Cataracts: Your Most Common Questions, Answered.

Watch our most recent video, where I answer some of the most commonly asked questions surrounding cataracts, as well as some misconceptions of cataract surgery.

• What is a cataract?
• What are the symptoms of cataract?
• How are cataracts diagnosed?
• How long does cataract surgery take?
• Will I need to stay overnight for cataract surgery?
• When will I be able to see clearly after cataract surgery?
• How much does cataract surgery cost?
• What happens if I have a complication arising from surgery?

“Today we’re going to talk about cataracts, and answer some of the most frequently asked questions that we get asked both in person to me when I’m consulting but also coming through our website and questions that patients often telephone about.

First question and most frequently asked question is…

What is a cataract?

A cataract is a natural ageing change in the lens of the eyes. Most of us will develop cataracts and cataracts start off in life by initially impairing our close vision.

So that sensation that we suffer from or notice in our 40s and 50s where we can’t see up close, things we tend to push further away are the very earliest sign that the lens in our eye is changing.

I have this model to show you which shows you where the lens of the eye is and the lens of the eye is inside the eyeball.

This is a model of it sitting behind the iris which is the coloured portion of the eye and this is the lens that changes in the development of cataract, that lens changes from being crystal clear and transparent, which is the lovely state of the crystalline lens when we are children and growing up as young adults, into a lens that gradually loses colour, transparency and increases scatter of light.

And at that point, when the lens starts impairing our vision, we call that change cataract.

What are the symptoms of cataract?

Well, cataracts can creep up on us, so often we don’t really appreciate that cataract is affecting our eyesight.

We just think we’re not seeing quite so clearly, struggling a little bit to read, noticing a bit more glare when driving at night. But typically, cataracts affect our vision, so they can reduce the contrast of our vision, making it harder to see in low light.

They can increase glare so if we’re looking at a point source of light, for example, oncoming headlights at night or the full moon, often we’ll see some glare around the edge or halo or streaking.

And lastly, of course, we may just not see as clearly, struggling to see subtitles on the television, struggling to see fine detail.

These symptoms, in turn, can lead us to headaches eye strain but more worryingly sometimes loss of enjoyment, loss of our interest in doing things and that’s one of the major drawbacks of the development of cataracts.

How are cataracts diagnosed?

Typically cataracts can be diagnosed by opticians so on a routine sight test if vision is found to be not normal or reduced an optician will typically examine you, have a look into your eyes and can see cataract.

Or, you can approach us directly, we can examine your eyes, dilate your pupils and have a look for cataract there. So cataracts can be seen on routine examination by a specialist.

Cataract surgery has evolved over many, many, many years. Modern cataract surgery really begins its story after the Second World War and there were different types of cataract surgery.

Initially a type of cataract surgery called intracapsular cataract surgery was performed and this was a type of cataract surgery in which the lens of the eye, the cloudy lens of the eye or cataract was removed but another lens was not replaced and you may recall elderly relatives or people who would wander around with very very thick spectacles and these are people who might have had that type of cataract surgery.

So a cataract with no lens resulting in a very strong optical correction and very thick glasses. Intracapsular cataract surgery then made way for extracapsular cataract surgery.

Extracapsular cataract surgery as well as intracapsular cataract surgery involves removing the whole of the lens in one piece. So at the end of the cataract surgery you could actually see the yellow cloudy lens that had been removed.

Later on, modern cataract surgery, really from the 80s, 90s onwards, involves a process called phacoemulsification. Phakos being Greek for lens and emulsification meaning to liquefy. Modern cataract surgery is usually a combination of phacoemulsification with the implantation of an artificial lens.

How long does cataract surgery take?

I’m often asked how long cataract surgery takes. Cataract surgery takes me about 15 or 20 minutes. During that time most people are awake.

I can talk to you so I will guide you through the procedure and you would be looking at a light, experiencing blurry vision, blurry movement and some pressure sensations.

But 15 minutes is about average for a cataract surgery procedure. We often offer cataract surgery to both eyes at the same sitting. And so when one surgery is complete, provided that you’re comfortable and happy, we will then proceed with the second eye surgery. And so the whole of that procedure will take around half an hour.

Will I need to stay overnight for cataract surgery?

We’re often asked whether an overnight stay is required in hospital after cataract surgery. And you’ll be pleased to learn that this isn’t the case.

So almost all of our procedures are performed as day case surgery procedures which means you’ll come into hospital or the clinic on the day of surgery, undergo the procedure, be in the theatre for around half an hour and then as soon as you’re ready to leave afterwards you’re free to do so.

The next group of questions I’m often asked is about recovery and returning to normal activity.

When will I be able to see clearly after cataract surgery?

You will be able to see as soon as you sit up after the operation has been completed. So we expect the return of vision to be immediate.

You will have just undergone a surgical procedure and you will have large dilated pupils. So everything looks a bit blurry and a little bit hazy, but you will be able to see immediately. Certainly well enough to navigate and walk.

Some hours after the procedure, as the pupils start to come down, vision becomes clearer. When you leave the hospital, we usually ask patients to wear a clear or transparent protective shield or sunglasses but vision is still pretty good at this stage.

Within a day or two, particularly as the pupils start to come down, vision starts to become much clearer and and more stable. And we expect most people to be able to return to driving, for example, within that first week of surgery.

What about other activities? Bending over to pick things up, walking, exercise. Again, most activities can be resumed fairly quickly.

You can bend over and pick things up, but we don’t want you to lift heavy weights, usually for around a week after surgery. Exercise after a few days, but gentle exercise. And most importantly, we want you to avoid trauma or injuring your eye.

How much does cataract surgery cost?

Cataract surgery is covered by most medical insurers and we accept most medical insurers. So if you are an insured patient, you should not have a problem the cost of cataract surgery.

Some insurers will not cover the full price of surgery, but again, our office can talk you through that and help you speak with your insurer.

If you are self-paying you can pay for cataract surgery all in one go but cataract surgery can also be paid for with interest-free credit and that typically lasts over a 10 month period.

Credit can be arranged for cataract for longer than 10 months so it can make cataract surgery really quite affordable.

Speak to our office who can help guide you through all of the various payment options for surgery.

What happens if I have a complication arising from surgery?

Our hospitals run 24/7, 365 days of the year and we will provide you with telephone numbers in hours and out of hours so that you can contact us at any time.

Emergency out-of-hour numbers are available so again you can pick up the phone and ask us anything at any time.

Complications themselves are rare. Major sight-threatening complications are very rare, one in many, many thousands.

Unfortunately, in eye surgery, when surgery is performed by an expert, not only are complications rare, but the treatment of those complications can often result in a full restoration of vision.

Cataract surgery is a surgical procedure. So having surgical expertise, excellent facilities and excellent backup facilities cannot guarantee a perfect outcome and cannot guarantee that no complication will arise, but they minimise the risk of any complication and can result in the treatment of that being prompt and effective.”