A cataract is a very common condition which causes cloudiness in the lens of your eye and reduces your ability to see. Cataracts get worse over time and with age, so your vision progressively deteriorates.

Mr Wallace Poon, Consultant Ophthalmic Surgeon, explains what cataracts are.

Your eye is shaped like a ball, with clear tissue at the front called the cornea. Light entering your eye through the cornea is focused by the lens onto the retina. The cornea does most of the work, while the lens ‘fine-tunes’ the focus.

The shape of your lens constantly changes to help you see things clearly in the distance and close up. This is called ‘accommodation of vision’. As you get older, your lens becomes less able to change its shape to focus properly. When this happens, most people can see clearly in the distance, but they aren’t as good at seeing things close up.

The lens of your eye can also be affected by a cataract. The lens is normally clear so that light passes directly through and focuses on your retina. The lens is clear because of the way its cells are arranged. When a cataract develops, it changes the way these cells are arranged, causing the lens to become cloudy instead of clear. This results in less light passing through the lens and a reduction in the quality of your vision.

Cataracts can occur for a number of reasons, including:

• Getting older (age-related cataracts)
• Long-term steroid medication
• A family history of cataracts
• Diabetes (blood sugar levels above a safe range can cause changes that result in cataracts)
• Eye injury

Cataracts usually develop slowly and although symptoms vary from patient to patient, there are common symptoms that most people will experience.

Most patients eventually develop a cataract in both eyes, but not necessarily at the same time. When a cataract starts to develop, you may begin to feel your sight isn't quite right. If you wear glasses, the lenses may seem dirty, even when they're clean. Gradually, you’ll find your sight becoming cloudier, making it harder to see.

For many people, bright lights appear to glare, and car headlights become more dazzling than they used to be. There may also be a slight change in your colour vision, with objects appearing more yellow than before and colours may look different when looked at with one eye as opposed to both eyes.

If a cataract is ignored, your sight will become increasingly cloudy, resulting in a deterioration of your vision. Most people choose to have their cataracts removed when the change in their vision starts to impact on everyday life.

When your vision affects your quality of life and prevents you doing things you love, your GP or Optician may recommend cataract removal surgery. You can also choose to have corrective lens replacement surgery.

You can choose from a range of advanced lenses, which will correct your eyesight at the same time as removing your cataract. Your Consultant will help you decide which lens replacement surgery would best suit your lifestyle.

Standard lenses

The standard artificial lens is monofocal. This provides one focal point, so you can choose to have either clear distance vision or the near vision needed for reading, using a mobile phone, looking at a watch or choosing from a menu. If you opt for this lens, you'll need reading glasses or distance glasses after your cataract surgery.

We'll also check your eyes for astigmatism; if these are present (and significant) you may need to continue to wear glasses at all times after cataract surgery, unless you opt for the Toric lens option.

Multifocal lenses

If you’d like to be assessed for multifocal lenses as part of your cataract treatment, you’ll need to attend a special lens clinic with an Optometrist and a Consultant, who’ll perform a few tests to determine your suitability.

These lenses provide clear vision plus a full range of vision - distance, intermediate and near. You’re less likely to need glasses after this cataract treatment, if at all. There are some compromises with these lenses, which will be discussed at your consultation.

Toric lens for astigmatism

Toric lenses correct astigmatism and are available as a monofocal or multifocal lens. Our expert Ophthalmic Consultants now use Callisto Eye®, our new ultra-modern microscope to achieve perfect alignment of your toric lenses.

This technology allows for faster treatment due to less manual functions and reduces the risk of refractive errors and residual astigmatism.

Find out more about your lens replacement options from our cataract surgery brochure (PDF).

You’ll be treated in our safe, comfortable and modern Eye Unit. The cataract removal is carried out as day surgery, so you’ll be able to return home on the day of the operation, although you won’t be able to drive yourself.

The operation takes around 30 minutes and will be carried out under a local anaesthetic, so you’ll be awake, but you won’t be able to feel any pain. After the local anaesthetic has taken effect, your surgeon will make tiny cuts on the surface of your eye in order to remove the cloudy lens. The lens will usually be broken up using ultrasound waves, before it’s removed. The capsule the lens sat in is left behind and the new artificial lens will be placed in this capsule, where it will remain permanently.

After cataract surgery, your eye is usually left without stitches, allowing it to heal naturally

If you’re attending for cataract removal, you don’t need to bring anything with you though you may like to wear sunglasses after your surgery. 

Cataract surgery isn’t painful; although some patients report pressure or discomfort. Numbing agents such as a local anaesthetic will be used to ensure your procedure is as comfortable as possible.

The cataract operation itself takes about 15-20 minutes, though you may be in the department between two and four hours.

We have the time and space to care and our experienced team will talk you through your recovery after private cataract surgery.

You may have some mild pain or discomfort after the cataract removal which we’ll help you manage with simple painkillers. It may take several hours before the local anaesthetic wears off and you can start to feel your eye properly again, and it’ll probably be covered with a protective bandage. You may have eye drops to help prevent infection and to control swelling in the eye.

We’ll discuss your aftercare and any follow-up appointments with you before you leave the hospital.

You’ll need to wear the shield until the morning after your operation. You can then remove it during the day and start your eye drops. However, you’ll need to wear the shield for three nights to protect your eye while you sleep.

Although the discomfort can last only a few days, some patients notice that they feel fatigued for a few days after the operation and may need to take some time off work if you feel more tired than usual.

Most people notice their discomfort easing a couple of days post-surgery. However, the healing process can take between four and six weeks.

• Avoid excessive bending down or bending over, heavy lifting and strenuous activity as this can increase blood pressure in the eyes
• Avoid rubbing your eyes for the first week
• Do use any medication that’s prescribed to you, and take painkillers if you experience discomfort
• Do continue to use your eyes; read a book if you’re able to

Our advice is to refrain from driving for one week following surgery.

Your Consultant will be able to advise, depending on the activity. For example, we’d advise that you don’t start swimming again until four to six weeks after your surgery.

Our advice is to refrain from wearing makeup for four to six weeks after surgery.

Your clinician will take measurements of your eyes at your pre-operative assessment. This allows us to work out the best prescription lens to use at the operation. We aim to give you normal distance vision, but you may need to use reading glasses after the operation.

We advise that you attend your optician approximately six weeks after your cataract surgery.