A focus on cataracts
A cataract is common, easily diagnosed, and highly treatable. And its success rate makes cataract treatment the UK's most common surgical procedure
What is a cataract?
A cataract is a common clouding of the lens that can affect vision in older people, although there are certain types that affect younger people as well.
Cataracts in old age are extremely common – some 300,000 procedures to treat them take place in the UK every year, making it the country’s most regularly performed operation. In fact, cataracts are the cause of some form of visual impairment for most people aged over 65 in the UK.
It's worth taking a minute to understand what a cataract is, what its symptoms are and how to treat it. Whether for your own benefit or for an elderly relative, this is particularly appropriate as June is Cataract Awareness Month for 2016. Throughout the month, people are especially encouraged to have their eyes tested for signs of cataracts and other potentially sight-threatening conditions, like age-related macular degeneration and glaucoma.
What causes cataracts?
Your lens is a clear disc, made of water and protein that focuses light on to the retina at the back of the eye to ensure the brain receives a clear, sharp visual image. With age, the protein can often start to clump together, creating increasingly opaque obstacles for the light to pass through. This in turn reduces the sharpness of the image reaching the retina, causing your vision gradually to worsen over time.
Although, this is less common, your lens may slowly become yellow or brown. While this doesn't cause as much deterioration in the sharpness of the image, it will make it more difficult to identify and differentiate between blues, blacks and purples.
Warning signs of cataracts to look out for
In the early stages of developing a cataract, the warning signs include blurred vision, faded colours, problems with glare, poor night vision and double vision (sometimes extending to multiple images in one eye). Talk to an eye-care professional if you're worried about any of these symptoms, or if you feel your prescription for spectacles or contact lenses is changing more frequently than you would expect.
There are steps you can take to protect your sight, including wearing sunglasses or a wide-brimmed hat in bright weather, giving up smoking, cutting back on alcohol and eating foods that are packed with antioxidants, like fruit and leafy vegetables.
A professional eye examination can diagnose cataracts
If you are concerned, you should rapidly arrange for a comprehensive eye examination, including a dilated eye exam. This involves the use of eye drops to widen your pupils, allowing your ophthalmologist to study your retina and optic nerve using a magnifying lens.
Cataracts treatment through non-surgical methods
Even if a cataract is diagnosed, it doesn't mean you'll automatically have to have surgery straightaway. Many people benefit from new spectacles, better lighting, antiglare sunglasses or magnifying lenses. But if these do not help, cataract surgery is the next step, especially if your cataract is starting to interfere with day-to-day life.
According to the Royal College of Ophthalmologists, fewer than 2% of patients have any serious, unforeseen complications.
Cataract surgery is safe and effective
It's very important, however, to bear two factors in mind. First, delaying surgery will not cause any long-term damage to your eye. And second, cataract surgery is one of the safest and most effective operations there is – according to the Royal College of Ophthalmologists, fewer than 2 per cent of patients have any serious, unforeseen complications.
Cataract surgery checklist: 9 things to remember
To help you prepare for cataract surgery, we've put together a handy checklist of 9 things to remember before your operation.
Before your surgery, you'll be given plenty of information about what to expect and how to prepare. However, in the weeks leading up to your operation, it can be tricky to remember everything you need to do.
1. Prepare for your pre-surgical appointment
Your pre-surgical appointment is a great time to have any questions you have answered. You should take certain information to this appointment, such as any prescriptions you have and your medical history. You should also make your surgeon aware of any other conditions you may have.
2. Get a good night's sleep
We all know the importance of a good night's sleep, and the night before your cataract surgery is no exception. However, many people will struggle to sleep well the night before so try and relax before going to bed. A decent doze will help you feel more energised and better prepared to take on the next day.
3. Just relax
It's perfectly normal to feel anxious before your operation. If you are feeling worried, try and remember to relax. Simple breathing techniques or meditation can help to ease feelings of nervousness. The risk of complication with cataract surgery is very small and most cataracts are treated successfully1.
4. Avoid alcohol
It's a good idea to avoid drinking alcohol the day or night before your surgery. Not only can alcohol dehydrate your eyes, but it can also interact with certain medications or drops that you'll be given during your procedure.
5. Get a lift
After your surgery, you won't be able to drive for a period of time, so you'll need to arrange for someone to drop you off and pick you up from hospital. You shouldn't drive again until you've had your eyesight checked and you've been given the go ahead. Some people will be able to drive the next day, but for others it may take up to four weeks2.
6. Let your work know
You'll most likely need two weeks off work following cataract surgery. However, the length of time off depends on how well you heal and how you respond to the surgery. Another thing to consider is the type of job you do; for example, if you're exposed to dust, you may need more time off than someone who has an office job.
7. Wear loose clothing
On the day of your surgery, you should wear loose-fitting, comfortable clothes. A blouse or shirt that buttons up at the front is a good idea as you'll need to avoid contact with your eye after the operation. You should also avoid wearing anything that is too tight around the neck.
8. Go makeup free
Make sure to not wear any makeup 24 hours before and on the day of your cataract operation. Any makeup or lotions will need to be removed before your surgery takes place. During your recovery, you shouldn't wear eye makeup for at least four weeks3.
9. Wear sunglasses
After surgery, your eyes will be sensitive to light. Make sure you have some sunglasses to hand as they will help to shield your eyes and keep you protected from the sun during daylight hours.
You can find out more on cataract surgery and what to expect here.
How should I prepare for cataract surgery?
Cataract surgery is one of the most commonly performed procedures in the UK with a very high success rate. The risk of serious complication remains very low. Once you have made the decision to have cataract surgery, there are few things you ought to know to help you through the process.
Your pre surgical appointment is a great opportunity for your surgeon to assess your cataract. At this point it's important to take all relevant information to your appointment; including your previous medical history, a list of medications you are taking and a recent copy of your spectacle prescription. If you suffer from systemic conditions such as high blood pressure or diabetes, your surgeon may refer you to your GP to optimise your medical condition before surgery.
Another important decision to make with your surgeon is the choice of the intraocular lens.. Traditionally, a monofocal lens would be used to achieve clear vision for a fixed focal point. However, with advancing lens technologies patients are now able to be spectacle free for various tasks. These lenses are not suitable for everyone and your surgeon will be able to tell you if you would benefit from a premium lens.
On the night of your surgery you should try and get a good night's sleep as you may be understandably anxious. Make sure to avoid alcohol and follow any pre op instructions you would have been given with your medication and eye drops; especially if you are having your surgery under sedation or general anaesthetic.
You also should organise someone to drive you and pick you up as you will not be able to drive yourself after the surgery. You will also need to inform your employer that you'll be off work for up to two weeks after your surgery.
On the day of the surgery, you should wear loose clothing and no eye makeup as this area will be cleaned to be ready for surgery. You should allow for a few hours for admission, installation of drops, the actual surgery and post op instructions.
Post-surgery you may feel some discomfort. It's a good idea to stock up on food and water before surgery as you may be light sensitive and not want to go food shopping. Your eye will also get sticky post-operation and you'll need access to a clean bowl, gauze and sterile water in the form of cooled boiled water. Sunglasses will be useful if you are trying to go out as the light will bother the operated eye.
Sunglasses will be useful if you are trying to go out as the light will bother the operated eye.
What happens during cataract surgery?
During the operation itself, the natural lens is removed and most often replaced with an artificial 'intraocular' lens or IOL. You will not see or feel the new lens. In some rare cases, patients with another eye disease or problems cannot have an IOL; they might instead be offered soft contact lenses or high-magnification spectacles.
What to expect after cataract surgery
Recovery from the operation is usually rapid. While complications such as retinal detachment are rare, they are serious and need to be referred immediately to an eye-care professional. However, healing is usually complete within eight weeks. Vision might be somewhat blurred for some time following surgery, but one of the factors than can surprise patients the most is the brightness of the colours they experience. Typically, however, they become used to their more colourful world in a matter of months.
If you're worried that you might be starting to suffer from cataracts, or if you simply want to have your eyes examined by a professional, contact us to arrange an appointment with a Circle Health Group ophthalmologist.
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How do I book an appointment?
If you're concerned about symptoms you're experiencing or require further information on this subject, talk to a GP or see an expert consultant at your local Circle Hospital.