‘Cloudy vision will have gone day after short op’
Cataracts are still the leading cause of blindness and vision loss worldwide. Here, Dan Morris, consultant ophthalmologist at the University Hospital of Wales and Nuffield Health Cardiff & Vale Hospitals, explains more about the condition
What are cataracts and when they are likely to occur? A cataract is a clouding of the lens inside the eye, causing blurred vision and sometimes glare.
They usually develop gradually and affect distance vision first.
Most commonly cataracts affect individuals over 50 years of age – more than half of people over the age of 65 can expect to be affected by cataracts at some stage.
However, they can occur in any age group, especially after trauma or if you take steroids.
Fortunately, in almost every case, vision can be improved and restored to a good level using modern cataract surgery techniques, by replacing the cloudy lens with a new plastic lens usually under local anaesthesia.
When is surgery recommended? Patients who are suffering visual problems and are suspected of having cataracts by their optician or GP are usually referred to the hospital eye service for further examination.
The ophthalmologist performs a full eye examination for diagnosis of cataracts and for making the clinical decision whether cataract surgery should be performed.
Measurements of your eyes will be taken to assess the strength of the artificial lens that you will need to replace your natural lens.
Normally if you have cataracts that affect your vision in both eyes, you’ll need two separate operations, usually carried out eight weeks apart, to allow your first eye to heal.
What happens operation? At the Nuffield Health Cardiff Bay Hospital, we have a skilled team of nursing staff and operating theatre during the technicians to ensure that the patient journey is as comfortable as possible – you will be looked after every step of the way. Everyone is understandably anxious about surgery on their eyes, but the experienced staff are able to put you at your ease to make it as painless and stress-free as possible.
The cloudy lens is removed and it is replaced with an artificial lens.
How long does the procedure take? You are normally at the hospital for half a day. It is usually a straightforward procedure taking about half-anhour as a day case operation surgery under local anaesthetic, which means you will be awake.
It is not painful and, although the thought of someone operating on your eye can be terrifying, most people comment afterwards that it is not as bad as they thought it was going to be.
How do you perform the lens removal? When you arrive, the nursing staff check your blood pressure to make sure you are fit for surgery, then put drops in your eyes to dilate your pupil.
I come and have a chat to answer any final questions and address any concerns. Then you are taken to the operating theatre where the anaesthetist makes the eye numb.
After applying a special drape on the eye, I make a tiny incision in the eye, I break up the cataract using ultrasound technology and remove it. The new lens is curled up and placed in the eye. Usually no stitches are needed and a pad is put on the eye. When can the patient go home? Most people go home the same day with a friend or relative.
You will need to arrange for someone to collect you and take you home. You will have a pad over your operated eye overnight and so it is a good idea to have someone at home to look after you.
I generally see the patient again after a few weeks but if there are any problems or concerns you can contact me any time of day or night.
What results can people expect? After this short day case operation, the cloudy vision will have gone the next day. Most people will not need glasses for driving or watching television but you may still require glasses for reading or to correct astigmatism – this is where the eye is rugby ballshaped, rather than round.
No operation is perfect or without risk and there is a very small chance of complication, which will be discussed with you beforehand. Some people may not get a perfect result because of other eye diseases like macular degeneration or glaucoma.
What else? As a private hospital, we also offer premium lens surgery, which involves removing cataracts and the need for wearing glasses at all.
Cataract surgery presents an excellent opportunity to get rid of the need for glasses altogether.
Using premium, multifocal and toric intraocular lenses, built to the individual measurements of the patient’s eye and placed at a specific angle to counter astigmatism and provide help with reading, patients can now achieve near-perfect vision for near and distance without glasses.
Clear lens replacement surgery is also an alternative treatment to laser eye surgery, particularly for middleaged people and those with extreme short or long sightedness who do not want to wear glasses or contact lenses.
Once these lenses are in place, there is no visual deterioration over time but occasionally the capsular bag which the plastic lens sits in becomes cloudy, requiring a simple laser treatment to clear it which can be performed in the clinic setting.
If you have clear lens replacement surgery you will never require cataract surgery because the natural lens is replaced and an artificial lens cannot become cloudy in the same way that a natural lens can.