What is a cataract?
A cataract is an eye condition that makes it difficult to see. In a normal eye, there is a clear lens which helps you to focus. If you have a cataract, the lens is cloudy.
This happens gradually over a long period of time. Your vision will become blurry as the cataract develops, until the whole of the lens is cloudy. Your sight will slowly get worse, becoming blurry or misty, making it difficult to see clearly.
Cataracts can happen at any age but usually develop as you get older. Cataracts can also develop due to diabetes, use of steroid medication, trauma or for genetic reasons.
If a cataract prevents you from reading or driving, or doing your normal day-to-day activities, it is advisable to have surgery.
After surgery, the cataract will be gone and you should be able to see more clearly. Your eyesight won’t be perfect if you have other eye problems, but you should be able to return to routine activities of daily life and the things you enjoy.
Other available treatments
Surgery is the only way to cure a cataract. However, you may not need surgery if you can see well enough for your everyday activities. Or, you may just need to wear glasses.
Before your operation
Before you come into hospital for your operation, you will be asked questions about your health by one of our nurses. Further ‘pre-assessment’ questions may be asked over the phone, or you might be asked to come into the hospital for some simple tests, such as a blood test or a test on the heart called an ECG (Electrocardiogram).
Please let us know if you are taking any regular or herbal medication. We need to know everything about all the medication you take. Be sure to bring your medication with you on the day of your operation in the original containers. If you do take prescribed medicine on a regular basis, we will give you specific advice about continuing your medication, and what to do on the morning of your operation.
If you are a diabetic you’ll be given instructions about your medication on the day of surgery and told when to stop eating and drinking.
It’s particularly vital you tell us if you are taking any type of blood thinning medication (anticoagulant). Medication of this kind can make your blood clot more slowly. We need to ensure your blood is clotting normally before we operate.
If you are having a general anaesthetic, it’s very important not to eat or drink anything for four to six hours before your operation. This helps to prevent any regurgitation of stomach contents during the anaesthetic, as this can cause damage to the lungs.
If you are going home the same day as your operation and have had a general anaesthetic, you’ll need someone responsible to stay with you for 24 hours afterwards. Also, because of the effects of the anaesthetic, you will not be able to drive, so you’ll need someone to help you get home.
Even if you do not have a general anaesthetic, the operation will affect your vision and you will not be able to drive yourself home. You may find it helpful if there is someone with you at home after your operation.
Please let us know if anyone you have been living with, or had close contact with, has had MRSA or if they work in a healthcare organisation.
MRSA stands for Meticillin Resistant Staphylococcus Aureus. This bug, which can be found on the skin, doesn’t normally cause problems. But if it gets inside the body, it can cause an infection that can be difficult to treat. If we think it is necessary we can test you before your operation to see if you have this bug on your body.
To further reduce the risk of any infection, we would ask you to have a shower or bath before you come to the hospital. Please ask any visitors with infections (especially sickness or diarrhoea) not to visit you in hospital.
Also, it’s best to leave plenty of time to get to the hospital on the day of your operation, so you’re not rushed and arrive as relaxed as possible.
On the day
At the hospital, one of our Healthcare Team will meet you to explain each stage of your treatment and recovery. They’ll take notes on your general health, medical and surgical history and ask if you have any allergies. Your blood pressure, pulse and temperature will be taken and an identification band with your name and hospital number on it will be placed on your wrist.
You will be shown where the alcohol hand rub is and how you and your visitors should use it. You will also see staff members using this before they treat you; please feel free to ask us if we have washed our hands.
Your consultant will come to see you. And if you haven’t signed a consent form already, you’ll be asked to sign one by your consultant. This is to confirm that you understand the details of your operation, the benefits and the risks associated with it, both during and after your operation.
When it’s time to go to the operating theatre, our ward staff will take you. There, our theatre staff will take you to the anaesthetic room. They are very reassuring – they will understand how you feel and will try to help you in every way possible.
You will be given eye drops before the operation. These are prescribed by the consultant and are needed to prepare your eye.
After the operation
Once your operation is over, you’ll be taken to the recovery room where you will recover from your operation. Our nursing staff will be there to check on you. You will have a protective pad and a plastic shield covering your eye for a few hours. The local anaesthetic does cause numbness, but normal sensation will return in a few hours.
Back in your room
Once back from your operation, our nursing team will continue to check on you, to make sure you are recovering well.
It is normal for the eye to feel a little bit uncomfortable but regular pain relief is usually enough to treat this. After the operation, you will be given more eye drops containing a steroid, to help reduce inflammation, and an antibiotic to help stop any infection. Try not to touch or disturb your dressings as this can introduce infection. If you notice any discharge or have any pain, don’t hesitate to speak to one of the nurses.
After you’ve recovered from the effects of any anaesthetic, you can have something to eat and drink.
Don’t forget to wash your hands with soap after going to the toilet at any time.
Going home
Once you have been discharged and someone has arrived to help you home, you may leave the hospital.
It’s usual to return to see your consultant as an outpatient after your operation.
You will be given details about any appointments before you leave.
At home
When you get home, you should rest for the first two or three days, but it is important to keep mobile. Avoid bending over as this may cause pressure on your eye.
We will do all we can to help and reassure you.
Caring for your eye drops
You will be prescribed eye drops to use when you get home. These will have been tested to make sure they are free from germs. To keep them in good condition, please make sure you:
· Keep the bottle tightly closed when not using the drops
· Keep the drops in the refrigerator if you are told to
· Do not put the dropper down on any surface
· Do not let the nozzle of the dropper touch your eye or fingers
· Never lend your eye drops to anyone else
· Dispose of your eye drops after four weeks. (When you open the drops, write the date on the bottle, so you know when to throw them away).
Using your eye drops
Before using your eye drops, wash your hands thoroughly. Tilt your head backwards and look up; pull down the lower eyelid until there is a small pocket. Then squeeze the dropper bottle and allow one drop to enter the pocket between the lower lid and the eye.
Try not to let the dropper touch your eye or eyelid. Close your eye and blink several times, but do not rub it.
Getting back to normal
If you work, your consultant will tell you when you are able to go back to work. It may depend on the type of job you do. You should avoid excessive bending, lifting heavy objects and doing any strenuous activity for four to six weeks after the operation.
You can do light jobs, housework and cooking almost immediately after the operation and you will be able to read, watch TV and go out as usual. You should be able to get back to most of your activities by four weeks, as long as your eye has healed. You can wear glasses if they help with your vision. However, you will need new glasses after the treatment and should visit your optometrist to get them.
Driving is dependent on your vision. You should check with your surgeon when you can drive again. If you are in any doubt about your insurance cover, it’s best to contact your insurance company. It is normal to experience blurred or double vision, although this should improve by the second day. Your eye may be red and bright lights could be uncomfortable. Your eyesight should improve within a few days, although complete healing can take several months.
You can shower or bath and wash your hair after 48 hours, but be careful not to get soap and water in your eye.
It’s important that you don’t rub your eye. To prevent yourself doing this in your sleep, you will need to use the plastic shield taped over your eye at night for one to two weeks. Keep the plastic shield clean by washing it with soap and water.
If you go outside, protect your eye with glasses to avoid anything such as dust or grit blowing into it. If you find that your eyes become sticky, you can gently wipe the eyelids with cotton wool dampened in cool water that has been boiled.
Complications and risks
As with all surgery, there are risks involved. Your consultant will be well informed about all of these and can talk you through them.
Complications are rare. Don’t worry, your Healthcare Team is there to reassure
and help you if anything unusual happens.
Risks specific to cataract surgery are:
· You may experience mild pain. Severe pain is unusual and you should seek advice from your surgeon
· There may be some aching of the eye, or bruising of the eyelid. This will settle down
· You may have some blurry vision for a few days, but this should improve and you may see some immediate difference in your vision. Full healing will take several months
· Bleeding is a risk with any type of surgery. There can be some bleeding into your eye, making it slightly red
· There may be some thickening of the lens casing, (the part which holds the lens in place). This can be corrected with laser surgery
Infection is a risk of any surgery. Your eye will be monitored while you are in hospital and if an infection is diagnosed antibiotics may be prescribed.Signs of infection to look out for when at home:
· More pain or tenderness than you have had before, which a simple pain killer such as
paracetamol does not control
· Redness/swelling or a sticky discharge around the eye
· Sudden deterioration of your vision
We don’t want you to worry. So if you have any concerns or notice anything unusual, please do call us at the hospital and talk to a member of the nursing staff. We’re here to help.
