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Cataract surgery, what is cataract and what to expect

What is a cataract?


A cataract is when the clear lens that is within the eye is no longer clear. It becomes a cloudy lens and results in blurred or cloudy vision. Over time, the cloudy lens can progress resulting in worse vision.




What causes cataract?


Most cataracts develop with ageing. They can also develop following an injury to the lens of the eye. Some cataracts develop after having previous eye surgery such as retinal detachment surgery or with diabetes. There may also be a link between cataract and smoking. They may develop with other medical conditions such as diabetes. Other less common causes of cataract are genetic when they develop at birth.



Can cataracts be cured?


The vision with cataracts can be improved by using glasses, having better lighting or wearing sunglasses if they are causing glare. There is no medical cure for cataracts and the treatment required is surgery.


What are the 3 types of cataract?


The three most common types of cataract are nuclear sclerotic, cortical and posterior sub capsular. There is another less common type called polar which develops earlier in age. The symptoms of each type are as follows:


  • Nuclear sclerosis - this is where the nucleus which is the main part of the natural lens hardens and yellows. Initially it can just change your eye prescription and give you second sight which is a temporary improvement in your near vision. As it progresses however, worse vision will develop.

  • Cortical - these are more common in people with diabetes. The natural lens develops a spoke like appearance which gives problems of glare in sunlight as well as changes in contrast and depth perception. Eventually a clouded lens will develop and vision loss.

  • Posterior subcapsular - these are more common in diabetes, those are very short sighted and patients with medical conditions that have required steroid treatment or those that use steroids recreationally. Initially there are changes in night vision and difficulty reading. There may also be glare in sunlight. This type of cataract tends to develop more quickly than the nuclear sclerosis or cortical types.


How long do cataracts take to develop?


Most cataracts are age related and develop slowly over years. Cataracts due to diabetes or steroids may develop much more quickly. Cataracts due to trauma or an injury to the eye can develop over days.


Will I still need glasses after cataract surgery?


After cataract surgery most people choose to have good distance vision with the need for glasses for reading. Some people who don't want to wear glasses choose to have extended vision or multifocal lenses in their surgery which can make them less dependant on glasses. For prolonged reading however or certain lighting situations glasses may still need to be used.



Is cataract surgery painful?


Cataract surgery is a painless procedure for most patients. For the few who report pain during the surgery, the ophthalmologist can take certain steps during the surgery to limit any discomfort such as increasing the anaesthetic or giving a different type of anaesthetic around the eye during the operation.


Does cataract surgery give you 20 20 vision?


There is a high chance of getting 20 20 vision following cataract surgery if there are no other problems affecting the eye. However this is not guaranteed. It is important to discuss the possibility of getting excellent vision with your cataract surgeon during the initial consultation and discuss what type of intraocular lens is most suitable for you as they all have their advantages and disadvantages.



Are you sitting or lying down during cataract surgery?


You will need to b lying down during your cataract surgery. For some people who are unable to lie flat a slight tilt can be provided or a general anaesthetic given if the tilt is not sufficient to keep you comfortable during the operation.



What happens if you blink during cataract surgery?


You are able to blink normally during cataract surgery. A device in placed in the eye so that the eyelids do not move. Numbing drops are applied so that you do not feel discomfort or pain. Forceful blinking is not recommended as this can make you feel discomfort from the device that is used during the procedure.


Can you watch TV after cataract surgery?


You can watch TV after cataract surgery on the same day. The vision may still be blurred and should improve over the next 3 days. There is no harm from using your eye to watch or see things during this time.


Do and dont's after cataract surgery


Do:

  • Use you your eye drops as instructed by your ophthalmic surgeon

  • For the first 3 days take things easy

  • Use your eye shield at night for the first week

  • Take simple painkillers if you need them

  • Shower and bathe normally but avoid water entering the eye for 1 week

  • Read, use your computer and watch your TV

  • Wear sunglasses when going outdoors

  • Avoid swimming for 1 month after the surgery

Don't:

  • Allow water, shampoo or soap to enter your eye for 1 week

  • Rub your eye

  • Lift any heavy weights, do strenuous exercise or housework

  • Wear make up or eye creams for the first 4 weeks

  • Drive until your doctor says your vision is good enough for you to do so