Cataract Diagnosis and Treatment

A key indicator of cataract development is clouding or blurring of the vision that cannot be corrected with glasses. That, coupled with “night halos” or glare, sensitivity to light, double vision in a single eye, difficulty driving and reading or colours appearing less sharp/vivid may be an indication of a cataract. However, the best way to know for sure if you are developing cataracts is by scheduling a consultation with one of our eye specialists. They will run a series of tests to properly assess your eyes and diagnose the cause of your poor vision.

Cataract Diagnosis

Cataracts can be diagnosed by an optometrist or an ophthalmologist by performing a series of tests, usually included in a comprehensive eye examination. The following tests help eye specialists diagnose cataracts and determine their severity.

Visual Acuity
A visual acuity test uses an eye chart to measure how well you can read a series of letters. Your eyes are tested one at a time, while the other eye is covered. Using a chart or a viewing device with progressively smaller letters, your eye doctor determines if you have 20/20 vision or if your vision shows signs of impairment.

Slit Lamp Examination
A slit lamp allows your eye doctor to view the structures at the front of your eye under magnification. The microscope is called a slit lamp because it uses an intense line of light, a slit, to illuminate your cornea, iris and lens, and the space between your iris and cornea. By looking through the slit lamp, the doctor can examine the lens to detect any abnormalities and determine the degree to which the lens is clouded due to cataract.

Pupil Dilation
To prepare for a pupil dilation exam, your eye doctor will put drops in your eyes to open your pupils wide. This makes it easier to examine the back of your eyes (retina). Since the clouding of the lens is not noticeable until a cataract reaches an advanced stage, dilating the pupil (causing an increase in pupil size) enables the ophthalmologist to view your entire lens. By thoroughly examining the lens, your doctor can determine whether or not a cataract is affecting your quality of vision.

Contrast Sensitivity
Contrast sensitivity testing is similar to visual acuity testing but places greater emphasis on how cataracts can decrease image contrast due to light scattering and glare caused by the cataract. By measuring your ability to distinguish between finer increments of light versus dark (contrast), contrast sensitivity testing is sometimes a useful measure of visual function, especially in situations of low light, fog or glare, when the contrast between objects and their background often is reduced.

Treatment

Cataracts cannot be fixed with glasses, contact lenses or laser eye surgery — the only effective treatment for cataracts is lens replacement surgery. Lens replacement surgery involves removing the clouded lens and replacing it with a clear artificial lens. The artificial lens, called an intraocular lens (IOL), is positioned in the same place as your natural lens and it remains a permanent part of your eye. When you decide to have lens replacement surgery, your ophthalmologist will talk with you about IOLs, how they work and which IOL treatment option will provide you with the best visual outcome possible.

Before the Surgery

Your ophthalmologist will measure your eye to set the proper focusing power for your IOL. Also, you will be asked about any medicines you take.

You may be prescribed eyedrop medicines to start before surgery. These medicines help prevent infection and reduce swelling during and after surgery. There will also be drops to use afterwards.

The Day of Surgery

• Prior to going into surgery, you will have local anaesthesia administered to numb your eye. You may also be given medicine to help you relax during the procedure.
• During the procedure, you will be awake but you won’t feel anything. You may see light and movement, but you will not see what the doctor is doing to your eye.
• Your surgeon will enter into the eye through tiny incisions near the edge of your cornea (the clear covering on the front of your eye). The surgeon uses these incisions to reach the lens in your eye. Using very small instruments, the surgeon will break up the clouded lens with the cataract and remove this material through the small incisions. Then your new lens is inserted into place.
• Usually, stitches are not required to close the incisions. Since they are so small, these “self-sealing” incisions will close by themselves. To protect your eye while you heal from surgery, a cover will be placed over your eye.
• Before going home after surgery, you will rest in a recovery area for about 15-30 minutes. During this time, one of our nurses will run through run through your medications to make sure you understand what to do at home to aid the healing process.
• Cataract surgery is generally done on an outpatient basis, which means you won’t need to stay in a hospital after the surgery. The whole procedure is very quick and usually takes less than 30 minutes. However, to allow time for preparation and recovery after the surgery, you can expect to be at Oasis Surgical for 2-3 hours in total.
• If you have cataracts in both eyes, surgery typically is performed on one eye, and then a few days or a few weeks later, it’s performed on the second eye. This approach allows the first eye to recover and your vision in that eye to stabilise before surgery is performed on the other eye.

After Your Surgery

After the procedure, you may experience some mild discomfort for a few days. While the recovery period can vary from person to person, in general, most patients report clear vision the day after after cataract surgery. However, it is important to remember that each person heals differently and you may need as long as a week or two before you see images in their sharpest focus. Depending on the focal point of the lens you have chosen you may need to update your glasses a month or so after surgery before the vision is perfect. After about a week or two, you can go back to doing all the things you enjoy (now with great vision!)

Things to remember after surgery:

• You will have to use eye drops after surgery. Be sure to follow your doctor’s directions for using these drops.
• Don’t drive on the first day.
• Immediately after the procedure, avoid bending over, to prevent putting extra pressure on your eye.
• Do not rub or press on your eye. Your ophthalmologist may ask you to wear eyeglasses or a shield to protect your eye.
• Don’t expose your eye to irritants such as grime, dust and wind during the first week after surgery.
• To reduce the risk of infection, avoid swimming or using a hot tub during the first week. Avoid getting soap or water directly in the eye.
• Do not do any heavy lifting or strenuous activity for a few weeks. Your ophthalmologist will talk with you about how active you can be soon after surgery. He or she will tell you when you can safely exercise, drive or do other activities again.
• Even if your vision is great and you have no post-surgery concerns post, make sure you attend your follow-up appointment with your surgeon after the procedure to make sure there are no complications.

Book an Appointment

Cataract removal is one of the most common eye operations performed in New Zealand today. It is also one of the safest and most effective and is successful in over 98% of cases. Due to advancements in technology, the results of modern lens replacement surgery are more predictable, there are few side effects and the eye usually makes a full recovery within only a few weeks.

The ophthalmologists at Auckland Eye use the latest and most sophisticated techniques and equipment to ensure the best results for your lens replacement surgery. If you have a question about cataract surgery or would like to book an appointment, please contact our friendly specialist team on 0800 AKL EYES or email to admin@aucklandeye.co.nz.