What is a cataract?
If you have a cataract that means that the lens inside your eye which focuses light on the back of the eye is no longer as clear as it should be – rather like having a greasy smudge on your glasses. This results in blurred vision, often worse when driving at night. Over time, months or years, the cataract will become worse and eventually you will no longer be able to drive. If left longer still it will become difficult to read and your vision will become progressively worse eventually resulting in reversible blindness.
What happens during cataract surgery?
During cataract surgery the cloudy lens is removed and a replacement plastic lens is inserted allowing you to see clearly again assuming that the rest of your eye is normal. You need to lie as flat and still as you can for between about 10 and 30 minutes depending on the complexity of the cataract. The operation is a day case procedure and it is usually performed using local anaesthetic drops to numb the eye although very anxious patients or patients who are unable to stay still can have a general anaesthetic so that they are not aware of the procedure. During the procedure you will see coloured lights and hear the noise of the phacoemulsification machine working. There should be no pain although you can feel pressure and pulling on the eye.You can go home shortly after the procedure and will be given eye drops to use for a few weeks after the operation. It is usual to wear a plastic shield over the operated eye at night to prevent pressing on the eye accidentally when asleep for the first week.
Are there any risks to cataract surgery?
All operations have complications but cataract surgery is one of the safest. The vast majority of patients have no problems and are delighted with the results. Serious side effects such as blindness in the operated eye are very rare.
Will I need to wear glasses after cataract surgery?
Some people can manage to see in the distance and up close for reading without glasses after cataract surgery with a monofocal lens implant. However most people will need reading glasses following cataract surgery but may prefer to wear varifocals or bifocal glasses for convenience.It is possible to implant multifocal lenses which are a compromise aimed at getting people out of glasses both when driving and when reading. The multifocal lenses (sometimes called premium lenses) offer the best chance of not needing glasses at all after surgery but this comes at a price. They usually cost a lot more and the quality of the vision may be worse than with a fixed focus lens, glare and halos being particular problems.
How do I choose the best cataract surgeon?
This is not as straight forward a question as it sounds. Cataract surgery is an increasingly safe operation and all consultant eye surgeons should be capable of performing a competent operation. In choosing a surgeon you will therefore need to consider the price, proximity and specialist expertise as well as reputation. For some people going for the cheapest option seems to be the best idea. This is not always the case as many cheap offers include a hard sell of so called premium lenses and hidden costs such as fees for postoperative checks which put together can add thousands to the price. More sensible is to go for an all inclusive package and make sure your consultant surgeon will be easily contactable in case you have any questions or problems after the operation.
Diabetic patients and elderly patients would do well to consider seeing a consultant who specialises in retinal diseases. Wet age related macular degeneration is often misdiagnosed as early cataract by optometrists and GPs who do not have access to Ocular Coherence Tomography retinal imaging systems like the ones used by East Point Consulting Rooms, the private clinic at James Paget University Hospital. Delayed diagnosis can result in permanent severe loss of vision which is largely avoidable with modern treatments and early detection.
Likewise patients with a medical history of uveitis, retinal detachment, glaucoma or corneal disease would be well advised to seek a specialist who regularly treats these conditions in their NHS practice.