Frequently asked questions about cataracts

Cataracts are a common eye condition where the lens becomes cloudy, impairing vision. They develop gradually and may cause blurred vision, glare sensitivity, and difficulty seeing at night. Distinguished consultant ophthalmologist Mr Qasim Mansoor answers every possible question you may have about cataracts, including surgery and what to expect afterwards.

What people are prone to cataracts?

Cataracts typically occur as we grow older, although individuals as young as 40 may also develop them. Occasionally, infants are born with cataracts, in which case it's imperative to promptly inform your doctor and schedule an appointment with an Ophthalmologist for evaluation.

Risk factors for cataracts include the following:

• Family history of cataracts.
• Diabetes.
• Smoking.
• Prolonged use of steroids.
• Eye trauma.
• Excessive alcohol consumption.

Is there anything I can do to prevent cataracts?

Since cataracts develop as a result of ageing, unfortunately, medication or diet cannot contribute to the prevention of cataract development.

I’ve been told I have cataracts but was told to wait a while before operating, why was this?

Occasionally, alterations in the cataract within the eye may be minimal and may not impact your vision significantly. In such cases, if the specialist deems the changes to be mild, they might opt to postpone surgery until the cataract progresses to a denser stage. However, if the mild cataracts are interfering with your daily activities, it's possible to discuss this with the specialist, and surgery may be considered sooner.

How long does the operation take?

The surgical procedure typically lasts between 15 to 45 minutes. Occasionally, this duration may vary based on the complexity of the required surgical techniques and the surgeon's preference regarding the method of eye anaesthesia.

Will I be put to sleep?

The procedure is typically performed under local anaesthesia to ensure the area is numb, minimising any sensation. However, in certain cases, the surgeon may recommend a general anaesthetic, a decision that will be thoroughly discussed with you based on your best interests.

Will I experience pain during the procedure?

The eye will be numbed using drops and possibly an injection in the surrounding area, ensuring you should not feel any discomfort.

Will I see an immediate improvement after the surgery?

Yes, you should notice a clear improvement in your vision right away. If you experience worsening vision post-surgery, contact your surgeon promptly.

What postoperative care will be necessary?

Your surgeon will provide you with eye drops and schedule a follow-up assessment a few weeks after the procedure.

I've undergone cataract surgery, but I've been informed about a "secondary cataract." What does this mean?

After cataract surgery, a cloudy film may develop on the lens inside the eye, known as a "secondary cataract." This condition is common and can be easily treated with laser therapy by your surgeon.

Will I still need glasses after cataract surgery?

During the procedure, a new lens is implanted in the eye. Various lens options are available, some of which can eliminate the need for glasses entirely, while others may reduce dependence on them for certain distances. Your surgeon will discuss these options with you thoroughly before the surgery.

What are the potential risks associated with cataract surgery?

Like any surgical procedure, cataract surgery carries certain risks. Here are some possible complications that may occur during or after the surgery:

• Risk of infection.
• Inflammation.
• Bleeding.
• Swelling.
• Displacement of the lens.
• Development of glaucoma.
• Rare chance of sight loss (0.03% probability)

I've undergone laser refractive surgery on my eyes. Can I still undergo cataract surgery?

Yes, you can. It's advisable to provide the surgeon performing your cataract surgery with any reports from your laser refractive surgery during your initial consultation.

Is surgery the only option for cataract removal?

Yes, surgery is the primary method for removing cataracts.

I've undergone laser refractive surgery on my eyes. Can I still undergo cataract surgery?

Yes, you can. It's advisable to provide the surgeon with any reports from your laser refractive surgery during your initial consultation.

How is the cataract removed?

Cataract removal is typically done through a process called phacoemulsification, where a vibrating needle and a flow of fluid are used. This method is considered the safest because the small incision seals quickly and usually doesn't require stitches. It's important to note that laser is not used in cataract removal.

During the procedure, a small incision is made at the cornea's edge, and the cataract membranes are preserved to facilitate implant fixation. These membranes remain clear after removing the cloudy contents. However, there's a risk of these membranes becoming cloudy over time, with approximately a 50% chance within five years when using a Perspex implant. To mitigate this risk, acrylic or silicone implants are preferred, with opacification rates ranging from 5% to 30% within five years. If membrane opacification occurs, a simple outpatient laser procedure can restore vision.

What should I expect during my appointment?

Your initial consultation will involve a thorough examination using a slit lamp microscope to assess the eye's interior. Dilating drops may be used, so it's advised not to drive on the appointment day due to potential vision blurring. After the examination, your surgeon will discuss management options with you.

If surgery is recommended, it will be scheduled for a separate day. Before the surgery, you'll have another appointment for general health checks and eye measurements to select the appropriate lens for your operation.

I wear contact lenses. How does this affect my cataract treatment?

During your initial consultation, you'll be asked to remove your contact lenses for a comprehensive eye health assessment. Regardless of whether you wear contact lenses or glasses, the same treatment options are available for cataract surgery.

Can I drive after the operation?

No, driving immediately after surgery is not recommended. It's advised to wait at least two weeks before operating a vehicle.

When should I seek medical advice?

You should seek medical advice if you experience:

• Blurry or misty vision.
• Difficulty seeing in low light conditions.
• Increased sensitivity to bright lights or glare.
• Diminished brightness or vividness of colours.
• Halos around lights.

If you require cataract surgery and would like to book a consultation with Mr Mansoor, simply visit his Top Doctors profile today