The eye is like a camera where the retina is the film at the back, and the lens is positioned at the front of the eye, just behind the pupil. A cataract is a clouding in the lens of the eye. The lens in your eye focuses light and is constructed of proteins and fluid. The proteins are arranged in a parallel fashion to allow the light to pass through the lens without interruption. The pupil dilates and contracts to control the level of light reaching the retina and the lens adjusts automatically to allow you see objects clearly at various distances.
The blurring of vision is gradual, but like looking through opaque glass, hardly affecting the sight at first. Light from the sun, a lamp or oncoming headlights cause dazzle and in daylight colours seem faded. Patients often remark that colours are more vibrant in one eye than the other.
The most common type of cataract is the one that people get as they become older it is called a nuclear cataract because it affects the central core of the lens. This develops quite slowly sometimes taking many years to affect the vision significantly.
A cortical cataract occurs in the peripheral part of the lens and often looks like the spokes in a bicycle wheel. It takes some time for these ‘spokes’ to grow centrally to affect the vision and doctors often see signs of this cataract before the patient’s vision is affected.
A subscpsular cataract occurs at the back of the lens typically afflicting people with diabetes and those on steroid therapy. This causes a ‘stippling’ on the surface of the lens like a semi-opaque bathroom window and can occur quite quickly sometimes blocking off the vison within a year.
In most cases cataracts surgery is performed under local anaesthetic which may just be eye drops alone, or an injection around the eye (a bit like for a filling at your dentist’s), but often a combination of both of these methods is used. If you are really nervous then you should speak with your surgeon about the possibility of a general anaesthetic. You are normally admitted to hospital at 8 am and you will usually be home by lunchtime. Nowadays the procedure is straight forward and takes about 20 minutes, nonetheless great skill is required to perform one of these operations which involves a team of doctors and nurses in a theatre setting, where important precautions are taken to prevent infection. The media often portray this operation as a simple procedure which it is definitely is not, but in skilled hands it is very successful in most cases. During the operation a tiny plastic lens (an IOL) is placed in the eye to help focus the light post-operatively. Prior to surgery a special test called biometry is carried out to decide on the power of the IOL to be inserted.
You will be asked by your surgeon if you would like to have your eyes focussed for the distance following surgery. Most people wish for this, but if you are short-sighted your surgeon will probably suggest that enough short-sightedness should be left post-operatively, so that you may continue to read without glasses. Short sighted people really value this facility that they naturally have. However, if you are a short sighted golfer, or other sportsperson, then you may wish to be able to see in the distance without glasses poster-operatively. This all needs to be discussed with your surgeon prior to the operation. If you are happy wearing bifocals or varifocals then you may wish to continue with these following surgery for convenience sake and it is worth mentioning this to your eye doctor before your operation.
Most patients recover very quickly following cataract surgery. A plastic eye-guard is worn at night for a couple of weeks to prevent inadvertent rubbing of the eye during sleep. Many recommence driving after one to two weeks.
You will be required to use post-operative steroid/antibiotic drops for 4 weeks to prevent infection and to settle post-operative inflammation. Usually you return for follow up one week after surgery but if undue soreness or blurring occurs a few days following discharge, then you should return to the clinic or hospital immediately for a check-up.
Most patients return to normal activities such as work after two weeks.
Healthcare Abroad, 5 Daly’s Lane, Rush, Co. Dublin, Ireland
+353 87 721 6943
Landline: +353 (1) 267 8011
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