Concerned about cataracts? Symptoms and surgery explained


So, you have concerns about cataracts either for yourself or a loved one. Cataracts are a fairly common condition of the eye and consists
of some clouding of your own natural lens. And in those cases, they’re age-related and
develop very gradually. Some cataracts can develop earlier in life and some even can
be diagnosed at birth, but rarely. Occasionally cataracts are related to diabetes, iritis,
very long steroid drops therapy, or to previous eye surgery. The good news is that this cause
of poor vision is treatable and probably the most satisfactory to treat. The symptoms are
that there is some blurring or haziness of your vision and particularly glare in bright
lights which can be quite disturbing in sunlight or with oncoming headlights when driving at
night. Another symptom is difficulty with reading. Although, with a particular kind
of cataract the so-called nuclear cataract, some of my patients become gradually more
short-sighted, suddenly enabling them to read without glasses. The decision if and when
to have cataract surgery is really entirely subjective, but generally we are guided by
the fact that patients want to keep driving or wanting to perform specific tasks in life
which have become difficult to do, for example small print reading, watching TV or playing
golf. In most cases, and that is my very personal view, I would always wait with cataract surgery
until the cataracts interfere with normal life. Meaning that my patient is actually
disturbed by the lens changes. Rarely do I recommend to have a cataract operated on early.
For example, if the core of a nuclear cataract becomes harder and hard and harder. Cataract
surgery is a surgery and we remove the cataract which is your own cloudy lens with the help
of ultrasound through a very small keyhole incision and replace it with a folding acrylic
implant lens. We will try to reduce your post-operative glasses wear as much as possible but you may still require distance glasses for best vision and even reading glasses. In either
case your glasses’ prescription will change after the operation. During an initial consultation
we will have a discussion with you regarding all the options and all the pros and cons
of implanting special lenses including trifocal and toric lenses which have the potential
to make you fairly spectacle independent. The surgery itself is pain-free. We will numb
the eye with very strong drops and just to reassure you, there will be no sharp needles
involved. You will be lying down during the surgery and as I already mentioned we use
ultrasound to remove the lens and then replace your old lens with a new customised lens.
Part of the operation can be done with laser. However, big studies have shown that this
does not significantly change the outcome. So it is really up to each surgeon whether
or not to use laser during cataract surgery. Recovery after cataract is reasonably swift.
Within a few days you will see fairly well and you will need to take anti-inflammatory
drops for around 4 weeks. I would always discuss all of the pros and cons and the risks and
benefits of cataract surgery with every patient during an initial consultation and also the
post-operative visual requirements which will include a choice of intraocular lenses depending
on your expectations and your post-operative requirements. Sometimes you will not mind
wearing glasses after the surgery and some patients would love to be ideally spectacle
free. I often get asked whether cataracts can come back; and the short answer is no.
The slightly longer answer is that most patients after cataract surgery do get something, we
call posterior capsular thickening which affects the clear membrane behind your new lens which
is at the time of surgery perfectly clear but which tends to or pacify over time. In
most patients, this will happen anytime between three months or ten years after the surgery.
Luckily, the treatment for this is a small pain free procedure called YAG laser capsulotomy
which can be done on an outpatient basis.

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