Overview

Cataract surgery
Cataract surgery

Cataract surgery involves replacing the cloudy lens inside your eye with an artificial one.

It has a high success rate in improving your eyesight.

It can take 2 to 6 weeks to fully recover from cataract surgery.

What are cataracts?

Cataracts are when the lens of your eye, a small transparent disc, develops cloudy patches.

When we're young, our lenses are usually like clear glass, allowing us to see through them.

As we get older they start to become frosted, like bathroom glass, and begin to limit our vision.

Cataracts most commonly affect adults as a result of ageing. 

Find out more about age-related cataracts

Do you need surgery?

If you have cataracts, it's your decision whether or not to go ahead with cataract surgery.

Cataracts usually get slowly worse over time.  Whilst spectacles and brighter reading lights may help for a while, surgery to replace the cloudy lens is the only way to improve your eyesight.

Surgery is usually offered on the NHS if your cataracts are affecting your eyesight and quality of life.

The decision to have surgery should not be based solely on your eye examination (visual acuity) results.

You may have other personal reasons for deciding to have surgery, such as your daily activities, hobbies and interests.

You can choose to put off surgery for a while and have regular check-ups to monitor the situation.

There are no medicines or eye drops that have been proven to improve cataracts or stop them getting worse.

If you are concerned that you may have cataract, please make sure you have a regular eye examination at your local Optometrists (opticians). If you are over 60 or on certain financial benefits this is likely to be free on the NHS.

Find Opticians

If your Optometrist (optician) finds cataract that are causing significant symptoms, they are likely to put some drops in your eyes to get a better view of the rest of your eye to check for other eye conditions. They will also ask you a number of questions about your lifestyle and how you feel the cataract is affecting you before they refer you.

Before the operation

Before surgery, you'll be referred to a specialist eye doctor for an assessment.

During an assessment different measurements will be taken of your eyes and your vision.

The assessment is an opportunity to discuss anything to do with the operation, including:

  • your lens preference, such as near sight or long sight
  • the risks and benefits of having surgery
  • if you'll need glasses after surgery
  • how long you'll take to fully recover

If you're used to using one eye for distance and one for reading, which is called monovision, you can ask to stay that way.

This usually means you'll get a near sight lens fitted in one eye and a long sighted lens fitted in the other eye.

The operation

Cataract surgery is a straightforward procedure that usually takes 30 to 45 minutes.

During the operation, the surgeeon will make a tiny cut in your eye to remove the cloudy lens and replace it with a clear plastic one.  This incision is self healing and there is usually no requirement for stitches.

Under the NHS, you will usually be offered mono-focal lenses, which have a single point of focus.  This means the lens will be fixed for either near or distance vision, but not both.

With the NHS, you will usually be offered monofocal lenses, which have a single point of focus.  This means the lens will be fixed for either near or distance vision, but not both.

If you go private, you may be able to choose either multifocal or an accomodating lens, which allow the eye to focus on both near and distance objects.

Most people will need to wear glasses for some tasks, like reading, after surgery regardless of the type of lens they have fitted.

If you have cataracts in both eyes it may be recommended that both eyes are treated on the same day. This procedure is known as immediate sequential bilateral cataract surgery (ISBCS). ISBCS is usually only recommended for people thought to have a low risk of complications. The surgeon will discuss this with you if this is an option.

Find out more about recovering from cataract surgery.

Benefits of surgery

After cataract surgery you should be able to:

  • see things in focus
  • look into bright lights and not see as much glare
  • tell the difference between colours

If you have another condition affecting your eyes, such as diabetes, macula degeneration or glaucoma, you may still have limited vision, even after successful surgery.

Risks of surgery

The risk of serious complications developing as a result of cataract surgery is estimated at around 1 in 50 cases.

These can include:

  • blurred vision
  • some loss of vision
  • detached retina - where the thin layer at the back of your eye (retina) becomes loose

Most of these serious complications can be treated with medicines or further surgery.

There's a very small risk – around 1 in 1,000 – of permanent sight loss in the treated eye as a direct result of the operation.

 

Recovery

You should be able to go home on the same day as your cataract surgery.

You may have a pad and plastic shied over your eye when you leave hospital, which can usually be removed the day after surgery.

Feeling should start to return to your eye within a few hours of surgery, but it may take a few days for your vision to fully return.

It's normal to have:

  • grittiness
  • watering
  • blurred vision
  • double vision
  • a red or bloodshot eye

These side effects usually improve within a few days but it can take 4 to 6 weeks to recover fully.

You will normally be advised to see your local Optometrist (Optician) after this recovery period to check if you need any new glasses, they may also help you decide after a first eye operation whether the other eye may also require surgery for cataract surgery, or in the future.

Cataract surgery has a high success rate in improving your eyesight and should allow you to return to your normal activities, like driving.

When to seek help

Contact your eye surgery department as soon as possible if you experience:

  • increased pain and/or redness
  • decreased vision

Do's and don'ts

For the first few weeks after surgery:

Do:

  • use your eye drops as instructed
  • take it easy for the first 2 to 3 days
  • use your eye shield at night for at least a week
  • take painkillers if you need to
  • bathe and shower yourself as usual
  • wear your eye shield when washing your hair
  • read, watch TV and use a computer
  • use your shield, old glasses or sunglasses outdoors
  • avoid swimming for 4 to 6 weeks

Don't:

  • do not rub your eye
  • do not allow soap or shampoo to get into your eye
  • do not drive until you get the all-clear from your doctor
  • do not do any strenuous exercise or housework
  • do not wear eye make-up for at least 4 weeks
  • do not fly without seeking advice from your doctor

You could arrange for someone to help take care of you until your vision returns, particularly if the vision in your other eye is poor.

If you work, how soon you can return will largely depend on your type of job and if you need new glasses.

Using your eye drops

Before you leave hospital, you'll be given some eye drops to help your eye heal and prevent infection.

It's important to use your eye drops as instructed by your doctor. 

Unless told otherwise, you should:

  • start your eye drops the morning after the operation
  • only use them on the operated eye
  • wash your hands before using your drops
  • don't stop your eye drops without advice from your doctor
  • don't let anyone else use your eye drops

You will be told how long to use your drops for at the hospital after your operation and what to do if you have any problems. Most patients will not be followed up at the hospital but you will be advised to book an appointment with an optometrist (optician) 4-6 weeks after your surgery date. The optometrist will do a check up and report back to the hospital and GP on how your eyes are post surgery.

How to apply eye drops

1. Wash your hands.

2. Tilt your head back.

3. Look up at the ceiling.

4. Gently pull down the lower lid.

5. Squeeze the bottle until a drop goes into your eye.

6. Close your eye and wipe away excess liquid.

7. Do not let the bottle touch the eye.

8.  Safely dispose of the drops once you have finished your course of treatment.

How to clean your eye

  • boil some water and allow it to cool
  • wash your hands
  • dip cotton wool or clean gauze in the cool boiled water
  • gently wipe from the inside (near your nose) to the outside corner of your eye
  • do not wipe inside your eye
  • do not wash your eye out with water
  • do not press on your eye

During the first 2 weeks, you may need to clean your eye twice a day because the drops and the healing process can cause slight stickiness.

Find out more about cataracts on the RNIB website.

 

 



The information on this page has been adapted by NHS Wales from original content supplied by NHS UK NHS website nhs.uk
Last Updated: 19/10/2021 12:17:49