What is a cataract?
The lens in the eye can become cloudy and hard, a condition known as a cataract. Cataracts can develop from normal aging, from an eye injury, or if you have taken medications known as steroids. Cataracts may cause blurred vision, dulled vision, sensitivity to light and glare, and ghost images. If the cataract changes vision so much that it interferes with your daily life, the cataract may need to be removed. Surgery is the only way to remove a cataract. You can decide not to have the cataract removed. If you don’t have the surgery, your vision loss from the cataract will continue to get worse.
How will removing it affect my vision?
The goal of cataract surgery is to correct the decreased vision that was caused by the cataract. During the surgery, Dr Adams removes the cataract and puts in a new artificial lens called an intraocular lens or IOL. Cataract surgery will not correct other causes of decreased vision, such as glaucoma, diabetes, or age-related macular degeneration.
What types of IOL are available?
Dr Adams will help you decide on the type of IOL that will replace your cloudy lens. There are IOLs available to treat near-sightedness (myopia), far-sightedness (hyperopia), and astigmatism. IOLs usually provide either near or distance vision: these single focus lenses are called monofocal IOLs. Some IOLs can provide for near, intermediate, and distance vision: these multiple focus lenses are called multifocal IOLs and extended depth of focus (EDOF) IOLs. IOLs that treat astigmatism are called toric IOLs. There is no “better” option – the choice is dependent upon your eye health as well as your visual requirements. Certain eye conditions render particular IOLs unsuitable.
What happens during cataract surgery?
Cataract surgery is a day procedure and is performed under local anaesthesia. A series of anaesthetic drops are instilled and/or local anaesthetic is injected around the eye. You will also be given a mild sedating drug to relax you. You should not feel any pain or be able to see the surgery while it is happening, and you may not remember the surgery afterwards. Dr Adams makes an incision less than 3mm long to enter the eye with a special ultrasound instrument. This breaks the cataract into smaller pieces which are then removed by suction – called Phacoemulsification. The IOL is inserted into the eye through the same wound. Usually stitches are not required as the small incision self-seals. Your eye will be covered with a clear plastic shield, this will remain in place until four hours later when you administer your first post-operative eye drops.
What are the major risks of cataract surgery?
Cataract surgery is a commonly performed surgery and the success rate is higher than 99%. We need to let you know about the possible complications below, even if some are very rare, so you have informed consent.
All operations and procedures have risks and can result in unsuccessful results, complications, injury or even death, from both known and unknown causes. Risks of cataract surgery include, but are not limited to: bleeding; infection; pieces of the lens that cannot be removed; high eye pressure; a detached retina and visual changes such as glare or haloes and visual loss. You may need additional treatment such as extra drops, injections or surgery to treat these complications; this is not included in the fee for this procedure.
You will need to use eye drops after the surgery – these will be provided to you. In the first few days it is normal for the eye to be red (particularly if you take blood thinners); this does not affect the visual outcome. Sometimes the pupil remains dilated for a day or two due to the dilating drops we use during surgery which can make things seem blurry. Most people notice their vision is clearer within a couple of days but sometimes it can take longer for everything to settle down. Different people recover at different rates - this can depend on the density of the cataract removed, the shape of your eye, your age and your pre-existing eye health.
It is very common for you to experience a foreign body sensation or grittiness after surgery. This is where your nerve endings and skin on the eye are healing. Use lubricants / artificial tears for symptomatic relief when necessary. If you have dry eyes, your symptoms may worsen for a time after surgery – use extra lubricants for relief. Your natural lens (cataract) has been replaced with an artificial lens, so you may notice some transient effects whilst your brain gets used to the new lens. These can include seeing a dark shadow in your outer vision which disappears when you hold a hand to your temple like a blinker (negative dysphotopsia). Sometimes you experience a fluttering or jitter in your vision. These symptoms will fade – it is best to ignore them, in the same way you first notice the rim on a pair of glasses but eventually you ignore it and so no longer notice it unless you look for it.
Dos and Don’ts after surgery
- Wash your hands before using your drops or cleaning your eye
- If you need to clean your eye, use a clean tissue with cooled, boiled water
- Do not apply undue pressure to the eye
- Use all the eye drops as directed including any usual drops you use – start a fresh bottle after the operation
- Wear the protective shield for 1 week at night
- Resume gentle physical activity and continue to watch television or read
- Shower or bathe but do not allow tap water to enter your eye for the first few days
- DO NOT RUB or apply pressure to the eye
- Don’t drive for at least 48 hours after surgery
- Don’t forget to keep all follow up appointments
- Do not swim for 2 weeks (with goggles) or 4 weeks (without goggles) following cataract surgery.
- Contact Dr Adams at Insight Eye Surgery on 07 3154 1515 (Brisbane) or 07 5345 5011 (Noosa) if you have any significant problems, such as severe pain, decreasing vision or worsening discomfort or swelling around the eye. It is not unusual for your vision to fluctuate a little but a sudden or significant loss of vision is unusual.
- For after-hours emergencies only, attend the Emergency Department at your closest hospital.
To make a booking for a consultation or procedure, contact us.
Please have on hand your:
- Medicare card number
- Health fund details (if applicable)
- DVA/Pension/health care card details (if applicable)
- Current referral letter