Cataract refers to the clouding of all or part of the normally clear, focusing lens of the eye. This results in blurred or distorted vision.
Cataracts most often occur in older people as part of the normal aging process. Occasionally, they may be present at birth; or develop as a result of eye injury, previous eye surgery, illnesses (eg diabetes), or the use of certain medications (most notably steroids).
The most common symptom is painless blurring of vision which worsens gradually. Other symptoms include glare, poor vision in bright light, double vision in one eye, impaired night vision, fading or yellowing of colours, frequent spectacle prescription changes and the need to use brighter light to read.
The rate at which a cataract develops is highly variable, even between the two eyes of the same individual. It is impossible to predict how fast a cataract will progress.
A thorough medical examination by an eye doctor (ophthalmologist) is recommended to diagnose cataracts. You will also be told if there are other reasons for your symptoms.
There is at present no known medication that will prevent cataracts or reverse them once they develop. The only effective treatment for cataracts is their removal through surgery.
Cataract surgery is an elective procedure, performed only when the symptoms are interfering with your lifestyle or work, and preventing you from carrying out your normal daily activities and tasks.
The decision to operate is reached by you and your ophthalmologist together, after an evaluation of your symptoms and visual needs.
Medical advancements have made cataract surgery a painless experience. Only anaesthetic (numbing) eyedrops are used and the whole operation can be carried out in 15-20 minutes without any pain. An anaesthetist will be present to help with some light sedation so that you will be comfortable and relaxed. See Cataract Surgery
If you have cataracts in both eyes, surgery is typically performed on one eye first followed by the second eye a few days or a week later. This is a safer approach as it helps to ensure IOL suitability and accuracy, and that the first eye is smoothly on the road to visual recovery before we operate on the other eye.
Monofocal IOL provides focus at only one distance and a Multifocal IOL provides vision across varying distances. Both come with a Toric version, if required, for correction of astigmatism. Multifocal IOLs are considered premium and involve an additional fee compared with standard Monofocal IOLs. If your eye is suitable for a multifocal lens, they give you the greatest chance to be completely spectacle-free.
- provide vision across varying distances so that you have natural clear vision for distance, mid-distance (intermediate) and near vision. This means you may be totally spectacle free with no need for reading glasses.
- intermediate vision is good and usually better than using monovision technique with monofocal lenses .
After the operation, you will be observed for about 1-2hours in the Day Surgery recovery ward before you go home. There will be a transparent eye shield to protect your operated eye. You may experience mild discomfort and tearing, some photophobia and blurriness because of pupil dilation, vision may be hazy in the first 24 hours. After this time, vision should be fairly clear and will continue to improve over the next few days. You will be given eyedrops to be used for up to a month. A list of post-operative instructions will also be provided. It is important that you use your eyedrops, follow all instructions and come for all post-operative check-ups as advised.
Problems after cataract surgery are rare, but they can occur. You should call your eye doctor immediately if you have unusual pain, severe swelling and redness, loss or sudden deterioration of vision.
Cataracts do not re-appear once they have been removed surgically. However, a condition known as after-cataract (posterior capsule opacification) can develop in about 20% of people several months to years after surgery. This is due to clouding of the back lens capsule that is left intact after phacoemulsification to support the IOL implant. This posterior capsule opacification causes a decrease in vision but is easily treated with a quick and painless laser procedure. Clear vision is then restored and the condition does not recur.
Advances in modern surgical techniques have made cataract surgery highly successful. Benefits include greater clarity of vision, better colour perception, improved contrast sensitivity and the possibility of being completely free of glasses or contact lenses.
Cataract surgery is considered highly successful with favorable outcomes at approximately 98-99%.
However all surgery entails risk, and complications may occur which at worst can result in permanent loss of vision. Possible complications range in severity and include infection (endopthalmitis 0.1%), retinal detachment (0.03%), inflammation and swelling inside the eye, posterior capsule rupture with retention of a fragment of cataract inside the eye, glaucoma, haemorrhage (bleeding), possible worsening of certain eye conditions (such as diabetic retinopathy), and failure to improve vision if other eye diseases are present (such as macular degeneration). Sometimes, these complications may require further treatment or surgery in an attempt to repair them.
Minor side effects include dry eyes or worsening of an existing dry eye condition, night vision glare and haloes, an unwanted image such as a light streak or a crescent of shadow that is seen at the far periphery of vision. These are mostly temporary and will taper off in 3-6 months.