Cataracts

What is a cataract?

A cataract is the most common disorder of the lens, in which the lens becomes clouded and stops light from reaching the back of the eye, causing blurred or misty vision.

Cataracts often develop in both eyes, although each eye may be affected differently. They are more common in older adults and can affect your ability to carry out daily activities, like driving. It can also affect babies and young children.

Cataracts usually grow slowly over many years, so you might not notice symptoms at first. Read on to find out more about cataract symptoms and cataract surgery.

What is the first sign of cataracts?

As cataracts form slowly, you might not notice any changes to your sight at first, but as they develop, you’ll start to notice cataract symptoms, like:

• Blurred or misty vision

• Sensitivity to light

• Struggling to see in low light

• Colours beginning to look faded

• If you wear glasses, your lenses might seem dirty, even if they're not.

Cataracts aren’t usually painful, but they can be if they're in an advanced stage or if you've got another eye condition.

If you’re experiencing any of the above cataract symptoms and these are affecting your quality of life, you should arrange to see an optician.

How are cataracts diagnosed?

If you have cataracts, your vision will be like looking through a frosty or steamed-up window. This is because the usually clear lens of your eye is cloudy.

Having cataracts can make it more difficult to read, drive a car (especially at night) or properly see expressions on people's faces.

A cataract will be diagnosed by an optician when they examine your eyes for cataracts. They’ll run a series of tests, including a ‘visual acuity’ test, which measures your ability to see different distances. If the optician suspects cataracts, they may refer you to an eye specialist (ophthalmologist) for more tests and treatment.

What do cataracts look like?

In some cases, if a cataract has matured over time, the pupil can appear white because the lens is completely clouded by a very dense cataract. But, most cataracts are not visible.

Cataract surgery

The only treatment that is effective for cataracts is cataract surgery, an operation that replaces the cloudy lens in your eye with an artificial one. Cataract surgery takes less than an hour. It’s often carried out as day surgery (under local anaesthetic), so you should be able to go home on the same day.

After cataract surgery, you should be able to:

• See things in focus

• Look into bright lights and not experience glare

• Tell the difference between colours.

If you have another condition affecting your eyes, such as diabetes or glaucoma, you may still have limited vision, even if your cataract surgery is successful. But most people will experience an improvement in their sight almost immediately after cataract surgery.

During cataract surgery

Cataract surgery is usually a form of keyhole surgery, known as phacoemulsification. It’s a straightforward operation that will include:

• A tiny cut to the front of your eye

• Ultrasound waves used to break up the cataract, which is then removed through a small tube

• An artificial clear plastic lens is then inserted inside the lens capsule.

You'll be given a local anaesthetic, either as drops or by injection, before your cataract surgery.

During cataract surgery, you'll be offered one of the following lenses:

• Monofocal lens - A single point of focus, meaning the lens will be fixed for either near or distance vision (not both)

• Multifocal or an accommodating lens - A lens that allows the eye to focus on both near and distant objects.

After cataract surgery

Following cataract surgery, it's normal to experience the following side effects:

• Grittiness

• Watering

• Blurred vision

• Double vision

• A red or bloodshot eye.

It can take a few days for your vision to fully return after cataract surgery, and you might need to wear glasses for some activities, like reading, regardless of the type of lens that’s been fitted.

You might also be given a pad or plastic shield to cover your treated eye. This can usually be removed the day after your operation.

Cataract surgery has a high success rate and can take up to six weeks to fully recover.

Dos and don'ts after surgery

The dos and don'ts for the first few weeks after cataract surgery include:

Do:

Use your eye drops
Take it easy for a few days
Use your eye shield at night for at least a week
Take painkillers (if you need to)
Bathe or shower yourself as usual
Wear your eye shield when washing your hair
Use your old glasses or sunglasses outdoors
Avoid swimming for 4-6 weeks.

Don't:

Rub your eyes
Allow soap or shampoo to get into your eye
Drive until the doctor says you can
Do any strenuous exercise or housework
Wear eye make-up for at least four weeks
Fly without seeking advice from a doctor.

What causes cataracts?

You’re more likely to develop cataracts as you get older, but doctors aren’t entirely sure why. But we do know there are several factors that can increase your risk of developing cataracts. These are:

• A family history of cataracts

• Smoking

• Eye injury

• Long-term use of steroids

• Drinking too much alcohol

• Health conditions, like diabetes.

Types of cataracts

There are many types of cataracts, including:

• Nuclear Sclerotic - The most common type of age-related cataract, forming at the centre of the lens. Over time, the lens gradually turns more densely yellow and further clouds your vision

• Cortical - This cataract develops on the outside edge of your lens, called the cortex. It can make your vision hazy, like you're looking through a fog

• Posterior Subcapsular - Formed inside the back of your lens capsule, the part of your eye that surrounds the lens and holds it in place. It will affect your close-up vision and make it harder to see in bright light.