When the lens becomes cloudy, light struggles to pass directly through it and you may notice problems with your vision. A cataract is not a growth or a film growing over your eye; it is simply your lens becoming cloudy.
Types of cataracts
There are three different types of cataracts. Nuclear, cortical or subcapsular.
Nuclear sclerotic cataracts usually develop with age. They form deep in the central part of the lens and increase gradually.
Cortical cataracts can be caused by increased risk factors such as diabetes. This type of cataract begins at the edge of the lens and can be described as gradually moving into the centre in a spoke-like manner. Cortical cataracts can develop quite quickly, over a period of months.
Subcapsular cataracts can be caused by taking steroid medication, diabetes, radiation or extreme near-sightedness. This type of cataract forms at the back of the lens. It can make vision blurry and make it difficult to see in bright light. Activities such as driving, especially at night, can be particularly difficult.
Double vision or ghosting of images (especially if only noticeable in one eye)
Sensitivity to bright light
What causes cataracts?
The most common reason for cataracts is growing older, when natural changes within the lens occur. Most people over the age of 65 have some changes in their lens and the majority of us will develop a cataract in time.
Other common causes of cataracts include; diabetes, medications such as steroid eye drops, and previous eye surgery. There is research into other factors which may affect cataract development such as smoking, lifelong exposure to sunlight and a poor diet lacking antioxidant vitamins. In general, the reason for the cataract will not affect the way it is removed.
When to have cataract surgery
If you suspect that you have a cataract you will need a professional eye examination by your eye doctor, optician or ophthalmologist (after a referral by your GP). If your vision can be corrected to an acceptable level with glasses or contact lenses, surgery may be avoided at this time. If your vision loss cannot be corrected by the above measures and if this interferes with your daily life (driving, watching television, hobbies) then your cataract will need to be removed surgically.
The operation can be performed at any stage of cataract development. There is no need to wait until your cataract is “ripe” before removing it. Most people choose to have their cataracts removed when the change in their vision starts to impact their quality of life and cause them difficulties in everyday activities, such as driving, cooking, or reading.
What is cataract surgery?
Cataract surgery is the removal of the cataract and insertion of an artificial lens called an Intraocular Lens Implant (IOL) into the eye. It is the most successful and most frequently performed operation in the UK with over 325,000 cases annually. More than 90% of patients operated on have a significant improvement in their vision.
What does cataract surgery involve?
In cataract surgery, the old cloudy lens is removed with an ultrasonic probe and a new clear artificial lens is inserted in its place, which restores vision. You are able to choose the type of cataract lens that is right for you.
Standard intraocular distance lens. The standard NHS lens is a clear lens that improves distance vision. This is a very popular monofocal lens, although IOLs do not correct astigmatism, intermediate or near vision and most patients will need post-operative glasses to give good vision.
Toric distance lens for astigmatism. This lens gives good vision in the distance for patients with astigmatism. These can be used for mono-vision or used with multifocal lenses to improve near and distance vision. These lenses may be available at some treatment centres.
Extended depth of focus lens: distance and intermediate vision. These lenses give good distance vision and improve intermediate vision (e.g.computer screen). They are only suitable for eyes with low astigmatism. These lenses are available at our treatment centres.
Multifocal lens: near – intermediate – distance. These lenses have been widely used to improve near vision following cataract surgery but for some patients, they create glare post surgery. Some of these lenses are trifocal.
Bi-focal lens: distance and near. These give good vision for distance, intermediate and near. They generally reduce the need for wearing glasses, especially in good light. These lenses are only suitable for patients with low astigmatism. These lenses may produce some glare causing difficulties with night driving (<5%). These lenses are available at our Practice Plus Group Croft Shifa Health Centre in Rochdale.
Top-up multifocal lens: distance and near. Following cataract surgery, top up multifocal lenses can be used to improve near vision without glasses. There are potential problems of inflammation and glaucoma. These are offered at our treatment centres.
Tinted lenses. Some surgeons suggest that lenses with a yellow tint can protect the retina from future degeneration. They may be of benefit for patients with early retinal disease.
How long does a cataract operation take in the UK?
Cataract surgery usually takes about 15 minutes and most people go home from hospital about one to two hours later. It is done under local anaesthetic, which means you will be awake during the operation – most of the time drops will be used to numb the eye. The local anaesthetic may involve eye drops and/or an injection. It is a day case procedure which means you will not need to stay in hospital overnight.
What are the results and benefits of cataract surgery?
Patients often report an almost overnight improvement in their eyesight, with many returning to activities such as driving and reading with no further eye problems. Many people who have had cataract surgery also find that they rely less on glasses.
What are the risks and complications of cataract surgery?
The risk from cataract surgery is very low (< 1%) and complications are very rare. After the operation you will be sent home with eye care instructions and you will need to put drops into your eyes for a few weeks. Provided you follow the advice given to you after cataract surgery, your recovery should be complete and complication-free.
How urgent is cataract surgery?
Most cataracts take months to develop but getting a quick diagnosis is advised if you feel that you are having changes in your vision. Don’t ignore sudden eye problems as seeing an optician quickly may save your sight.
Once you have been referred for cataract surgery your hospital will offer a two stop patient pathway.
A specialist eye nurse will go through your symptoms, your previous eye and medical history and ensure you are fit for surgery.
The specialist nurse will make sure all the investigations and tests are completed before surgery. We will need information about your general health, medication, allergies and a recent blood pressure measurement. Please also make sure you bring reports (if available) of any previous eye procedure you had in the past, especially if you had laser corrective surgery.
Please continue with all your normal medication / drops. If you take blood thinners please inform the staff and they will advise you what to do.
The cataract operation will be explained to you including the risks and benefits and you will be able to ask any further questions.
Cataract surgery aftercare and recovery
Immediately after your operation you will be able to see from your eye(s) but they will be blurred, because your pupils will still be dilated.
You will be discharged from the hospital and be able to go home. If you have had a general anaesthetic you will be kept in until you are fully awake. As your vision will still be blurred after the operation a responsible adult must take you home and stay with you for at least 24 hours. If the eye is uncomfortable, please use your normal pain tablets.
You will be given post operative drops and instructions as to how to put them in. It is important to prevent infection by following the instructions given, particularly good hand hygiene whilst using the eye drops.
As glasses used prior to the operation will not be suitable for your operated eye, it may help to remove the lens from your glasses or buy some temporary reading glasses.
You will be given contact details should you have any concerns or worries post operatively.
Eye health is important and we advocate a healthy lifestyle that supports healthy eyesight. If you need support to give up smoking or lose weight you will be able to speak to our healthcare team.
How long does it take to recover from cataract surgery?
If the cataract operation is successful you should experience an improvement in clarity, colour, and peripheral vision with less glare. For some this takes a matter of hours, others take one to two weeks to see well.
Do and don’ts after cataract surgery
Take it easy at home for a few days following surgery
Avoid strenuous effort for about one month
If you experience any discomfort such as a headache or mild pain take paracetamol or your usual painkillers
It is okay to bend down but not lift heavy things
Watching TV and reading will cause no harm
You may experience some double vision or distortion immediately following surgery, but this will get better
A scratchy / gritty eye is normal, do not rub the eye
You may need to wear dark glasses for a few days as you eye(s) will be more sensitive to light
Do not get the eye wet for the first 24 hours
Following surgery to your second eye you may need new glasses, they can be prescribed by your optician 6 weeks following surgery
Private treatment for cataracts
Private treatment for cataracts allows you the flexibility to choose your place of treatment as well as the date that suits you. It also allows greater treatment options, with different types of lenses available.
Paying for cataracts surgery
There are two ways to access cataract surgery at Practice Plus Group:
Pay for yourself
Please note that enhanced cataract lenses are only available privately. NHS only offer standard lens.
Cataract surgery costs
If you choose our self-pay option, cataract surgery is £1995 per eye. You will be able to access a first consultation within 2-4 weeks, for £95. This will be with an experienced consultant and include tests to help diagnose your problem and decide the best options available for you. Your surgery will be within around 2-4 weeks post consultation, but it might be even quicker.
The difference between NHS and private cataract surgery in the UK
The main difference between NHS and private cataract surgery in the UK is the choice of lenses available and the cataract operation waiting times. If using self-pay with Practice Plus Group you will be able to choose a different type of lens, such as a top up multifocal lens. This is not an option with NHS cataract surgery which uses the standard intraocular distance lens.
At Practice Plus Group you will usually have cataract surgery within seven weeks from the date of the booking enquiry.
Choosing a cataract surgery provider
You need to feel comfortable with your choice of provider. Some things to bear in mind when making a choice:
Are you comfortable with the location?
Is the surgery competitively priced?
Do you have a choice of lenses?
How quickly can you be seen / have the operation?
During the procedure your eye will be cleaned with an antiseptic solution. A drape is placed over your eye. This is lifted off your face and air blown under the drape. We monitor your breathing and pulse during the surgery.
The cataract is removed by phaco-emulsification. This technique uses an ultrasonic probe to break up the old lens. Your surgeon will insert a new lens into your eye. You may hear the ultrasound and may see more clearly when the new lens is inserted.
Stitches are not normally needed but may be used at this stage if necessary.
If you feel discomfort during the surgery we can give you more anaesthetic.
Pre-operative assessment for cataracts:
A pre-operative assessment is our opportunity to ensure that the procedure for which you have been referred is right for you. We’ll explain your treatment to you and make sure that you are well enough to go ahead with it. It is also your opportunity to meet the team who will care for you and to ask any questions.
How long does knee replacement surgery take?
Surgery can take between one and two hours and is usually carried out with a spinal anaesthetic. Patients can also have a short-lasting intravenous sedative, so they snooze during the procedure, but recovery is enhanced having avoided a full general anaesthetic.
Cataracts treatment FAQ
Find answers to common questions…
Cataracts form over time so that vision gradually deteriorates without treatment.
Because the affected lens is replaced with a clear artificial lens it is not possible for the cataract to return. After weeks or months, you might experience cloudy vision that might be related to cloudiness of the back support of the artificial lens. This could be safely and easily corrected with a laser. If this occurs please contact your optician to get referred to receive this laser treatment.
It is done under local anaesthetic, which means you will be awake during the operation. Most of the time drops will be used to numb the eye.
This depends on the severity of the cataract, it is best to discuss options with your optician or ophthalmologist who will best advise on the timing of surgery.
Because cataracts form over time, you will notice a gradual reduction in your vision which will start to interfere with your daily activities such as driving or reading. If left untreated, cataracts may get worse and cause severe loss of vision.