What are cataracts?
Cataracts are cloudy patches that form in the eye’s crystalline lens, causing blurred vision and sometimes the complete loss of sight. The lens is a transparent, biconvex structure that lies just behind the pupil, allowing light to reach the back of the eye (retina). By changing shape, it enables the eye to focus on objects at various distances. Cataracts are the result of a build-up of protein on the lens which prevent light from reaching the retina thus impeding vision. They are extremely common and are usually age-related.
How much does private cataract surgery cost?
Private cataract surgery in the UK can cost anywhere from £1,800-£3,000 including the hospital and surgeon fees
Prices vary due to the location of the clinic, the reputation of the surgeon and the type or severity of the cataract. We recommend that that you compare compare surgeon and clinic reviews to find a suitable match for your surgery.
Can I get cataract surgery on the NHS?
If you are living with cataracts, you may find that this inhibits your ability to live your life as you wish.
Cataracts impair your ability to do everyday tasks such as driving, reading, or things around the home. It is under these circumstances – when your eyesight is suffering – that you may be able to have cataract surgery on the NHS. Over time, cataracts will cause your eyesight to degenerate, and no other forms of treatment such as eye drops or medications have been found to be effective in stopping this degeneration. Today, surgery has been developed so that cataracts can be operated upon at any stage, so you do not have to wait until your eyesight has been seriously impaired to take action. NHS clinical commissioning groups (CCGs) often outline specific criteria regarding when it’s appropriate for a candidate to undergo cataract surgery.
While you are waiting for your procedure, you may wish to take other steps that can help to mitigate the damage caused by cataracts. These can include reading and working in brighter lighting, investing in new glasses or contacts, wearing anti-glare sunglasses, and using a magnifying lens when reading fine print.
Cataract surgery can also be used to treat other eye conditions such as diabetic retinopathy. To find out more if you are eligible for this kind of treatment on the NHS and when you could expect to receive it, talk to your optometrist.
Cataracts develop slowly over time and it may be a while before you notice any symptoms. They are not painful and should not cause you any physical irritation. The first signs are usually misty or blurred vision or you may notice small patches where your eyesight is not as clear. Other symptoms include:
- Finding that your glasses or contact lenses are less effective
- Struggling to see clearly in bright or dim light conditions
- Finding the glare around bright lights to be extremely uncomfortable to look at
- Seeing halos around bright lights (headlights, street lights etc…)
- Seeing everything with a yellow/brown tinge
- Finding that colours are less vivid
- Double vision
How to treat cataracts
Initially you may be able to live with the symptoms by getting a stronger prescription or using bright lights for reading and other tasks. However cataracts will worsen over time and you will eventually need to be treated. The most common treatment is surgery, a very simple and effective procedure. The three forms of surgery that are most commonly used are:
- Extracapsular cataract surgery
- Intracapsular cataract surgery
Phacoemulsification: Cataract surgery involves removing the cloudy lens from the eye and replacing it with a clear artificial lens. The most commonly used technique is called phacoemulsification; a process where, under local anaesthetic, a small incision is made in the cornea and an ultrasonic device used to break up the lens. The pieces are then removed via suction back through the incision.
Once the old, cloudy lens has been removed an artificial intraocular lens (IOL) is inserted into the lens capsule to replace it. These lenses are permanent and, since they are made from silicone or acrylic, new cataracts are unable to form on them. The mono-focal IOL that is commonly used mimics the natural lens and restores your pre-cataract eyesight. If you have this type of IOL you will probably still need to use glasses or contact lenses for certain tasks. However, there are now a wide variety of IOLs available that can also improve your vision whether you be near or far-sighted. For more information on these IOLs click here [thought we could add a link to Refractive lens exchange article here, to avoid repetition].
Extracapsular cataract surgery: When cataracts are very advanced it may not be possible to break the lens up using ultrasound and extracapsular surgery may be recommended. This technique requires an anaesthetic injection to the eye and the doctor will then need to make a larger incision in order to remove the lens in one piece. Once it has been removed an IOL is inserted in exactly the same way as it is would be using the phacoemulsification technique. However, due to the larger incision, sutures are required to help heal the wound and recovery times are therefore longer.
Intracapsular cataract surgery: In rare cases it may be necessary to, not only remove the entire lens, but also the capsule that holds it in place. As this requires an even larger incision it is typically only used in cases where there is significant trauma to the eye. The IOL that replaces the natural lens is then placed directly in front of the iris as opposed to its usual position behind. Again this form of surgery necessitates sutures and a much longer healing period.
What to expect on the day of the surgery
Surgery is performed as an outpatient procedure and usually takes no more than half an hour. Prior to the surgery you should make arrangements for someone to pick you from the hospital as you will not be permitted to drive and you should avoid wearing any eye make-up. If you have cataracts in both eyes they will be treated on separate days, usually a few weeks apart. Just before the procedure commences you will be given a mild sedative and anaesthetic drops will be applied to your eye to numb it.
Cataract surgery involves removing the cloudy lens from the eye and replacing it with a clear artificial lens. The most commonly used technique is called phacoemulsification; a process where, under local anaesthetic, a small incision is made in the cornea and an ultrasonic device used to break up the lens. The pieces are then removed via suction back through the incision.
Once the old, cloudy lens has been removed an artificial intraocular lens (IOL) is inserted into the lens capsule to replace it. These lenses are permanent and, since they are made from silicone or acrylic, new cataracts are unable to form on them. The mono-focal IOL that is commonly used mimics the natural lens and restores your pre-cataract eyesight. If you have this type of IOL you will probably still need to use glasses or contact lenses for certain tasks. However, there are now a wide variety of IOLs available that can also improve your vision whether you be near or far-sighted. For more information on these IOLs click here
The incision made during cataract surgery is so small that it will not require stitches and will be left to heal naturally. Some doctors recommend wearing a protective patch for up to a day following surgery to protect the eye from external sources of infection and/or irritation.
Following the surgery you may experience some mild discomfort and your doctor will probably recommend you take over the counter painkillers. You will also be required to use antibiotic eye drops for a few weeks to help reduce the likelihood of infection. You will be advised to avoid strenuous activity for a short period but otherwise you should be able to resume your normal activities within days.
You will notice an improvement in your eyesight almost immediately following cataract surgery and once the eye has fully healed you will be given an eye test to check whether you need to wear glasses.
Complications following cataract surgery
Cataract surgery is an extremely safe procedure that is carried out on millions of people every year around the world, but as with any surgical procedure there are a small number of complications that you should be aware of.
- Dislocated IOL: a problem that arises when the new lens ‘shifts’ slightly out of position. It can usually be put back in place through a short, outpatient procedure.
- Infection or inflammation of the eye: can be treated with antibiotic eye drops and, if caught early, should not result in any significant problems.
- Retinal detachment: a condition where small tears in the retina lead to it detaching from the eye. When this happens patients are likely to experience flashes of light and floaters (small shapes that can be seen ‘floating’ in your field of vision). This can be corrected surgically and, as long as it is diagnosed promptly, should not lead to any permanent problems.
- Increased pressure in the eye (intraocular pressure): this is a fairly common side effect that usually rectifies naturally in time but, if not, can be treated with medication.
Posterior capsular opacification (PCO) & YAG laser capsulotomy
In a small number of patients, the capsule which holds the IOL in place thickens and becomes cloudy – a condition known as posterior capsular opacification (PCO). When PCO occurs your sight is likely to become misty and you may notice increased glare and halos around bright lights. Although it affects your eyesight, the thickening does not damage your eye in any way and is easily treated using a procedure known as YAG laser capsulotomy.
YAG laser capsulotomy is an outpatient procedure that can be performed in 20 minutes and does not require any further incisions to the eye, making it extremely safe and painless. First you will be given eye drops to dilate your pupils and additional drops to numb the surface of the eye. You will then be asked sit at a machine very similar to those used during routine eye tests. The doctor will put a mirrored lens on your eye allowing him/her to clearly see the affected area and will use a laser attached to the machine to make a small hole in the membrane. This enables light to get through again, clearing up your vision.