A cataract can occur in one or both eyes but can’t spread from one eye to the other. Cataracts are painless and if left untreated, can result in complete loss of vision. They can also impact your quality of life, by limiting your ability to drive, read or perform daily tasks.
Many patients will have early cataracts and not have significant visual symptoms. For these patients it is often appropriate to leave the cataract alone until symptoms develop. The only proven effective treatment for cataracts is surgical removal; fortunately, cataract surgery is a very safe and common procedure that can restore cataract-related vision loss.
Symptoms of cataracts
Cataract symptoms often develop gradually, and can include:
- Cloudy or blurry vision (often described as looking through a frosted glass or through a mist)
- Problems with reading, particularly street signs or writing on the TV
- Sensitivity to glare (difficulty with oncoming headlights or the sun low in the sky)
- Difficulty with seeing faces against a bright background
- Multiple images (for example seeing double in one eye)
You might have been told by your optometrist that you have an early cataract but at this stage your symptoms may be mild with no change in vision. However, your symptoms are likely to become more noticeable as the cataract develops. Once they start to interfere with your daily activities, book an appointment with your optometrist or GP or who can discuss the next steps, which might involve cataract surgery.
What causes cataracts?
Cataracts are very common – it is estimated that more than 370,000 people in New Zealand have the condition.
Cataracts are often related to ageing, as the natural lens in the eye changes from being clear to becoming more cloudy and yellow during middle age. However, cataracts can also develop in younger people because of illness, medications or injury to the eye.
There are four broad causes for cataracts:
- Age-related cataract: This is by far the most common form of cataract, generally occurring in people over 60.
- Secondary cataract: Caused by another medical condition, such as diabetes or the long-term use of certain medications.
- Congenital cataract: Present at birth or becoming apparent during childhood, due to a genetic condition, injury, or infection.
- Traumatic cataract: Caused by a significant injury to the eye, for example a heavy blow or object hitting the eye.
Risk factors for developing cataracts include:
- a family history of cataracts
- long-term steroid medication
- previous eye injury
- lifestyle factors including diet and smoking
- high levels of exposure to UV light, for example from working outside
Do I need to have cataract surgery?
Cataract surgery is very rarely an essential operation, and if your cataract is mild you can choose to delay having surgery until your symptoms worsen. Cataracts usually progress in time and no medical treatments have been shown to improve or slow down their development. Your optometrist can monitor the cataract’s development until you feel it is time to consider surgery.
What happens at my initial cataract consultation?
During your initial visit to St George’s Eye Care, you will undergo a detailed assessment. This will include a range of non-invasive tests to measure your eyes and to evaluate your overall eye health. We will ask questions about your medical history to fully understand your health. Your consultant will explain all the findings and discuss the options for treatment. This will include explaining the surgery and considering different lens implant choices.
Modern surgery is highly successful for most patients but, as with all operations, there are cataract surgery risks which your consultant will discuss with you.
If you are happy to proceed, an appointment will then be booked for you to attend to have surgery.
What happens on the day of cataract surgery?
On the day of surgery, you will be admitted into St George’s Hospital’s Day Care Unit. Anaesthetic drops will be administered into your eyes to ensure they are numb before surgery, to prevent you feeling pain. Surgery is a short and usually routine procedure that is performed in the operating theatre.
Once in the operating room you will be lying on your back while holding one of our nurse’s hands for reassurance and communication. Meanwhile, the surgeon will prepare your eye and then perform the surgery, which involves removing the cloudy lens and replacing it with a clear, artificial lens made of a type of plastic (called an intraocular lens or IOL).
Afterwards, a recovery nurse will ensure you are comfortable and go through the discharge instructions with you. You will not need to stay in hospital overnight and can travel home shortly after the operation.
What anaesthetic options are available?
Over 90% of patients at St George’s Eye Care choose to be awake and have topical anaesthesia (with eye drops) to numb the eye during surgery. This ensures a rapid recovery with excellent results for our patients. Your surgeon will discuss this with you in more detail at the time of booking your surgery.
What is refractive cataract surgery?
You may hear this term when reading about cataract surgery. Essentially, this refers to cataract surgery where the emphasis is to minimise the need for glasses after surgery. At St George’s Eye Care, we consider all cataract surgery refractive in nature, and we will always discuss with you what you can expect regarding the need for glasses afterwards.
When the cataract is removed, we replace this with an artificial intraocular lens, of which there are many different varieties and options available. Your eye surgeon will discuss the range of lens options that are available and explain whether these are appropriate for your eye and your needs. It is only with the extensive tests and assessment at your initial consultation that the surgeon can advise you on which lens is most suited to you. Options include standard monofocal lenses, toric lenses to correct astigmatism, plus multifocal or extended depth of focus lenses to assist with near vision tasks.
In 2021, St George’s Eye Care was one of the first eye clinics in New Zealand to offer patients a new class of intraocular lens that provides an extended range of vision You can read more about this option here.
What is recovery like after cataract surgery?
A clear shield, or sometimes a full eye pad will be placed over your eye at the end of the operation. There may be some mild discomfort for the first day or two, and your vision could be blurry at first – this is completely normal. You will be prescribed eye drops to reduce inflammation while your eye heals, these typically are taken for four weeks.
During the first two to three weeks, it is important to avoid heavy lifting, strenuous activity and swimming. For the first week we recommend you avoid dirty environments where you might get dust or mud splashed into your eye. We also recommend that you don’t use eye make-up, to prevent irritation.
Why choose St George's Eye Care for your cataract surgery?
At St George’s Eye Care, we have performed more than 4000 cataract operations since opening in 2015, using the latest surgical techniques – including small incision cataract surgery, which reduces recovery time and complications. We can offer you the convenience of cataract surgery onsite at St George’s Hospital (where we are located). The theatres are state-of-the-art and opened in 2020.
We encourage all patients to play an active role in their treatment plan, and we take a personalised approach to cataract surgery. We ensure you will have a high-quality, dedicated ophthalmic care team. You will see the same eye surgeon before, during and after your treatment, and we communicate regularly with your GP and optometrist regarding your long-term eye health.
Our two ophthalmologists, Dr Paul Baddeley and Dr Oliver Comyn, are highly skilled and experienced with over 35 years of cataract surgery between them. They both worked at prestigious eye hospitals in the United Kingdom and are regularly involved in clinical research and teaching.
We use the latest equipment and intraocular lenses for our patients, and we also endeavour to ensure our charges are affordable so that quality cataract surgery remains accessible.
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Want to know more?
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Alternatively, please don't hesitate to phone or email us with any questions.
We look forward to talking with you soon.
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