About cataracts
How does the eye see?
Before we look at how a cataract develops it is necessary to find out how the normal eye works.
The eye functions like a camera. There is a focusing part at the front that produces a sharp image on the retina at the back of the eye.
The focusing part consists of the cornea and the lens. The pupil is similar to the aperture of a camera, regulating the amount of light entering the eye.
The retina contains special cells called rods and cones that register the light and turn it into electrical impulses that are sent to the brain so that we can see.
Fine vision such as reading is performed by a small central part of the retina called the macula.
How are cataracts formed?
The majority of cataracts occur as a part of the normal ageing process in the lens.
In some people who suffer from diabetes or eye diseases such as uveitis, they form slightly quicker. Cataracts can be hereditary and are sometimes seen in children.
Cataracts manifest as cloudiness and opacity within the lens inside the eye. Normally this lens is crystal clear and its purpose is to focus light onto the retina at the back of the eye.
Cataract formation is like the process of cooking an egg. At the start of cooking, the egg white is clear but steadily becomes opaque. A similar process occurs in the lens of the eye. The cloudy lens will not transmit light clearly on the retina therefore causing blurred vision.
Pauline’s story: Patient experience of life after surgery
What is cataract?: Mr Ursell explains the condition
Cataract Symptoms
How do cataracts affect vision?
Cataracts cause problems with vision, such as having difficulty whilst driving or watching television, or with close work and reading. Some cataracts cause glare in bright lights and can be particularly troublesome when driving at night.
Cataracts can also cause a yellowing of the vision. Having cataracts may necessitate an increase in the strength of glasses required to see clearly. Therefore, having to change the strength of your glasses frequently can be an early sign of cataracts.
Cataracts are painless and develop slowly over many years. However, the symptoms can occur over a short period of time. They are very common and most people will require surgery for cataracts at some stage during their lives.
Most people notice that they are having problems in their 60s but they can occur earlier or later.
Cataract Removal
Surgery is the only way to cure cataracts. There are no known dietary or lifestyle changes to prevent it. Although it is a common misconception, lasers are not usually used to remove cataracts.
Cataracts are removed by an operation called ‘phakoemulsification’.
You will have drops in the eye to dilate the pupil and to anaesthetise the eye. Local anaesthetic drops are used to numb the eye and prevent any pain.
A microscope and miniature instruments are used to painlessly dissolve the cataract and place a new plastic lens inside the eye. The strength of the lens is tailored to fit your eye and takes into account your glasses prescription. The 2.2mm long incision is self-sealing and does not usually require stitches..
No needle, no patch surgery
Professor Ursell has pioneered ‘no needle, no patch’ surgery.
Due to the way surgery is performed with micro incisions there is no need for needles to provide anaesthetic into the eye. The area is numbed with gentle eye drops that do not sting and the whole operation is painless so you stay awake throughout. You will not see any of the instruments and patients report seeing pretty swirling patterns similar to the Northern Lights.
As the disruption to the eye is so minimal and the incisions are so strong, there is no need to cover the eye with a patch after the operation which many patients used to find very inconvenient. Often patients claim that when looking in the mirror next day they cannot tell which eye has been operated on.
Naturally, we understand some patients have perfectly reasonable fears about having surgery whilst fully conscious but the benefits hugely outweigh the downsides. Professor Ursell has performed thousands of operations this way and is a specialist at reassuring you both before and during the operation.
We have found over the years that our figures show 99% of patients are comfortable with this and will always elect to have the second operation this way after the first. If you are still not comfortable with ‘no needle’ anaesthesia then we have the facility to provide general anaesthetic if needed.
Our aim is to make the whole experience as comfortable for you as possible and this attitude has enabled Professor Ursell to create one of the largest practices for cataract surgery in the area, mainly through word of mouth..
Vicky’s story: Vicky recalls her surgery and how she’s benefitting
Results & Risks
What are the risks and complications of cataract surgery?
Cataract surgery is generally a very safe procedure. However, as with any surgical procedure results cannot be guaranteed and occasionally complications do occur.
After surgery you may expect to experience some pain, light sensitivity and glare.
Mild irritation for a few days is common. Severe pain may indicate raised pressure or an infection, in which case please contact us immediately.
Light sensitivity and glare can occur. As the cloudy cataract is replaced with a crystal clear lens, it may take some time to adjust to the extra light entering the eye. One advantage of this is that colours seem brighter.
Variations in outcome.
Need for glasses after surgery.
The strength of the implant lens is calculated to minimise the need for glasses following the operation. Most patients with a monofocal implant will be able to see clearly without distance glasses and use simple reading glasses. Some patients elect to have reading vision and use distance glasses as an alternative. Sometimes you will require glasses for distance, reading or both despite perfect surgery. This means that the vision will be clear when wearing the glasses. In extreme cases, the implant may have to be exchanged.
Paul’s story: A Vice President of a major telecommunications agency, gave us an insight into how his life has changed since having cataract surgery.
Stitches
Modern phakoemulsification surgery does not require stitches, as a keyhole incision is used. Very rarely a stitch is used for technical reasons. This may cause some astigmatism and blurred vision until it is taken out two weeks after surgery.
Vision threatening complications
Cataract surgery is generally very safe and successful. The chance of having a serious complication that severely damages vision is in the region of 1 in 500.
Book an appointment
Contact a member of our team today to schedule an appointment and get started on your journey to better sight.