Cataract and Cataract Surgery
What is a cataract?If your doctor or optometrist has told you that you have a cataract, don’t be worried. Over half of those aged over 65 have some cataract development. Most cataracts can be successfully treated with surgery.
A cataract is a clouding of the normally clear lens of the eye. The lens focuses light rays on the retina at the back of the eye to produce a sharp image of what we see. When the lens becomes cloudy, light rays cannot pass easily through it, and the image becomes blurry.
Some misconceptions about cataractsA cataract is:
- Not a cancer
- Does not spread from one eye to the other
- Not a cause of irreversible blindness
What causes a cataract?Cataracts can form at any age, but most develop as part of the ageing process. Younger people can develop cataract as a result of:
- Eye injuries
- Certain diseases such as diabetes
- Medications such as steroids
- Long standing inflammation in the eye
- Genetic inheritance
Common symptoms of cataracts
- Hazy or blurred vision
- Glare or light sensitivity in bright light or while driving at night
- Poor vision at night
- Needing brighter light to read
- Fading or yellowing of colours
- Double vision in one eye
- Frequent change of eyeglass prescription
How is a cataract detected?A thorough eye examination can detect the presence and extent of a cataract, as well as any other condition that may be causing blurred vision.
There may be other reasons for reduced vision in addition to the cataract, particularly problems involving the retina or optic nerve. If these problems are present, perfect vision may not return after cataract removal.
How fast does a cataract develop?How quickly a cataract develops varies among individuals, and may even vary between the two eyes.
Most cataracts associated with the ageing process progress gradually over a period of years. Other cataracts, especially those in younger people and those with diabetes, may develop rapidly over a few months.
It is not possible to predict how fast cataracts will develop in any given person.
What can be done to help?When cataracts are mild, vision can sometimes be improved with a change of glasses. However, the main treatment is to have a cataract operation. There are no medications, dietary supplements, exercises or optical devices that have been shown to prevent or cure cataracts. Protection from excessive sunlight may slow the progression of cataracts. Sunglasses that screen out ultraviolet (UV) light provide some protection.
When should surgery be done?In the past, eye surgeons often waited until the cataract became ‘ripe’ before removing it. Nowadays, with modern surgery, the surgery can be safely carried out at any stage of the cataract’s development. If visual impairment interferes with your ability to drive, read, work, play sport or do the things you enjoy, then you will probably want to consider surgery.
What can I expect if I decide to have surgery?Before surgery:
Be sure to mention any special medical risks that you may have and ask Dr Hornsby if you should continue your usual medications.
Your eye will be measured with special instruments to determine the power of the intraocular lens to be placed in the eye during surgery.
On the day of surgery:
For most people it is possible to have your operation and go home on the same day. Sometimes surgery will mean a short stay in hospital. Just before surgery you will be given eye drops to enlarge your pupil. A medication to help you relax can be given if you wish. A local anaesthetic will numb the area to be operated on. You will usually be awake during the procedure but you should not feel any pain. You may see light and movement, but you will not be able to see the surgery while it is happening. You will not have to worry about keeping your eye open.
The skin around the eye will be cleaned with antiseptic and a sterile drape will be placed over the face. There will be plenty of oxygen and fresh air to breathe. The operation generally takes up to 45 minutes.
The operation is performed with the aid of an operating microscope. A small incision is made at the top or side of the eye. The eye is not taken out of its socket during the surgery. Instruments are used to fragment the cloudy lens. These fragments are then suctioned out of the eye. The back membrane of the lens (called the posterior capsule) is left in place. A plastic intraocular lens implant is placed inside the eye to replace the natural lens that is removed. The wound is then closed, sometimes requiring small stitches. The stitches cannot be seen and may or may not be removed at a later stage.
After the operation:
After the surgery a pad or shield will be placed over the eye to protect it from accidental rubbing or bumping.
Your sight will usually improve after a few days. You will need to take it easy for a couple of weeks so that the eye can heal. Eye drops will need to be used. It is a good idea to have some help at home, especially if you find it difficult to put drops in your eye.
- Avoid rubbing your eye
- Wear the eye shield provided at night for the first two weeks
- Avoid heavy lifting, straining, strenuous exercise and swimming
- You can do light housework or cooking, but try to get some help if you can
- You don’t need to stay indoors but take care if it is windy, in case anything blows in your eye
- Wash your hair leaning backwards rather than forwards
- Avoid eye make up for six weeks
- Avoid driving until your eye doctor tells you that it is safe
- New glasses are usually prescribed 4-12 weeks after the operation
- How long you are off work depends on the type of work you do. Ask Dr Hornsby about this
When is laser used?The posterior capsule sometimes turns cloudy after the original cataract surgery. If this blurs your vision, a clear opening can be made painlessly in the centre of the membrane with a laser.
Will cataract surgery improve my vision?Vision improves in over 95% of patients after cataract surgery, however a small number of patients may have problems.
ComplicationsIt is important to remember that, like any operation, problems may occasionally occur.
There may be occasional problems related to the local anaesthetic injection given before surgery. These can include bruising around or inside the eye and occasionally temporary problems with double vision after the operation.
Infection, bleeding and swelling or detachment of the retina are some of the more serious complications that may affect your vision. There is about one chance in one thousand of a serious complication which may require special treatment or result in loss of part or all of the vision.
Sometimes the posterior capsule breaks during surgery. There is about one chance in two hundred of part or all of the cataract falling to the back of the eye during the operation and requiring a second separate operation to remove it.
A very rare complication is sympathetic ophthalmia. Here an immune reaction develops that can cause loss of vision in both eyes. The incidence of this condition is less than one in fifty thousand. This rare condition can usually be successfully treated with medications.
ConclusionCataracts are a common cause of poor vision, especially in the elderly. Dr Hornsby can tell you if cataract, or some other problem is affecting your vision and help you decide if cataract surgery is appropriate for you.
Change the text size
AddressSuite 15, Mater Medical Centre
76 Willetts Road
Mackay QLD 4740