In the eye there is a lens which focusses light on the retina at the back of the eye. This lens should be clear to allow light to pass through it and to achieve good vision. If this lens becomes cloudy it is called a cataract. A cataract can be mild to severe and can occur in one eye or both eyes. See “About the Eye” for more information about eye anatomy.
Cataracts & Cataract Surgery
As a cataract develops it begins to reduce vision. Cataracts can make the vision blurred when looking in the distance and for reading. When cataracts are present, glasses will not fix the vision because the light cannot get to the back of the eye without being obstructed. Cataracts can cause other symptoms such as glare around lights when driving at night, or halos around lights.
Usually cataracts are part of the ageing process. Occasionally cataracts can occur for other reasons such as after previous eye surgery, eye injury or from steroid eye drop use.
- Come for an assessment: An assessment involves getting your vision checked, undertaking various painless tests and then seeing your eye surgeon to assess your cataracts.
- Discuss with your eye surgeon whether cataract surgery is appropriate
- Organise surgery for your first eye (the second eye can be done a few weeks later)
Cataract surgery involves the removal of the cloudy lens (the cataract) and replacement with an artificial lens (called an intraocular lens).
Just before surgery, the pupil is dilated. This allows the surgeon to access to the lens which sits behind the pupil. In surgery, small incisions are made in the cornea. The lens is broken up into small pieces and removed using ultrasound energy (called phacoemulsification). A new artificial lens is folded so that it can fit through the small corneal incision and then opens within the eye. Antibiotics are placed in the eye and a dressing is used to cover the eye before you leave the operating theatre.
Most cataract surgery is performed with local anaesthetic and sedation. The anaesthetist will place a drip in the arm and give sedation, then place anaesthetic around the eye so that there is no pain during the surgery. Occasionally a general anaesthetic is performed.
On the day of surgery it is important to remember to fast appropriately. The hospital will give you instructions in advance. When you arrive at the hospital you will fill in forms and be given drops to dilate your pupils. After surgery you will be allowed to go home and you will need someone to assist you. You will not be able to drive. You will have an eye patch covering the eye that has had surgery. That night you should rest and leave the pad in place.
You will be reviewed on the first day after surgery. At this point the bandage will be removed. The vision is often blurred after surgery and gradually improves over days or weeks. Please follow your doctor’s instructions but some common recommendations include:
- Post-operative antibiotic and anti-inflammatory drops are used for about 4 weeks after surgery. These should be started on the first day after surgery. They should be taken at least 3 minutes apart.
- Use only medications ordered by your doctor
- Avoid rubbing or pressing on the eye
- Avoid strenuous activities
- Try to avoid getting the eye wet during first week after surgery. You may wash your face with a washer but don’t wash your hair if you cannot keep water out of the eye.
- Don’t wear eye-make up for two weeks after surgery
- The shield should be applied at bedtime to the operated eye for 7 nights
- Sunglasses should be worn outdoors
- Ask your doctor about driving and working
You will generally be checked again a few weeks after surgery.
Please contact your doctor immediately if you develop:
- Vision loss or a drop in vision
- Significant pain
- The eye becomes red
- You see flashing lights or floating objects in your vision
If needed, the second eye surgery is usually performed a few weeks to a month after the first eye.
As with any surgery, there are risks with cataract surgery. Fortunately severe complications such as infection and loss of vision are infrequent, but they can occur. It is important to discuss with your eye surgeon all the risks that are involved in cataract surgery.
- Distance vision: The majority of people choose to target good distance vision without glasses. Most people will then wear reading glasses and/or multifocal glasses.
- Monovision: Some people want to reduce their requirement for glasses. Monovision involves targeting distance vision with one eye and near vision with the other eye. This can be a good solution for some people. Your eye surgeon will discuss with you the pros and cons of Monovision.
- Multifocal intraocular lens: Another option to reduce the requirement for reading glasses are multifocal intraocular lenses. In contrast to monovision, the target is for each eye to see both distance and near. Multifocal lenses can be a good option for people who do not want to wear reading glasses. There are a number of specific issues that can occur with these lenses, so it is important to discuss these with your eye surgeon.
You can get new reading glasses approximately one month after your cataract surgery.