A cataract is a clouding of the lens in your eye. It can affect one or both eyes. Cataracts are treated by surgery, where the cloudy lens is removed and replaced by a clear artificial lens.
Does everyone get cataracts?
Cataracts are responsible for around 50% of world blindness. Most cataracts develop slowly over time and affect people over the age of 60. However in some cases, cataracts can start at an earlier age especially in someone who is diabetic, or on steroid medication.
What happens if cataracts are left untreated?
In most cases, cataracts will continue to worsen slowly over time, causing progressive reduction in vision. Driving can be affected, as well as overall quality of life. In some cases, a change in the glasses prescription may improve your vision if the cataract is worsening, but other times it will not. If unsure, it is better to have a comprehensive eye examination and discuss this with your ophthalmologist. The examination is also useful to exclude other eye conditions that could affect the vision, such as macular degeneration, other retinal diseases and glaucoma.
When should I have my cataract surgery?
Cataracts can be removed at any stage. Making the decision to have your cataracts removed depends on a number of things, including how badly your sight is affected, whether you have any other eye conditions, if you only have sight in one eye and how you use your sight on a daily basis. Surgery should be carried out if the benefit of the operation outweighs the small risk associated with the surgery.
The vast majority of cataract surgery is performed by phacoemulsification. This means an instrument uses sound waves to break up the lens in the eye and remove it. A small incision is made in the front surface of the eye. Once the cataract is removed, it is replaced with a clear lens implant known as an intraocular lens, or IOL. This is done under local anaesthetic as a day-case procedure, and on average takes fifteen to twenty minutes. Sometimes the patient may prefer to have an injection (subTenon’s local anaesthesia) or general anaesthetic. This will be discussed at the outpatient appointment. In most cases, stitches are not required and the eye heals very quickly.
Complex Cataract Surgery
There are a number of situations where particular features of a person’s eye may increase the risk of complications. One of the complications is when the support structure that holds the lens in place (the capsule) tears or loses its attachment to the wall of the eye. This may lead to parts of the cataract to fall to the back of the eye and some of the jelly to come to the front of the eye. A number of additional steps may become necessary to complete the operation safely, and sometimes a second procedure is needed. This may include a vitrectomy operation by a surgical retina specialist.
Combined Cataract Surgery
When a patient needs a vitrectomy operation for a retinal condition, a cataract may also be present. In this select case, you may be offered a combined cataract and vitrectomy procedure; such that only one combined operation is done, instead of two separate procedures.
Posterior capsular opacification (misting up or scarring of the capsule behind the lens implant) may occur in a number of patients, and may happen within months or years of cataract surgery. A simple outpatient laser procedure can effectively treat such a condition. It rapidly restores the vision to its previous state.