Cataract

What is Cataract?

A cataract is a clouding of the lens inside the eye. With cataracts, the vision gradually becomes misty or foggy making it difficult to read or drive (especially at night). For people who have cataracts, seeing through cloudy lenses is a bit like looking through a frosty or fogged-up window.

Cataracts usually build slowly as we age, and early on they do not interfere with vision. But with time, cataracts will eventually interfere with the clarity of your vision affecting your daily activities and at that point, it will need treatment by surgery.

Fortunately, with modern technology, cataract surgery is generally safe and quick procedure. Mr Ellabban has operated on thousands of patients with cataracts and he is experienced in all types of cataract surgery.

Peripheral Cataract

Central Cataract

White Cataract

Signs and symptoms of cataract

Cataract can cause different symptoms depending on the type and density of the cataract as:

  • Cloudy or misty or foggy or dim vision
  • Increasing difficulty with vision at night
  • Fading or yellowing of colours
  • The colours not looking as vivid
  • Seeing “halos” around lights
  • Ghosting of images
  • Frequent changes in eyeglass or contact lens prescription

How a cataract forms?

The lens, where cataracts form, is behind the iris (coloured part of your eye). The main function of the lens is to focus light that passes into your eye, producing a sharp image on the retina (back of the eye). As we age, the lens inside the eye becomes less transparent and thicker. The tissue within the lens starts to degrade and clump down, leading to the clouding of small areas within the lens. As the cataract continues to develop, the clouding becomes denser and involves a bigger part of the lens.

A cataract (cloudy lens) can scatter or block the light as it passes through leading to a b blurred vision. Cataracts usually develop in both eyes, but sone eye may have a cataract more than the other eye, causing a difference in vision between eyes.

How cataract is treated?

When the cataract interferes with your lifestyle or daily activities, it will need treatment. Surgery is the only way to treat cataract by replacing the cloudy lens with a clear plastic lens. Surgery is mostly done under local anaesthetic with some numbing drops or occasionally with a small volume of anaesthetic injection around your eye.

The surgery often takes between 10-15 minutes while lying flat and then you can go home after the surgery. You will be advised to put some drops after the surgery to help the eye to heal quickly.

Risk factors for cataract development

There are some factors that may increase your risk of cataracts, including:

  • Diabetes
  • Previous eye surgery
  • Prolonged use of corticosteroid medications
  • Excessive exposure to sunlight
  • Smoking
  • Drinking excessive amounts of alcohol

Types of replacement lenses

With recent advances in technology, there are different types of lens implants, called Intraocular lenses (IOL). The suitability for each design of lenses depends on multiple factors which will be carefully considered and discussed in details at your consultation. The decision is customised to the patient needs and his eye health. There are 3 main types of lenses:

Monofocal IOL

These lenses have a single focus and they are the standard treatment for cataract surgery. They are tailored to correct distance vision which means you are likely to need reading glasses as most senior people.

Toric IOL

Toric lenses are suitable for patient with corneal astigmatism (when the cornea, front part of the eye) is like a rugby ball rather than a sphere). They can correct astigmatism in the prescription.

Multifocal IOL

Multifocal lenses have more than one focus like varifocal glasses. They aim to give distance as well as near vision. They work well for many patients, however, some patient may experience some glare or halos from the lens.

Extended Depth of Focus (EDOF) IOL

Extended Depth of Focus (EDOF) is a new technology to correct presbyopia and offer an increased level of spectacle independence. EDOF lenses work by creating a single elongated focal point to enhance “range of vision” or “depth of focus”. They offer distance as well as intermediate vision for more spectacle independence.

What to prepare for a cataract assessment?

  • Bring a list of your current medications.
  • Bring previous prescription or optician documents, if any.
  • List all symptoms you are experiencing.
  • List questions to ask your doctor.

Why Choose Mr Ellabban for your Private Cataract Surgery?

  • Experience – Mr Ellabban has carried out more than 10,000 cataract surgeries.
  • Specially trained – Mr Ellabban is trained to deal with cataracts of different complexity and in challenging situations. He is also trained to deal with cataract surgeries alongside other eye problems.
  • Extremely low complication rate – Mr Ellabban complication rates are far below the national standards and are regularly audited.  Mr Ellabban is also a retinal surgeon which means he can deal with any complication that may occur during the surgery.

Before the surgery

Is there any way to prevent cataract?

Cataracts are often a part of the natural ageing process, and there is no medication or specific diet can prevent the deployment of cataract. However, some people may develop it at an earlier age than others, often called secondary cataracts as in cases of eye trauma, diabetes, and certain diseases.

Is there any way to treat cataract other than surgery?

Unfortunately, surgery is the only way to treat cataracts by replacing the cloudy lens with an artificial clear lens.

I was told that I have cataracts but the surgeon advised to wait a while before surgery, whys was this?

In some situations, the cataract may be only peripheral and has no or minimal impact on vision or daily activities. Therefore, the specialist may prefer to wait until the cataract becomes denser before offering surgical treatment.

However, if you have a mild cataract that is affecting your lifestyle, then you can discuss with the surgeon about surgery as needs vary from one person to another.

What is the risk of complications from cataract surgery?

Cataract surgery is one of the most successful surgeries, however, like any surgery, there is a small risk complication, e.g

  • Inflammation.
  • Bleeding.
  • Eye swelling.
  • Infection.
  • Uncommon, surgical complications.
  • Cystoid Macular oedema (1-2 %): swelling of the retina.
  • Rupture of the back capsule of the lens (<1%).
  • Very rarely, loss of sight (1 in 3000 chance).

However, some cataracts are more technically challenging than others. This will be discussed in details during the initial assessment. Being trained for retinal surgery, Mr Ellabban can deal with all types of challenging cataract surgeries and intraoperative complications.

During the surgery

Will I feel any pain?

The eye will be numbed using anaesthetic drops or occasionally a small injection around the eye, therefore, you should not feel any pain.

Will I be put to sleep during the surgery?

The surgery is usually performed with the aid of numbing drops or occasionally a small injection around the eye, so you should not feel any pain.

In very special circumstances, the choice of general anaesthesia is taken, usually as per patient request or if the surgeon finds this is the best for you. This decision will be discussed in details before the surgery.

How long the surgery takes?

In most situations, the surgery takes about 10-15 minutes. In some cases, the surgery may be prolonged but as you will be awake during, the surgeon will be able to advise you.

Following the surgery

What is the required care after surgery?

You will be advised to use some drops, commonly antibiotic drops for 1 week and ant-inflammatory drops for 3-4 weeks. You are advised to put the medications as you were instructed for safe recovery.

When can I drive after the surgery?

You should not drive straight after the surgery. In most situations, you can drive after one week from the surgery. However, this depends on many factors. For further clarifications, ask your doctor.

When I will notice an improvement in my vision?

Most people notice improvement in the clarity of vision in the first few days after the surgery which usually gets better over time.

When to seek advice after the surgery?

The surgeon will advise you if any follow-up appointment is required. After the surgery, you should seek advice if you feel:

  • You feel increasing pain in your eyes.
  • You feel increasing discharge from your eyes.
  • You feel increasing redness in your eyes.
  • Your vision has become misty or blurry.
  • You feel your vision has deteriorated.

Do I need to wear glasses after cataract surgery?

During cataract surgery, the surgeon will put an artificial lens implant inside the eye. The surgeon will arrange a measurement for the lens implant power. Mr Ellabban uses the latest technology to decide the lens measurement which has a very high degree of accuracy. The standard surgery with monofocal or toric lenses implants often aims to correct vision for distance. You will need glasses for reading mainly, although you may still need glasses for fine focusing for distance.

Some types of lens implants, called Multifocal lenses can correct vision for both distance and near, so that you are largely spectacle independent. Mr Ellabban will discuss these options with you before the surgery to satisfy your needs and make a personalised plan for the surgery.