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Mark Westcott

Firstly, don’t worry – they are, as we explained above, very common. However, cataracts cannot be treated with drops or medicines. The only treatment is to remove the lens through a tiny opening in the eye and replace it with an artificial lens - this is what is done during cataract surgery. Cataract removal is the most commonly performed operation in the UK


Where to find a surgeon

Your optometrist (optician) or GP can recommend an ophthalmologist (eye surgeon) or you can ask to see a specific surgeon who has been recommended to you. Your surgeon should be appropriately qualified (e.g. Fellow of the Royal Colege of Ophthalmologists, abbreviated to FRCOphth) and ideally should hold a substantive NHS consultant post. Note that it is not usually possible to request a specific surgeon within the NHS.

Can I still drive if cataracts have been diagnosed?

Generally patients with early cataract and mild symptoms can continue as normal with their day to day activities. However, if the cataract is severely cloudy, then patients will be aware of difficulties with reading, distance and driving vision. Your optometrist, GP, or ophthalmologist will advise you as to whether it is safe to drive, as you must satisfy certain criteria.

Should I have surgery privately or through the NHS?

Cataract sugery can usually be arranged at your convenience in the private sector (depending on when the surgeon's operating sessions are). Wait times will vary depending on the time of year and patient volumes. Our practice can usually arrange surgery within 2-4 weeks, although this has been done faster where patients have requested it (if they live overseas, for example). Obviously this comes with the usual benefits of private medicine, which can sometimes include your own room and facilities, although cataract operations do not usually require an overnight stay.

The NHS will give you less choice in terms of time and a longer wait, although these vary depending on which region you're in. Your GP can arange for you to be referred to your regional NHS cataract service. You can, via your GP, choose the unit you wish to be referred to, ("Patient Choice") but you may not meet surgeon before surgery, nor can you specify which surgeon operates upon you.

What are the risks of surgery?

It is important for all patients to be aware of the benefits and potential risks of cataract surgery. The modern phacoemulsification cataract operation is the commonest operation performed in the UK and one of the most successful operations of all.
In terms of success, the operation offers a 95% chance of improving your vision, assuming that there is no other disease within the eye. However, glasses may be required for reading and/or distance for best vision.
In terms of problems and complications, in approximately 5% of cases patients have minor complications. These may be, for instance, a technically longer operation or an operation that requires a longer length of recovery. These minor complications still result in a satisfactory visual outcome.
Another minor complication - although troubling to the patient - is an unexpected glasses prescription after surgery. Measurements are taken of the eye before the operation (biometry) and standard formulae are used to calculate the desired postoperative prescription. Occasionally a patient’s eye will not conform to the formulae, resulting in an unexpected glasses prescription. This occurs in about 5% of cases.
In terms of serious complications, all surgery offers a very small but finite risk of serious complications. The major risks we worry about include:
- Infection (1 to 2 per 1000 patients).
- Bleeding (less than 1 in 1000 patients).
- Retinal detachment (1 in 250 patients).
- Occasionally, the cataract can fall into the back of the eye during surgery and this requires an emergency second operation to remove it (1 in 500 patients).
- Damage to or clouding of the cornea (less than 1 in 100 patients).
- Extremely rare but serious circulatory problems in the retina (less than 1 in 3000).
- All of these potential complications, although rare, can lead to significant loss of vision and even blindness. The risk overall of this happening is probably in the order of 1 to 3 per 1000 but clearly all patients must be aware of this.
A less serious but troubling complication of cataract surgery is dry eye. This occurs in up to 10% of patients. Most, but not all, have history of dry eye and also blepharitis (inflammation of the eyelid) prior to surgery. Symptoms of dry eye are usually worse in the first few weeks after surgery. Usually they settle by 2-3 months and can be helped with lubrication drops. A small minority of patients are troubled with persistent dry eye symptoms. These patients will require ongoing and more extensive treatment for their post surgery dry eye.

We have put all the cataract information on the next few pages of our website into a pdf document for you to download and print out if you prefer.