Cataracts: Diagnosis and treatment

Diagnosis

The optician can usually see whether you have a cataract and how much of the lens is affected during an ordinary sight test.

You are unlikely to be offered any treatment if your sight is only mildly affected and not causing practical difficulties.  Wearing stronger glasses or using a brighter light when reading may be all you need at this stage.
 
Your optician can monitor the progress of your cataract at subsequent eye tests.  If you are under 70, you should have an eye test every two years. You should have an eye test every 12 months, if you are aged 70 and over. Eye tests check your eye health as well as your vision.

It is important to remember that you have a legal obligation to notify the DVLA (Driver and Vehicle Licensing Agency) if your vision or any medical problem is affecting your ability to drive. You should, when wearing your glasses, be able to read a car number plate at 20 metres.

Treatment

If the cataract is causing problems with glare, driving and reading road or other signs, recognising people’s faces or is stopping you do things you enjoy, you can be referred to a consultant ophthalmologist (eye specialist) at the hospital. 

You can discuss whether an operation to replace the cloudy lens with a clear plastic lens is appropriate and also the benefits and any potential risks of an operation. It may be possible to correct for short or long sight at the same time, so that your overall eyesight improves too. If you have cataracts in both eyes, they will be treated on separate occasions.

Some questions to ask before agreeing to an operation

• are there different types of lens available and what are their pros and cons?
• will this lens need replacing in the future?
• will there be things I might find difficult in the weeks after the operation? This is particularly relevant if you live alone.
• will it affect my glasses prescription?
• will I need to wear glasses once I have recovered from the surgery?
• when can I start driving again after surgery?
• are there any activities I should avoid whilst I recover from surgery?

If you are concerned about doing particular activities whilst recovering from surgery, such as dancing, yoga, or going to the gym, then ask your ophthalmologist for their advice.

If you live alone and have sight loss in one eye and rely on the vision in the eye to be operated on, let the hospital know. The hospital can help you arrange, through Social Services, any support you may need at home just while you recover from the surgery.

If you agree an operation is appropriate, you will be asked to attend an outpatient appointment.  Here measurements are taken for the new lens and there’s another chance for you to raise any further questions.

The operation normally takes place a week or so after this appointment and is usually a day surgery procedure under local anaesthetic.  So although you are awake, your eye is numb and you don’t feel anything.

After the operation 

You may experience a little discomfort immediately after the operation. Your vision will be a bit blurred whilst you recover, although you should soon start to notice a gradual improvement.  Many people find it takes a couple of weeks to appreciate the full benefit.

To ensure the success of the operation you are likely to be asked to:

• report any pain, redness or blurred vision or any new symptoms that develop in the days following the operation;
• wear the shield placed over your eye at the hospital. You can normally remove this the next day. The hospital will explain when it can be removed but speak to them if you feel unsure;
• avoid rubbing your eye. If you are a restless sleeper, you might want to ask hospital staff about wearing an eye shield at night;
• use the eye drops prescribed by the hospital. It is very important to use these drops for as long as the hospital advises as they help to prevent infection and inflammation.  If you’ll find it difficult to put drops in yourself and you live alone, discuss this with the surgeon before your operation. The nurses can show you how to put drops in your eyes.

Avoid taking strenuous exercise, swimming and heavy lifting whilst you recover from surgery.
 
Also

• take care washing your hair and avoid getting soapy water in your eye(s);
• avoid wearing eye make-up until the hospital is happy with your recovery.

Your follow-up appointment will probably be a few weeks after your surgery. Here you can find out how well you eye has recovered and ask any questions you have about driving again or getting new glasses.