June is Cataract Awareness Month, a time dedicated to educating people about one of the leading causes of vision impairment and blindness worldwide. SpaMedica is one of the country’s leading providers of NHS cataract surgery and we spoke to their Chief Medical Officer, Dr Alex Silvester, to address patients’ frequently asked questions about cataracts.
Cataracts are a clouding of the eye’s natural lens. This clouding can cause vision to become blurry, hazy, or less colourful, and make daily activities such as reading, driving and watching television more difficult. Cataracts usually develop slowly and can affect one or both eyes.
The most common cause of cataracts is ageing. Other factors that can contribute to the development of cataracts include diabetes, smoking, excessive alcohol consumption, prolonged exposure to ultraviolet sunlight, and certain medications such as corticosteroids.
Symptoms of cataracts include blurry vision, difficulty seeing at night, sensitivity to light and glare, seeing halos around lights, frequent changes in your glasses or contact lens prescriptions, and faded colours. If you notice any of these symptoms, it’s important to book at appointment with your local optician as soon as possible.
Your optician will perform an eye examination to determine the presence of cataracts.
While there’s no guaranteed way to prevent cataracts, certain lifestyle changes can reduce your risk of developing them. These include wearing sunglasses to block ultraviolet light, quitting smoking, reducing alcohol intake, maintaining a healthy diet rich in fruits and vegetables, managing underlying health conditions like diabetes, and having regular eye examinations.
The only effective treatment for cataracts is cataract surgery. Cataract surgery involves removing the cloudy lens and replacing it with an artificial intraocular lens (IOL). Treatment is highly effective, with most patients experiencing significant improvement in their vision.
Cataract surgery should be considered when cataracts begin to interfere with daily activities such as reading, driving, or watching TV. The decision is usually based on the extent of vision impairment and the patient’s specific needs and lifestyle. Speaking to an optician will help to determine the appropriate timing for surgery.
Cataract surgery is usually performed day case and typically takes about 20 minutes. For most patients, eye drops are used to numb the eye beforehand, and the operation is carried out under local anaesthetic. The surgeon makes a small incision in the eye to remove the cloudy lens and replaces it with an artificial lens. Recovery usually takes around 2-6 weeks, with many patients noticing improved vision within a few days.
Like any surgical procedure, cataract surgery carries some risks. However, serious complications are rare, and the surgery has a 99% success rate.
It’s essential to follow your surgeon’s post-operative advice to ensure a smooth recovery. One of the most important things to remember is not to touch or rub your eye – even with clean hands. You should avoid strenuous activities and heavy lifting, and use prescribed eye drops to reduce inflammation. It’s also important to avoid dusty environments for at least two weeks after surgery. Sunglasses can help with light sensitivity.
We advise our patients to avoid wearing any mascara, eye shadow, under-eye concealer, or eye creams for at least one week. This helps to prevent any potential irritation or infection caused by bacteria that can be harboured in makeup and applicators.
If you use eyelash extensions or fake eyelashes, they must be removed before your surgery. You should refrain from reapplying them for at least two weeks post-surgery to minimise the risk of infection and irritation.
You can wash your hair and shower as usual after cataract surgery, but be careful to keep your eyes closed and avoid getting water or shampoo in your eyes.
If you accidentally get shampoo or any foreign substance in your eye, rinse your eye with clean water and contact your treatment provider if you experience any discomfort or symptoms of infection.
You will need someone to drive you home from the hospital as the effects of dilating eye drops can take several hours to subside. After surgery, you must meet the DVLA’s driving eyesight rules before you can start driving again, including reading a number plate from 20 metres away.
Many patients require new prescription glasses or contact lenses after surgery. We recommend waiting until your eye has fully healed before scheduling an eye test for new prescriptions. If you have surgery on both eyes, consult your optician to ensure it’s safe to drive between procedures (there is typically a wait of 4-6 weeks before your first eye operation and your second eye operation).
Post-surgery, you will receive an eye shield to protect your eye from dust and other irritants. It’s crucial to wear this shield for the first night after your surgery, although you can take it off the following morning. Sleeping on your back is advisable to prevent the shield from slipping and to avoid contact between your eye and your pillow, which could introduce particles and bacteria. If sleeping on your back is uncomfortable, try sleeping on the opposite side of the operated eye.
It’s OK to resume light exercise after 1 week. You should avoid swimming or gardening for 2 weeks, and contact sports for 2-4 weeks.
We recommend waiting until your post-operative check before you fly. However, if it is unavoidable, the Civil Aviation Authority (CAA) recommends waiting one day following simple cataract surgery before flying. If you do go out of the country, it’s important to remember that it may be more difficult for you to obtain urgent/emergency care if needed, and this may not be covered by your holiday insurance.
Dry eye is a common issue following cataract surgery. Symptoms include redness, a gritty sensation, and watering. Lubricating eye drops can alleviate these symptoms and should be used regularly, both before and after surgery.
For those with pre-existing dry eye conditions, continue using your regular drops to maintain eye surface health. Persistent dry eye symptoms post-surgery are not unusual and may require ongoing use of lubricating drops. Patients should contact their local optometrist if symptoms persist.
Most people who are still in employment can return to work the day after their cataract surgery. Contact sports or roles involving control and restraint or working in a dusty environment should be avoided for a little longer (2-4 weeks) but are best discussed with your surgeon.
Don’t forget to schedule an eye test with your local optician at least once every two years, or sooner if you notice any changes to your vision.
Dr Alex Silvester is an ophthalmologist and Chief Medical Officer at SpaMedica. He has an interest in epidemiology and data analysis and is a member of the Vision Loss Expert Group, which provides global technical leadership in the development of epidemiological estimates for blindness and visual impairment. His work on reducing topical antibiotics following routine cataract surgery was shortlisted for a Public Health England Antibiotic Guardian award.
Alex has published papers in high impact journals including the Lancet, the British Medical Journal and the British Journal of Ophthalmology. He also regularly presents at international conferences on improving cataract surgery outcomes, risk stratification, and clinical governance.
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