What is a cataract?
A cataract is a clouding of the lens of the eye. The lens should normally appear clear but if you develop a cataract the lens becomes opaque like frosted glass. A cataract is a gradual change in the lens which interferes with your vision making it gradually more cloudy. There are other ways that your sight may be affected:
Blurred vision - your sight may become blurred or misty, this is common.
Light - you may find that light dazzles your vision. You may notice this at night from headlamps or in bright sunlight.
Colour - you may notice that your colour vision is less vivid than it was and appears faded.
Cataracts can form at any age but are more common as people get older.
Treatment
Altering your glasses may improve your vision; however, the most effective form of treatment for a cataract is an operation. The lens of the eye focuses light on the back of the eye which in turn forms an image. During the operation the cloudy lens is removed and replaced with a new plastic one. The correct term for cataract surgery is Phacoemulsification.
Sometimes the cataract is newly formed and may not be affecting your vision greatly. If this is the case your optician will advise you to return for another check up in a few months or a year to monitor the affect on your vision. If the cataract is developed, your optician will advise you that you require surgery.
You will be referred to the hospital for an assessment prior to surgery; the assessment will include a number of tests on your eye and a discussion regarding your general health and fitness for surgery.
The operation
The vast majority of people have cataract surgery under local anaesthetic, which is administered either via an injection or by using local anaesthetic drops in the eye. Having an operation under local anaesthetic means that you will be awake during the procedure, but will feel nothing in your eye.
The surgeon will explain everything to you and there will be an assistant in the operating theatre to make sure you are comfortable and provide you with support if you require it. You will be asked to lie flat and it is important that you lay still during the operation. The operation usually takes 15 to 20 minutes and is not painful. The surgeon may use stitches to secure the new lens. You will not feel these stitches and they cannot be seen after surgery.
Some patients do require a general anaesthetic. If this is the case they are put to sleep for the duration of the procedure.
What will happen if I decide not to have the operation?
A cataract usually gets slowly worse. Leaving a cataract untreated does not threaten your vision straightaway but it can be very disabling. If it does get worse, your vision will gradually worsen until you have very little vision left.
After the operation
An eye pad or shield will be applied to protect the healing eye from being knocked or rubbed. You will be given some time to recover and will then go home. Many patients report an instant improvement in sight, although you should be aware that healing can take several weeks or months.
You will be given drops to use for a few weeks after the operation. A nurse will teach you how to use the drops. It is important that you do not rub the eye as this may disrupt the healing process. You should also be cautious if out in windy weather in case something blows into your eye.
Patients under the care of ESL in the past have raised questions following cataract surgery. A list of those questions is highlighted below to assist you following the operation.
Problems/Complications
Cataract surgery is a common operation and one of the most successful. Very few patients experience post operative problems or complications.
When you are discharged from hospital you will be given an information leaflet to assist you in your recovery. You will also receive a telephone call from the nursing staff 24-48 hours following the operation to check that you are progressing well.
You should experience minimal pain following the operation; however, if your eye becomes painful and your vision becomes blurred you should contact the hospital for advise. If you have any concerns at any time after the operation please call a member of the nursing team at the hospital for advice on 01473 279 100 or the ESL office 01473 279 145.
Below are some Frequently Asked Questions that you may find useful.
How long before I can drive? This depends on the vision in the other eye. If vision is no worse, and you were driving before the operation, then you should be fine to drive the next day. If not, you must wait until you have been seen post-operatively, and had your vision checked.
How long before I can swim? Usually from 6 weeks after the operation; however, it is best to check with the optometrist at your follow up consultation. It is important that you do not rub your eye.
Will I be able to continue using facial make up? Please do not use face powder for 24 hours prior to surgery. You will be reminded of this at your pre-assessment appointment. Face powders tend to leave debris in the eye, making the surgery more difficult.
I've booked an overseas holiday, can I still fly? If so how soon? Yes you can go on holiday the next day. But you will be required to attend a follow up appointment 4-6 weeks following your surgery.
How soon can I play sport? It depends on the sport but usually the next day is fine. For very physically active sports, i.e. weight lifting or contact sports such as rugby, you should wait for 6 weeks following the operation.
How long will the operation take? The average time is 20 minutes for the anaesthetic to take effect, and 20 minutes for the operation itself.
Do I need somebody to come with me? You will need someone to take you home following the operation; however, during your time at the hospital there will be lots of people at the hospital to look after you. If you wish to bring a friend or relative they will be welcome.
Can I have breakfast before I come? Yes if you are having a local anaesthetic. No if you are having a general anaesthetic - you will be advised of this at pre-assessment.
Do I need to bring anything with me? You will need to bring the eye drops you were given at pre-assessment, and your usual medication. These will be returned to you when you go home.
I've got a cough/cold/flu. Should I still come? No - contact us as soon as possible to rearrange your appointment.
Do I continue to take my tablets? Yes as usual, unless you are told not to at pre-assessment.
What if I don't have anyone to put my drops in at home prior to the surgery, or at home after the operation? You will be taught how to use your drops at the pre-assessment clinic. There is a gadget called an auto dropper that can be used; more information can be provided if needed. As a last resort a district nurse can be organised to assist you in learning how to deliver the drops yourself.
Can I visit my hairdresser? You should wait for two weeks before having a perm, otherwise yes; however, be careful not to rub the affected eye, or to get any irritants near the eye.
Can I get my eye wet during washing, following the operation? You can wash in the usual way but make sure you do not get soap in your eye - this will cause you irritation.
Further Information
If you have any questions or concerns about your care, please contact the nurse in charge at the hospital.
You may also get further information from:
NHS Direct on 0845 46 47 (0845 606 4647 – textphone) and at www.nhsdirect.nhs.uk
Royal College of Ophthalmologists at www.rcophth.ac.uk
Royal National Institute for the Blind on 0845 766 9999 and at www.rnib.org