Time for a clearer view of cataract symptoms
ISION CAN WORSEN with age — and a major cause of this can be cataracts. A cataract is a progressive clouding of the eye’s natural lens, gradually making it opaque. Sufferers often describe the condition as being similar to looking through a waterfall or a piece of waxed paper, with a gradual blurring or dimming of vision.
Some identifying symptoms include excessive glare, which makes driving at night problematic and sometimes dangerous.
Reading may become challenging, while watching TV may be spoilt by loss of colour and difficulty reading subtitles and scores. It may also become harder to recognise people at a distance, or harder to see defects in the pavement or notice kerbs, leading to increased possibility of tripping and falling.
Jeremy Joseph, consultant ophthalmologist at Spire Bushey, says: “Many eye conditions cause similar symptoms to cataracts, so it is virtually impossible for a person to make their own diagnosis. It is therefore essential for most people to visit their optician or optometrist on an annual basis. An optician can generally diagnose cataracts fairly easily and will advise you on the need for referral to an ophthalmologist or eye specialist, for surgery.”
But in many cases, cataracts cause very few, if any symptoms and do not need surgery. There is rarely any damage caused to the eye by leaving such cataracts in position. Watchful waiting is all that is required and it may take many years for the cataract to develop to the extent where surgery is needed.
Some cataracts just alter the power or prescription of the eye and all that is needed to correct this is a change of glasses.
However, when cataracts threaten to impair quality of life, consider surgery. Most people know when the time is right. For example, i f your eyesight b e c o m e s p o o r e r than the legal requirement for driving (being able to read a car number plate at 20m), then delaying surgery could increase the risk to the driver and other road users. An appointment with a consultant at a private hospital can be obtained within about a week and fixed-price packages are available for the uninsured.
Spire Bushey Hospital has eight consultant ophthalmologists who remove many hundreds of cataracts every year. Mr Joseph often sees patients who have concerns about this type of surgery. He says: “Cataract surgery is normally a very safe and highly successful procedure, which generally restores vision. It can maintain your self-confidence, keep you active, allow you to continue driving, facilitate your watching television and sport and even improve
communication, as good vision aids lip-reading for those who have impaired hearing.”
Some people may be reluctant to seek help or advice for cataract surgery but it should not be left too late, he says.
“While it is important to wait until you have sufficient symptoms to warrant surgery, it is equally important not to let your symptoms deteriorate too severely. For example, once you have lost confidence in driving due to poor vision from cataracts, it can be very difficult to regain this after surgery, even if your vision is restored.”
Patients need only be in hospital for the day and in most cases, surgery is carried out under local anaesthetic. The lens is removed via a tiny incision half the size of a fingernail, with no need for stitches. Precise measurements, taken before surgery, ensure the replacement lens is tailored to each individual’s eye, correcting the patient’s vision so that in most cases spectacles are not required for distance vision.
Patients leave hospital with an eye shield, which is removed the morning after the operation and they can usually see clearly immediately. Most patients comment that everything is very bright at first and that colours are very rich. Post-operative care involves drops to the eye and follow-up consultations with the specialist.