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What are cataracts?

Cataracts are formed when the clear lens inside your eye becomes cloudy or misty. This is a gradual process that usually happens as we get older. It does not hurt. The early stages of a cataract do not necessarily affect your sight, but if your sight becomes very impaired you may be referred for surgery to replace the cataract with a clear artificial lens. This surgery is normally carried out under a local anaesthetic and has a very high success rate.

Who is affected by cataracts?

Cataracts mainly develop in those aged 65 or older. Younger people can develop cataracts following an injury to the eye. Some medical conditions such as diabetes, or taking some sorts of medication such as steroids, may also cause cataracts. Smokers are also more likely to develop cataracts than non-smokers and there may also be a link between UV rays (sunshine) and cataracts. A very small number of babies are born with a cataract.

What are the symptoms of cataracts?

If you have cataracts you may notice that your vision is less clear and distinct. Car headlights and streetlights can become dazzling, and you may experience difficulty moving from shade to sunlit areas. Colours may look faded or yellowed.

Many people with a cataract notice that they need to change the prescription for their glasses more often than they used to. If you are long-sighted, you may even notice that you need your glasses less than you did before you had the cataract!

How do you treat cataracts?

Cataracts often simply mean that your prescription for glasses needs changing. If the cataract is still affecting your day-to-day life, and your optometrist cannot improve this enough by changing your glasses, you can ask them to refer you to an ophthalmologist (eye specialist) for surgery. This involves removing the cloudy lens (the cataract) and replacing it with a clear plastic one. If you have cataracts in both eyes, surgery will normally be carried out on one eye at a time.

What does cataract surgery involve?

Before cataract surgery
Surgery can be done as soon as the cataract is interfering with your daily life. You will have an initial appointment, usually with the ophthalmologist at the hospital, where you will be asked about your general health to help make sure that the operation is suitable for you. The ophthalmologist will also discuss the risks, and how they apply to your individual case.

If you decide to go ahead, you will be booked in for surgery. The ophthalmologist will assess and measure your eyes so that they can choose the correct lens to put in to your eye. If you wear contact lenses, you must leave them out for a week before the operation, as they may affect the accuracy of these measurements. The ophthalmologist may also be able to correct short- or long-sightedness and you may not need to wear your glasses as much after the operation.

During the cataract surgery
Most people will have one cataract removed at a time. However, some surgeons will carry out the operation on both eyes at the same time for patients who are at low risk of complications.

The operation usually takes from 15 to 45 minutes. It is normally carried out under local anaesthetic, so you will be awake, but will not have any sensation in the area around your eye. Some people may also be offered sedation. Throughout surgery, you will hear the ophthalmologist explaining what they are doing, and you may see some vague movements around your eye.

The ophthalmologist will make a tiny cut in your eye in order to remove the cataract and insert a plastic replacement lens. You will not normally need stitches, but your eye will be covered to protect it from knocks after the operation. You will be allowed to go home the same day, but should have someone to go with you and to look after you for 24 hours after surgery.

After cataract surgery
You will be given eye drops to use for the first few weeks after your operation. Nearly all of your vision will return within two days of surgery and many people are able to return to their usual daily routine 24 hours after the operation. You should avoid heavy lifting and strenuous exercise immediately after the operation, but you can carry on with most other activities around the home as normal. You should not drive until your ophthalmologist or optometrist advises you it is safe to do so. Your ophthalmologist will advise on when you can go back to work.

You should avoid wearing eye make-up, swimming, and getting soapy water in your eyes when you wash your hair for two weeks after the operation. If you go out on a windy day, you may feel safer wearing sunglasses to prevent grit getting in your eye.

After cataract surgery most people need to wear glasses for either distance, near vision or both. If you wore glasses before the operation, you will probably find that they will need changing after the operation – your ophthalmologist will advise when you should book an eye examination. You may find that it takes a few weeks to adapt to your vision with new glasses after cataract surgery. This is normal, and is due to your brain adapting to a different prescription.

If you have any concerns, call the eye clinic for advice.

Will my cataracts come back?

After some months or years, some people notice that their vision becomes cloudy or misty again in the eye where the cataract has been removed. This is not the cataract returning, but is due to the sac which contains the replacement lens clouding up. This cloudiness can be removed by painless laser treatment in a matter of minutes. Contact your optometrist if you are worried that this is happening to you.

Cataract advice, information and support

The Royal College of Ophthalmologists