few days or weeks, and the vision is often blurred in the period shortly after surgery.  Importantly, if you have moderate to severe pain in the days or weeks after surgery you should contact the hospital without delay, as although infection is rare, it needs to be treated quickly.   Most patients visit their optician for new spectacles at about 6 -8 weeks after surgery and it is not until this time that the vision reaches its best.  After cataract surgery you should remain under annual review by your optician as in some people a film develops over the lens implant and this can be picked up by the optician.  It requires referrral back to hospital but is very easily treated with a laser.

Any further questions? The Royal College of Ophthalmologists provides a useful patient information sheet that may provide some answers (click here to see), but you should not be afraid to ask the doctors or nurses if you have any questions.

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