Cataracts refer to the clouding of the clear lenses that sit in your eyes and are a common eye condition, especially among older individuals. Around one in three people aged over 65 have signs of cataracts.
Cataracts can reduce the clarity of your vision. Early symptoms include trouble seeing clearly at night when light levels are lower and consequently, the effect of your lens being cloudy is more pronounced. This most often occurs with nuclear cataracts — the most common type of age-related cataracts — where the clouding occurs mainly in the middle area of your lens.
If you have cortical cataracts, where the clouding affects the edges of the lens, you’re more likely to experience glare, especially around bright lights at night eg when seeing car headlights.
Posterior subcapsular cataracts cause clouding of the back of the lens and often interfere with your ability to read and see clearly in the daytime, as well as causing halos and glare around bright lights at night.
In rare cases, babies can be born with cataracts or develop them soon after birth (congenital cataracts), or cataracts develop in older babies or young children (developmental, infantile or juvenile cataracts). Due to the age at which these cataracts present, symptoms are not usually detectable. Consequently, cataracts are usually picked up during a newborn physical screening examination or a routine children’s eye test at the opticians.
Age is the biggest risk factor for developing cataracts. However, other risk factors include certain systemic diseases (eg diabetes, autoimmune diseases, cardiovascular diseases), long-term use of corticosteroids, trauma to the face or head, and previous eye surgery, injury or inflammation. Lifestyle factors, such as smoking and drinking too much alcohol, also increase your risk of cataracts.
Cataracts can be diagnosed via a slit lamp examination, where your doctor shines a light into your eyes to detect your cataracts. Your doctor will also perform an eye test to check your clarity of vision, and ask about your symptoms and medical history.
If you have been diagnosed with cataracts, this doesn’t mean you need to have cataract removal surgery in your near future. Surgery is only recommended when your cataracts are significantly affecting your vision and quality of life.
In the early stages of cataracts, your optometrist may be able to improve your vision with a stronger prescription for your glasses.
This is the most commonly performed surgery in the UK and is generally very safe. It is usually performed under local anaesthetic, so you will be awake but won’t feel any pain, and takes around 5–10 minutes. During your surgery, your cloudy natural lens is broken up into tiny pieces and removed via a thin suction tube. A clear, artificial lens is then implanted as a replacement.
You will not be able to see anything during your surgery, as a very bright light will be shone onto your eye throughout your procedure. You will, therefore, not see the instruments being used to operate on your eye. Some patients report seeing rainbow colours.
Types of artificial lenses
On the NHS, you will be provided with a monofocal lens, which will allow you to see clearly at near or far distances but not both. This means you will still need to wear glasses after your surgery.
Private cataract surgery gives you the option of choosing more advanced artificial lenses that allow clear vision at multiple distances — this can reduce or remove your need to wear glasses. There are also artificial lenses to correct astigmatism.
Advances in diagnostic equipment mean that patients with complex vision issues who could most benefit from advanced artificial lenses can now be more easily identified. This technology allows precision mapping and measuring of the shape and size of your eye, so that the power of the artificial lens can be precisely calculated to match your visual needs. This technology is currently available at Spire Regency Hospital in Macclesfield.
Mr Say Aun Quah is a Consultant Ophthalmologist at Spire Regency Hospital Macclesfield, specialising in ocular surface and corneal diseases, corneal transplantation, routine and complicated cataract surgery, refractive surgery (laser and premium lens implantations), oculoplastics and general ophthalmology. Using advanced diagnostics equipment available at Spire Regency Hospital, he is able to offer artificial lens implants for cataract surgery that are precisely tailored to individual visual needs. Mr Quah is also an active member of the clinical research community with numerous publications in peer-reviewed scientific journals.
If you're concerned about symptoms you're experiencing or require further information on the subject, talk to a GP or see an expert consultant at your local Spire hospital.