Dr. John Sheehan
MB, BCH, BAO, DCH, DME, MICGP, MRCGP, MD
Cataracts are cloudy patches in the lens (the transparent structure at the front of the eye) that can make vision blurred or misty. They can develop in one or both eyes, and one eye can often be more affected than the other.
The lens is normally clear and allows light to pass through to the back of the eye.
Over time, cloudy patches can develop, and more of them develop. As less light is able to pass through the lens, the person’s vision is likely to become blurry or cloudy. The cloudier the lens becomes, the more the person’s sight will be affected.
Cataracts are the main cause of impaired vision in the world, particularly in developing countries. They affect men and women equally.
Cataracts most commonly affect older people. Cataracts that affect older people are known as age-related cataracts. In the UK, it is estimated that more than half of people who are over 65 years of age have some cataract development in one or both eyes.
If cataracts are mild, stronger glasses and brighter reading lights may enable people to live with the condition. However, if left untreated, cataracts can cause blindness.
Once cataracts start interfering with daily activities such as cooking or getting dressed, surgery is usually recommended. It is estimated that around 10 million cataract operations are performed around the world each year. Cataract operations are generally very successful with few complications.
If you have cataracts, it could affect your ability to drive. It is important that you inform your doctor and the Road Safety Authority (RSA) about a medical condition that could have an impact on your driving ability.
People with diabetes tend to develop cataracts at an earlier age than others.
In the early stages of a cataract, your vision may be improved with stronger glasses, or by using a brighter light when you read, for example. However, the improvement may not last long.
Surgery is the only way to treat cataracts that become more severe.
Surgery may be recommended if cataracts affect:
- your ability to look after yourself or someone else
- your driving
- going out
- seeing people’s faces
- your work
- watching television
Cataracts are treated by having surgery to remove the cloudy lens in your eye. In most cases, the natural lens is replaced with an artificial, clear plastic lens. This is called an intraocular implant or intraocular lens (IOL).
Most cataract operations in Ireland are carried out under local anaesthetic, as keyhole surgery, where a very small incision (cut) is made. You will probably be admitted as a day patient (day case), which means that you will not need to stay in hospital overnight.
Different types of replacement lens are available.
During the operation, your ophthalmologist will make a very small incision (cut) in the surface (cornea) at the front of your eye. Your ophthalmologist will then insert a tiny probe through this cut. The probe breaks up the cloudy lens into tiny pieces using ultrasound (high frequency sound waves). The tiny pieces will then be sucked out of your eye.
Once this is done, your ophthalmologist will insert an artificial, clear plastic lens through the incision. The lens sits in a little ‘pocket’ called the lens capsule to keep it in place.
The operation usually takes 15 to 30 minutes, although sometimes it can take slightly longer.
The HSE website hse.ie has good practical information re cataracts.