Mr Ashish Patwardhan Consultant Ophthalmologist
Mr Ashish PatwardhanConsultant Ophthalmologist

Cataract

What is cataract?

The natural lens in the eye is normally transparent and allows light to focus on the retina at the back of the eye enabling a clear image.  Cataract is formation of opacity in this lens of your eye. This causes blurred vision, haloes around light and glare in headlights and sunlight.

What causes cataract?

The most common cause is age-related changes to the lens.  As a result it is commonly seen after the age of 60.  Occasionally cataract can develop at a much younger age due to the use of steroid, injury to the eye or metabolic disorders.

What is the treatment for cataract?

In the initial stages, a visit to the optician to change the prescription of your glasses can improve sight.  But when blurred vision affects normal everyday tasks such as reading, driving or watching television an operation is needed to remove the cataract.  The operation involves removal of the cloudy lens and replacing it with an acrylic intraocular lens (IOL) implant.  The implant stays in the eye indefinitely.

What different types of intraocular lenses are available?

There are different types of intraocular lenses available.  They do not differ in their quality but they perform different functions to improve vision.

The Standard monofocal lens will allow clear focus at a fixed distance.  This lens is included in the cost of your Cataract procedure. 

The Premium intraocular lens will provide focus at all distances (multifocal IOL), correct astigmatism (toric IOL) or do both (multifocal toric).  There will be an extra charge for this lens. Please read the leaflet on premium intraocular lenses for more information.

What does the operation involve?

The operation is normally carried out under local anaesthesia.  Eye drops are administered to numb the eye.  You will be awake during the operation but you will not feel any pain. During the operation the cloudy lens is removed using small incision phacoemulsification technique.  The skin (capsule) of the lens is left behind to support the new lens implant.  The new intraocular lens (IOL) is implanted within the capsular bag.  Normally stitches are not required as the cut seals itself.

What happens after the operation?

You will be ready to go home straight after the procedure.  You will use Exocin eye-drops 4 times a day for a week and Predforte eye-drops four times a day for 4 weeks.  It is not uncommon for the eye to feel a little gritty and uncomfortable for a few days.  You should notice improvement in your sight in a day or two.  However sometimes this can take a few days.  You will have a follow-up appointment in 4 – 6 weeks.  If you experience severe eye pain or your vision becomes quite blurred you must contact the hospital urgently. 

When can I drive?

You can drive as soon as you feel comfortable and can meet the DVLA standard of being able to read a standard number plate at a distance of 20 meters.  This can be discussed prior to surgery to assess individual cases.

What about new glasses?

Visit your optician after four weeks for a new prescription.  Bring this to your follow-up appointment.  Do not order new glasses until after this consultation.

What should I avoid after the operation?

You should avoid dirty, soapy water from the bath or shower in your eye for a week and swimming for 2 weeks.   You can resume all other normal activities the next day.  There is no restriction on bending forward (or backward!).

What are the complications of cataract surgery?

Fortunately major complications such as blindness are very rare but can happen in 1 in 1000 cases.  Minor complications that lead to partial vision loss can occur in 2 to 3 percent of cases.  Below is the list of recognized complications.  Some of these complications may require further treatment and/or further surgery.

 

Complications during the operation

  1. Break in the lens capsule (Capsule rupture)
  2. Prolapse of vitreous jelly (Vitreous loss)
  3. Loss of part or the whole lens to the back of the eye
  4. Bleeding behind the retina causing permanent visual loss (Expulsive haemorrhage)
  5. Injury or trauma to the intraocular structures
  6. Enlargement of cut requiring stitches

Complications after the operation

  1. Prolonged inflammation of the eye
  2. Infection (Endophthalmitis)
  3. Increased pressure in the eye (Glaucoma)
  4. Water-logging of cornea (Corneal Oedema)
  5. Detached retina
  6. Swelling/Fluid at the back of the eye in the retina (Macular Oedema)
  7. Droopy eyelid (Ptosis)
  8. Double vision or ghosting
  9. Displacement of intraocular lens
  10. Misshapen pupil
  11. Thickening or clouding of lens capsule (posterior capsular opacity)
  12. Unexpected refractive outcome – This means spectacle prescription much different from what was planned for.  This may lead to having to wear spectacles or contact lenses all the time.
  13. Seeing new floaters or worsening of pre-existing floaters.
  14. Visual disturbances (Dysphotopsia) – Seeing flashing lights, an arc of light in the corner, glare etc.
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Patwardhan Ophthalmology Limited trading as Mr Ashish Patwardhan. Registered in England and Wales No 07815014 Registered Office: Lowin House, Tregolls Road, Truro TR1 2NA