What are Cataracts?

A cataract is a clouding of part of your eye called the lens. Your vision becomes blurred because the cataract is like a frosted glass, interfering with your sight. It is not a layer of skin that grows over your eye, despite what you may have heard.

If your doctor or optometrist/optician has told you that you have a cataract, don’t be alarmed. Many people over 60 have some cataract and the vast majority can be treated successfully. Early cataracts may not affect your sight and do not need treatment.

What Does The Lens Do?

The lens is a clear tissue found behind the iris, the coloured part of the eye. The lens helps to focus light on the retina at the back of the eye to form an image. To help produce a sharp image, the lens must be clear.

Symptoms of Cataract

  • Blurry sight This is very common. You may notice that your sight has become blurred or misty, or that your glasses seem dirty or appear scratched.
  • Dazzled by light You may be dazzled by lights, such as car headlamps, and sunlight.
  • Change of colour vision You may notice that your colour vision has become washed out or faded.

What Causes Cataract?

Cataracts can form at any age. The most common type of cataracts is age-related cataract. These develop as people get older. In younger people cataracts can result from conditions such as diabetes, certain medications and other longstanding eye problems. Cataracts can also be present at birth. These are called congenital cataracts.

Although researchers are learning more about cataracts, no one knows for sure what causes them. There may be several causes and some studies have linked smoking, excessive exposure to sunlight and poor diet with cataract development. Sometimes cataracts are caused by other health problems such as diabetes.

Treatment

The most effective treatment for cataract is an operation to remove the cloudy lens. However, a good diet may help to slow the growth of age-related cataract.

Cataract Operation

In the past, eye specialists often waited until the cataract became “ripe” and your vision was very poor before suggesting you had the cataract removed.

Nowadays, with modern surgery the operation is usually done as soon as your eyesight interferes with your daily life. This includes having any difficulties with looking after yourself or others, cooking, driving, getting out and about, being able to read, work or do the things you enjoy.

If you are a driver you must reach the visual standard required by the Drivers and Vehicle Licensing Authority, and it may be necessary to have the cataract removed in order to keep your licence.

Before the operation

Almost everyone has a local anaesthetic. With a local anaesthetic, you will be wide awake but feel nothing in your eye.

Usually the eye specialist will explain what is happening as the operation goes along, and someone will also be there to hold your hand if you wish and make sure you are comfortable and relaxed. You may vaguely see some movement but no details of the operation.

If, however, you do have a general anaesthetic you will be completely unconscious, and it will be like sleeping through the operation.

The eye specialist does the operation with the aid of a microscope, through a small opening in the eye. This opening is so small that stitches may not be necessary. The operation often takes about 15 to 20 minutes, although it can last longer.

During the operation the lens with the cataract is removed and replaced with a clear plastic lens, so that the eye can see clearly after the operation. This plastic lens is called an intraocular lens implant and remains permanently inside your eye. There is no risk of your eye rejecting the new lens.

After the operation

Most people notice an instant improvement in sight, although complete healing may take several months. You may still need glasses, especially for close work, because the new intraocular lens implant is normally set up for distance vision.

If you were wearing glasses for distance vision (such as watching television) before surgery your glasses prescription will probably change afterwards. This is because the new intraocular lens will be set up to correct this. Your ophthalmologist would be able to explore the different options with you. You will be given eye drops to use for up to two months after your operation. It is a good idea to have some help at home, especially if you find it difficult to put your eye drops in.

Most people will have the operation and go home on the same day, and will probably be able to carry on with normal daily activities – but do think about the following:

Avoid rubbing your eye; discuss wearing an eye shield with hospital staff if you are a restless sleeper Don’t do any very heavy lifting, and avoid strenuous exercise and swimming

Take care if it is windy, in case anything blows in your eye, although you don’t need to stay indoors Take care washing your hair; avoid getting soapy water in your eye(s)

Avoid wearing eye make-up until the hospital are happy with your recovery.

The eye specialist or a nurse in the eye clinic will be able to answer any questions you may have, and advise you when to have an eye examination to get new glasses

Cataract surgery is one of the most successful operations. Fewer than two per cent of patients have serious, unforeseen complications. If you have any concerns after the operation ring the eye clinic or the doctor on call in the eye unit.

One of the most common and easily correctable complications is a thickening of the lens casing – the part of the eye that holds the lens in place, this can easily be corrected with laser treatment.

If you are worried about anything not covered in this general information, please contact the staff of your eye clinic, optometrist or family doctor (GP).