Am I too old to have surgery? I’m an 86-year-old woman with diabetes and cataracts and my eyesight is deteriorating rapidly in both eyes, although my left eye is worse. If so, would it make sense to have surgery on both eyes at the same time?
Mr Oliver Backhouse Consultant Ophthalmic Surgeon, Spire Leeds Hospital
Cataracts are natural clouding of the lens of your eye. They are rather like a 'bubbly bathroom window' – difficult to see out of. There is no medicine, laser or eye drops that can make them better. If you want to see brighter and more sharply then a cataract operation will be necessary. The right time to have cataract surgery is when you feel the risks of the operation are outweighed by the benefits. Cataract symptoms include: glare, dazzle, halos, blurred dim vision and occasionally double vision. There is no age limit to cataract surgery and you do not now need to wait for the cataract to mature. It is important to have a detailed examination to make sure that the reduced vision is due to the cataract and not other conditions such as diabetic changes, glaucoma or macular degeneration.
A cataract operation is usually done under local anaesthetic as day case surgery – so you arrive and go home the same day. General anaesthesia, where you are asleep, is also used in a small number of cases. The operation involves going inside the eye to remove the cloudy lens (the cataract) and replacing it with a clear acrylic one that stays in the eye permanently. Because it is necessary to go inside the eye there is the possibility of introducing infection. This is not very good news but is thankfully rare (less than 1 case in 1,000 approximately). Usually only one eye is operated on at a time because of this infection risk.
After the operation the eye may feel gritty for a few days, which is normal. The best vision comes after a few weeks when the eye has settled down. It is at this time that new glasses can be acquired. You can wear your old glasses in the meantime but the prescription will be wrong for you and so your vision may be blurred. Wearing your old glasses will not harm the operated eye. There are no hard rules regarding driving but it seems sensible not to drive for several days so the eye can settle. Normal car driving vision is being able to read a number plate at a distance of 67 feet. A standard lens used has a focus at a particular point so in order to see in the distance and particularly near, glasses may be needed. However, use of a multifocal lens such as the Mplus HD can remove the need for glasses. For further information please see www.cataract.org.uk