Cataract

What is a cataract?

The lens in your eye is normally clear and helps to focus the light entering your eye. It can become cloudy and cause your sight to become blurred, when we call it a ‘cataract’. A cataract is NOT a film or growth that occurs in the eye, it is clouding within the lens that sits just behind your iris, the coloured part of your eye (see figure 1.). Cataracts will usually affect both eyes but are often at different stages. Cataracts cannot be treated with medicines, eye drops or lasers. They are treated with surgery where the cloudy lens is removed and replaced by an artificial lens. Around 300,000 cataract operations are performed in the UK each year, most of these leave the patient with distance vision and no reading vision. Edgbaston Eye Consultants has the range of lenses that will give you distance and reading vision according to your lifestyle.


Figure1. Diagram of the eye showing how light is focused through the lens onto the retina. The lens is cloudy when there is a cataract and the light is scattered and blurred instead of focused to a point.

  • You can suspect that cataracts are developing in your eyes if you experience;
    • Decreased vision that can’t be corrected with glasses
    • Faded or washed out colours appear, often with a yellow haze
    • Light sensitivity, glare, and halos around lights especially in sunlight and when driving at night
    • Frequent changing spectacle prescriptions, usually becoming more short-sighted

Cataracts are usually age related, affecting about 1 in 3 people over the age of 65. This type of cataract forms over many years as the lens continues to grow throughout life. The effects gradually progress and often people do not realize they have cataracts until they are checked at their optician(Figure 2).

Figure 2.
Simulation of the type of vision you get as your cataracts develop. As they develop slowly, you sometimes don’t notice how bad your vision is until you go to your optician.

Cataracts sometimes are present at birth (congenital) but are not always advanced enough to cause a visual problem and need an operation in infancy. This type of cataract will often progress later in life and surgery will help restore vision.

Figure 3.
Congenital cataract that has not affected the vision for decades, but now has caused visual loss requiring surgery.

Other causes of cataracts include secondary effects from using medications (especially steroids), the effects of diabetes, previous eye injury, eye surgery, other eye diseases, or from radiation exposure.

  • Some factors may increase the chance of developing cataracts including:
    • Smoking
    • Diabetes
    • Having a poor diet
    • Steroid medicines
    • Excessive exposure to UV light from the sun or tanning beds
    • Having a family history of cataracts
Diagnosis

A cataract is usually diagnosed by a doctor or optometrist during routine eye checks, often before you have noticed your visual reduction. You will be referred to Edgbaston Eye Consultants by your optician or General Practitioner after an eye check at your Optician, or you can contact us and refer yourself for treatment.

Cataract assessment

The purpose of this appointment at the hospital is to make sure that cataract surgery is the best treatment for you. Please bring your current glasses, a list of your medications and any medical record books you may have. If you wear contact lenses these should not be worn for at least 48 hours before your appointment. Several eye tests will be conducted, and you should allow 2 hours for all the tests to be completed and your pupils dilated. When your pupils are dilated, your vision can be blurred temporarily for up to 4 hours and it is important that you don’t drive yourself back after the appointment.

We will examine your eyes thoroughly and perform scans to calculate the power of lens needed during the operation and to make sure that your retina is healthy. This way we can plan the operation that will suit you best and make sure that any factors that might make the operation complex are taken into account. Make sure you ask any questions you have about your surgery with the nurse and/or doctor at your appointment.

We aim to match the surgery that we offer you to your lifestyle. Most of our patients lead active lives; many are still working, most drive, use mobiles/ tablets and enjoy reading. This increases their visual needs for distance, intermediate and near vision. We address these needs at the preoperative clinic appointment and help you make a decision on when to have your operation and what lens to use during the procedure.

Lens choice

There is a wide range of lens types that we can implant to replace the cataractous lens that is removed (called intraocular lenses or IOLs). We will help you choose the one that best suits you, your eye, your needs and your lifestyle.

Monofocal intraocular lens

These have a single focal point and give clear vision at a set distance. If distance vision without spectacles is the planned result, but then reading glasses will be needed after the operation. Usually the plan is to increase the depth of focus by making the non-dominant eye see better at close vision, but it is rare to be completely spectacle independent after monofocal IOL implantation.

Multifocal Lenses

These are designed to give distance intermediate and near vision without spectacles. They work well with people who do not wish to wear spectacles all the time, though for some people glasses will be needed for very difficult visual tasks. Edgbaston Eye Consultants tend to use Extended Depth of Focus (EDOF) intraocular lenses which give a more natural change from distance to near vision, a bit like wearing varifocal spectacles, that is associated with fewer visual side effects after surgery.

Toric Lenses

These intraocular lenses are designed to correct astigmatism in the eye that will reduce the need to wear spectacles after surgery. They are one of the most effective strategies in reducing spectacle dependence in people with larger degrees of astigmatism, but often spectacles will be needed in certain circumstances.

Consent form

You will be asked to sign a consent form once all the pros and cons of the procedure have been explained to you. Cataract surgery is a safe procedure with a very low complication rate, but that does not mean that it is entirely risk-free, and these risks will be explained to you in detail. You should ask as many questions about the procedure as you have, so that you are sure that it is the best thing for you when you sign the consent form. You will be given a leaflet to take home that will allow you to read about the procedure in the comfort of your own home. You will then arrange a date to come for your operation.If you wish to know more about the information please navigate to the surgical section of our website.