So, you have concerns about cataracts either for yourself or a loved one. Cataracts are
a fairly common condition of the eye and consists of some clouding of your own natural lens.
And in those cases, they're age-related and develop very gradually. Some cataracts can
develop earlier in life and some even can be diagnosed at birth, but rarely. Occasionally
cataracts are related to diabetes, iritis, very long steroid drops therapy, or to previous
eye surgery. The good news is that this cause of poor vision is treatable and probably the
most satisfactory to treat. The symptoms are that there is some blurring or haziness of
your vision and particularly glare in bright lights which can be quite disturbing in sunlight
or with oncoming headlights when driving at night. Another symptom is difficulty with
reading. Although, with a particular kind of cataract the so-called nuclear cataract,
some of my patients become gradually more short-sighted, suddenly enabling them to read
without glasses. The decision if and when to have cataract surgery is really entirely
subjective, but generally we are guided by the fact that patients want to keep driving
or wanting to perform specific tasks in life which have become difficult to do, for example
small print reading, watching TV or playing golf. In most cases, and that is my very personal
view, I would always wait with cataract surgery until the cataracts interfere with normal
life. Meaning that my patient is actually disturbed by the lens changes. Rarely do I
recommend to have a cataract operated on early. For example, if the core of a nuclear cataract
becomes harder and hard and harder. Cataract surgery is a surgery and we remove the cataract
which is your own cloudy lens with the help of ultrasound through a very small keyhole
incision and replace it with a folding acrylic implant lens. We will try to reduce your post-operative
glasses wear as much as possible but you may still require distance glasses for best
vision and even reading glasses. In either case your glasses' prescription will change
after the operation. During an initial consultation we will have a discussion with you regarding
all the options and all the pros and cons of implanting special lenses including trifocal
and toric lenses which have the potential to make you fairly spectacle independent.
The surgery itself is pain-free. We will numb the eye with very strong drops and just to
reassure you, there will be no sharp needles involved. You will be lying down during the
surgery and as I already mentioned we use ultrasound to remove the lens and then replace
your old lens with a new customised lens. Part of the operation can be done with laser.
However, big studies have shown that this does not significantly change the outcome.
So it is really up to each surgeon whether or not to use laser during cataract surgery.
Recovery after cataract is reasonably swift. Within a few days you will see fairly well
and you will need to take anti-inflammatory drops for around 4 weeks. I would always discuss
all of the pros and cons and the risks and benefits of cataract surgery with every patient
during an initial consultation and also the post-operative visual requirements which will
include a choice of intraocular lenses depending on your expectations and your post-operative
requirements. Sometimes you will not mind wearing glasses after the surgery and some
patients would love to be ideally spectacle free. I often get asked whether cataracts
can come back; and the short answer is no. The slightly longer answer is that most patients
after cataract surgery do get something, we call posterior capsular thickening which affects
the clear membrane behind your new lens which is at the time of surgery perfectly clear
but which tends to or pacify over time. In most patients, this will happen anytime between
three months or ten years after the surgery. Luckily, the treatment for this is a small
pain free procedure called YAG laser capsulotomy which can be done on an outpatient basis.