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.
You may not initially notice any symptoms of cataracts since they develop slowly over time, but the most common signs of the disease are blurred or misty vision, and you may develop small white patches where eyesight is less clear. Other possible symptoms include:
- Difficulty seeing clearly in dim or bright lights
- Bright lights with glare around them are hard to look at
- Halos around bright lights, such as street lights or vehicle headlights
- Everything has a brown or yellow hue
- Colours appear faded or dull
- Double vision (seeing two images of one object
- Your contact lenses or glasses have become less effective at allowing you to see clearly
Here Professor David Gartry, Consultant Ophthalmic Surgeon at Moorfields Eye Hospital, discusses what you should do if you think you have symptoms of cataracts.
How Are Cataracts Treated?
Cataracts are treated through surgery. This involves the removal of the eye’s natural lens which is then replaced with an artificial silicone or acrylic one, known as an intraocular lens (IOL). Because IOLs are made of plastic, cataracts cannot form on them. IOLs are permanent and can remain in your eye for a lifetime without needing to be removed. The three most common types of cataract surgery are:
- Phacoemulsification cataract surgery: a small incision on the cornea is made under local anaesthetic. An ultrasonic tool is then used to break up the cloudy lens which is removed using suction. An IOL is then inserted behind the iris to replace the lens. The incision on will be left to heal on its own.
- Extracapsular cataract surgery: this is used when patients have cataracts that are so advanced that breaking them up using ultrasound is not possible. Instead, a larger incision is made on the cornea and the whole lens is removed in one go. Like with phacoemulsification surgery, the IOL is then inserted behind the iris. Absorbable sutures will be used to close the incision due to its large size.
- Intracapsular cataract surgery: very occasionally it is necessary to remove the capsule that holds the lens in place in addition to the lens itself. This procedure is only used where there is significant damage to the eye and it requires a bigger incision to be made on the cornea. In this instance, the IOL is positioned directly in front of the iris instead of behind it. Like with extracapsualar surgery, absorbable sutures will be used to close the incision.
- Laser cataract surgery: unlike traditional cataract surgery where an incision is made on the cornea using a hand-held tool, in laser-assisted cataract surgery this incision is made using a femtosecond laser. A specialist computer software is used to create a 3-D image of the eye to map the location, depth and length of your cataracts. Using this information, the laser creates a highly accurate and customized incision on your cornea. Like with traditional surgery, the old lens is then removed through the incision and an IOL is inserted.
Intraocular Lens Types
There are four main types of intraocular lenses (IOLs) used in cataract surgery to replace the natural cloudy lens. The type of IOL that will be inserted into your eye will depend on the type of refractive error you have, such as myopia (nearsightedness), hyperopia (farsightedness) or astigmatism.
- Monofocal: this is a standard single focus lens which allows you to see clearly at just one set distance – either near, far or intermediate distance. These lenses are most commonly used for far distance vision, and typically require you to wear glasses for near distance tasks such as reading.
- Multifocal: these lenses correct both long and short sighted vision issues by allowing you to focus at varying distances. They also alleviate the need for glasses.
- Accommodating: these lenses allow you to see clearly at various distances but unlike multifocal lenses, they require you to wear glasses for near distance tasks such as writing.
- Toric: these lenses are used to correct moderate to severe astigmatism, and so provide exceptional focussing power in just one area of the lens. Like with monofocal and accommodating lenses, they require you to wear glasses for near distance vision.
Cataract Surgery Cost
The average price for cataract surgery is between £1995 to £2995 per eye. The cost comparison table below shows you how much should expect to pay for cataract surgery at some of the UK’s leading eye surgery clinics. These prices are the very cheapest that these clinics advertise and are typically only offered to patients who have mild cataracts and a low prescription, so do not be surprised if you are quoted a higher price.
|Clinic||Price Per Eye|
|Advanced Vision Care||From £2950|
|Accuvision||Quotation Available on Request|
|Centre for Sight||From £2975|
|Optical Express||From £1995|
It is important to remember that the cost of cataract surgery can also vary between clinics due to a number of factors such as:
- Its location: clinics situated in busier, more urban locations where there is more competition often offer lower, more competitive prices.
- The expertise of the surgeon: every laser eye surgeon in the UK must be registered with the General Medical Council (GMC) in order to practice. The more experienced surgeons will also be certified by the Royal College of Ophthalmologists, meaning they can charge a higher fee.
- The technology: the newer the technology used by the clinic, the higher the price they will charge.
To find out more about the factors which can affect the cost of cataract surgery, visit our eye surgery pricing page.
You should also check what is included in the advertised price and more importantly, what isn’t included. Some clinics require you to pay extra for services such as follow-up appointments and aftercare which can drive up the total cost of your cataract surgery to much more than you had initially expected to pay. We recommend that you shop around several clinics to find a price that best suits your budget.
Intraocular Lens Cost (IOL)
The type of intraocular lens (IOL) that is used in cataract surgery can also affect the price. Premium lenses such as multifocal IOLs are more expensive, since they match more closely to the shape of your eye and allow you to focus at more than one distance. However it is worth remembering that these premium lenses can eliminate the need for glasses, which can save you a significant amount of money over time.
The table below compares the price per eye of the most common types of IOLs:
|Type Of IOL||Price Per Eye|
Can I Get Cataract Surgery On Finance?
For many people the cost of cataract surgery can be too expensive to afford, but fortunately many clinics are now able to offer finance packages that will allow you to spread the cost of the surgery. This is typically via the payment of an initial deposit, followed by small monthly financial instalments over a set period of time.
This cost comparison table shows the finance packages offered at some the UK’s top eye surgery clinics. Information on the deposit amount, as well as the monthly payment plans for the longest and shortest payback periods are shown.
|Clinic||Deposit||Shortest Payback Period||Longest Payback Period|
|Advanced Vision Care||From £1250||0% APR x 18 months = from £94.44 per month||Quotation Available on Request|
|Accuvision||Quotation Available on Request||Quotation Available on Request||Quotation Available on Request|
|Centre for Sight||Quotation Available on Request||Quotation Available on Request||0% APR x 24 months = from £94 per month|
|Optegra||No Deposit||0% APR x 12 months = from £207.91 per month||9.9% APR x 48 months = from £62.66 per month|
|Optical Express||From £500||0% APR x 10 months = from £149.50 per month||11.5% APR x 72 months = from £28.40 per month|
|Optimax||From £500||Quotation Available on Request||11.5% APR x 48 months = from £64 per month|
|Ultralase||From £590||Quotation Available on Request||11.5% APR x 36 months = from £64.40 per month|
Certain factors should be taken into consideration when you purchase your cataract surgery through finance:
- Initial deposits are usually around 10% of the overall cost of surgery, so you will need to make sure you have enough money to pay this.
- The fixed interest rate on monthly instalments typically increases the longer the payback period, meaning the total amount you pay the clinic will be more for longer financial agreements than shorter ones.
- It is important to keep up with your payments. Paying for things on finance can affect your credit score if payments are late or missed, which can make it difficult for you to enter into financial agreements in the future.
- Read the terms and conditions of your finance package carefully and make sure you understand them fully.
Can I Get Cataract Surgery On The NHS?
Cataract surgery on the NHS is available, but only if your cataracts are severely affecting your quality of life and you are struggling to carry out everyday tasks such as driving and reading. If your cataracts are not deemed serious enough to undergo surgery on the NHS, you will need to pay for the surgery yourself at a private clinic.
Cataract Surgery Procedure
Phacoemulsification is the most common type of cataract surgery carried out:
- An ophthalmologist will take measurements of your eyes to assess the type of intraocular lens (IOL) that will be placed into your eye.
- You should arrange for someone to pick you up following the procedure as driving after cataract surgery is not permitted
- The surgery typically takes between 30 and 45 minutes to complete.
- If both your eyes are affected by cataracts, they will be operated on separately around 6 to 12 weeks apart. This will give the first eye to be treated time to heal and your vision to stabilise.
- The operation will be carried out under local anaesthetic. This will be applied as eye drops, or given via an injection in the tissue surrounding the eye.
- A small incision will be created in the cornea.
- A tool is inserted into your eye through the incision which breaks up your cloudy lens into small fragments using ultrasound. These fragments are then liquified and sucked out of your eye.
- The IOL is then inserted into your eye through the incision and is positioned where the old lens sat.
- The small incision is left to naturally heal. If a larger incision had to be made, it will be closed with absorbable sutures.
- You will be able to go home a few hours after your surgery.
- You should notice an almost immediate improvement to your eyesight.
- Your surgeon may suggest wearing a patch for a few days to protect your eye.
- You may experience mild pain in the eye after cataract surgery. If so, over the counter painkillers will be recommended.
- You will need to administer antibiotic eye drops into your treated eye for four weeks after the surgery.
- You should be able to resume normal activities within a couple of days of undergoing the surgery, however a week off work is recommended.
Is There Anything I Should Avoid After Surgery?
There are a few things you should avoid after surgery in order to ensure the best possible recovery. You should:
- Avoid touching your eyes or getting sweat, dust or smoke in them.
- Avoid exhausting activity, such a lifting weights.
- Avoid swimming for two to four weeks.
- Avoid getting shampoo or soapy water in your eyes.
- Avoid wearing eye makeup such as mascara for a week.
- Avoid too much computer work.
Cataract Surgery Complications
All surgery carries risks, however cataract surgery is a very safe procedure so serious complications are rare. It is normal to experience mild pain or itchiness in your eye, blurred vision and a mild headache for a few days following surgery. However, if you experience any of the following symptoms after cataract surgery, you should consult your surgeon immediately:
- Dislocated IOL: this can happen if the new lens moves out of position ever so slightly. A short procedure as an outpatient should rectify this.
- Inflammation of the eye or infection: antibiotic eye drops can be used to treat this, and any inflammation or infection if diagnosed early shouldn’t cause any real problems.
- Retinal detachment: small rips in the retina can lead to retinal detachment. If patients experience light flashes and floaters, this could be the cause. Treatment is surgical, and again, if diagnosed early, shouldn’t cause any long term issues.
- Increased pressure in the eye (intraocular pressure): this is fairly common, but naturally treated – symptoms should subside over time. If this is not the case, then medication may need to be prescribed.
- Posterior capsular opacification (PCO): in a small number of patients, the capsule which holds the IOL in place thickens and becomes cloudy, causing your vision to become blurred. This can be easily treated using YAG laser capsulotomy, in which a laser is used to make a small incision in your eye’s membrane to enable light to pass through your lens, restoring your vision.