What is a cataract?
Inside the eye behind the pupil there is a natural lens. This lens is meant to be clear. When the lens becomes cloudy, or dark, it is called cataract.
How do cataracts affect vision?
As cataracts develop there will be a gradual deterioration in vision. There may also be problems with glare and sensitivity to bright lights. As the cataracts progress there may also be haloes around bright lights, especially noticeable during night driving. Colours will often become duller and darker and vision will progressively become more blurred, hazy and foggy.
How are cataracts treated?
Cataracts cannot be treated or prevented with medication, exercise or alternative therapy. Once they have developed surgical removal is the only treatment. The decision to proceed with cataract surgery will depend upon the degree to which the cataract is impairing vision and effecting lifestyle.
Surgical treatment involves removing the cloudy natural lens and replacing it with an artificial intraocular lens (IOL) implant. Cataract surgery can be performed using a variety of techniques but the most usual is small incision phacoemulsification or laser assisted cataract surgery (LACS).
This involves making a small incision (usually less than 3mm) and inserting a small probe into the eye. The probe is used to divide the natural lens into small pieces which are then suctioned away. The folded IOL is then inserted through the small incision into the eye, where it is unfolded and moved into position. The wound is then sealed without the use of stitches. After surgery the eye is covered with a patch for protection. This patch will be removed when you see the doctor the day after your surgery.
In LACS, the cuts and incisions are all made by a laser beam which will soften the central part of the cataract and divide the cataract into small pieces. The rest of the surgery is performed in the traditional way.
What happens after cataract surgery?
Visual improvement varies from patient to patient, but is usually noticed within the first few days following surgery. Initially bright lights will appear intense and it may be beneficial to wear sunglasses when outside. Antibiotic and anti-inflammatory drops are usually used for 3 to 6 weeks. Glasses are often still needed especially for reading and a new prescription will be provided once the eye has healed and drops are discontinued.
If both eyes are affected by cataract, surgery on the second eye will be performed on a different day, usually after the first eye heals. In some cases, pre-existing medical or ocular problems may prevent full visual improvement.
Can cataracts return?
No. Once the natural lens has been removed a cataract cannot come back. However, in some patients there can be a clouding of the original lens capsule which sits behind the intraocular lens. This clouding may take months or sometimes years to develop and is easily treated. A procedure called laser capsulotomy is performed to create an opening in the capsule which will restore clear vision. The procedure takes a few minutes, is painless and performed at Hawthorn Eye Clinic.
Do you take the eye out to do my surgery?
No we don’t. The eye is operated upon in its natural place.
I don’t want to feel anything. Will I feel something?
With the sedation in your vein you will be in a twilight sleep and with the anaesthetics around the eye, the eye will be numb. You will feel the surgeon touching your temple or forehead, but you should not feel pain. If you feel pain we can top up your anaesthetics. Some patients do not even remember the surgery, due to the sedation.
Do I have to have it done?
Cataract may reduce your vision below the legal requirements to hold a Driver’s Licence. It can also affect your ability to read and play sports. Reduced vision may increase your risks of falls and fractures. Patients with reduced vision from cataracts may suffer more from depression and tend to socialise less than patients with normal vision. If your cataract is causing significant blurriness of your vision, you should seriously consider cataract surgery. In some patients the blurriness of vision happens so slowly, that they become accustomed to it and will be unaware of it.
Is the surgery done by laser?
There are different ways of doing cataract surgery. Laser Assisted Cataract Surgery (LACS) is one option to do the surgery. Discuss this further with your eye surgeon.
Is there a risk with the surgery?
The success rate is very high (about 98%) Like any other operation there is a risk. However cataract surgery has a very high success rate of about 98%. Most complications can be treated successfully. The risk of losing vision or losing the eye from cataract surgery is less than 1 in 1000. Your eye surgeon will discuss the risks with you.
When can I drive after the surgery?
This varies from one person to another.
When can I play golf again?
Probably 4 weeks after the surgery.
Will I need to wear glasses?
The traditional way to do surgery is to insert a plastic lens that will give you good vision for distant objects, but you will need glasses for close-up work like reading. You may need “fine tuning” glasses for driving and watching TV.
The other options include “multifocal implants”, which have a good chance of giving you good vision for near and far objects, without glasses, but it will give you “halos” around light and a slight drop in contrast. Multifocal implants are best suited for patients who don’t want to wear glasses and are happy to accept small imperfection in their vision. Another option is to set one eye for distance and one eye for near work. This is called “mono-vision”. This option does not suit everyone. If you are keen on this option, it is best to have a trial prior to the surgery with your glasses or contact lenses.
How much will it cost me?
Your out-of-pocket payment will depend on whether you have private health insurance. For insured patients, we strongly recommend that you check with your health fund whether your are covered for cataract surgery (item 42702).
We will provide you with a written estimate of your out-of-pocket costs for the surgeon. Your health fund will inform you if you will need to pay an excess on admission to hospital. As anaesthetists charge different fees, we provide you with the phone number, so you can call them and be informed of their fees in advance.