A common result of ageing, cataracts develop in roughly 50% of people by age 60. The condition results from protein building up in the eye, clouding the lens and restricting the light that reaches the retina.
Vision can be affected in several ways – including blurring, issues with focus, light sensitivity and problems seeing in low light. Cataracts range from minor and manageable to large enough to obscure vision and interfere with everyday activities.
Causes: ageing, eye trauma, genetics
Although cataracts are a natural result of ageing, happening to almost everyone aged 70+, some factors can cause them to develop earlier or have a greater impact on vision.
If you have a history of eye infections or diseases, trauma to the eye or significant UV damage, diabetes or other long-term health problems, or family members with cataracts, you may be more likely to develop them. Some medications, particularly steroids, can also increase the risk.
Although cataracts come with ageing, some factors can cause them to develop earlier or have a greater impact on vision.
Risk factors include:
- History of eye diseases or infections
- Previous trauma to the eye
- UV damage
- Diabetes or other chronic conditions
- Use of medications, particularly steroids
- Family history of cataracts
Symptoms to watch for
- Cloudy, blurry vision – as if you’re looking through a mist or net curtain.
- Increasing light sensitivity
- ‘Halo’ effect around bright lights.
- Poor or worsening night vision
- Monocular double-vision – seeing multiple images in one eye
- Frequent prescription changes
- Dulling or darkening of colours
Diagnosis and treatment
Diagnosis involves visual acuity and contrast sensitivity tests, pupil dilation and examination under magnification.
Treatment for cataracts
You only need surgical intervention if cataracts seriously affect your vision and interfere with daily life. For example, if you’re finding it difficult to work, read or drive, your specialist will likely recommend surgery.
Cataract surgery involves removing the clouded lens and replacing it with an artificial version called an intraocular lens (IOL). The IOL fits into the space left by your natural lens – you won’t be able to feel it or tell it’s there. In most cases, IOL implants will last for the rest of your life. IOLs can even be customised to suit various vision needs, much like contacts or glasses, with bifocal, trifocal, monofocal, fixed focus or extended depth of focus available.
Small-incision surgery (phacoemulsification)
Using a high-powered microscope, your surgeon will make a 3mm incision near the edge of your cornea. A probe is inserted to break the clouded lens into smaller pieces using high-frequency vibrations, so it can be gently suctioned out.
Once the clouded lens has been removed, the surgeon will insert an IOL through the probe where it unfolds to fit.
Large- incision surgery
If small-incision surgery isn’t suitable for your situation, your surgeon may recommend a large-incision method. This involves making a larger incision to extract the clouded lens and replace it.
Recovery and risk
After your surgery, you will be monitored for a few hours before you can leave. Your eye will be covered with a shield, and you may be recovering from anaesthetic, so you will need someone to drive you home.
During recovery, bright light may seem particularly intense, so wear sunglasses for protection if needed. Avoid rubbing or touching your eye, and try not to do anything that will cause rapid movement or shock. Some patients may need to take paracetamol or other over-the-counter medications for pain.
Although cataract surgery is safe, there is a slight chance of complications. Your surgeon will be able to talk you through the risks.
Frequently Asked Questions
A cataract may be detected by your optometrist or family doctor. It is also important that a thorough eye examination is performed by your optometrist or eye specialist to ensure that there are no other causes for your blurry vision.
This varies among individuals and may even vary between eyes. In younger people and people with diabetes, cataracts may progress rapidly over a few months. However, most age-related cataracts progress gradually over a period of years.
Cataract surgery is usually considered when loss of vision begins to interfere with daily activities or affect your quality of life. Based on the specific symptoms, a patient and their surgeon should decide together when surgery is appropriate.
Cataract surgery at Auckland Eye offers people suffering from cataract problems a range of potential life-changing benefits, including:
- Improved sight and colour vision
- Improved clarity of vision
- Increased independence
- Improved quality of life
- Reduced dependence on corrective eyewear
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 97% of cases.
No. An anaesthetic is applied before surgery so that there is no pain, but some people experience slight discomfort after the surgery. The anaesthetic stops the eye from moving during the operation and your eyelids are held open by a small gentle spring, so all you have to do is lie still for the surgery. You cannot see what is happening during the operation.
Yes. It is not possible to get another cataract once it has been removed. However, approximately 10% of patients may become aware of a gradual blurring of vision some months to even years after the surgery as a result of the thickening of the lens capsule that supports your artificial lens. If this occurs clear vision is often simply restored by laser treatment, called a capsulotomy, which can be done during a short visit to the clinic.
There are many diseases which can affect and limit the eye’s visual improvement following cataract surgery. These can be diagnosed before the operation and your eye specialist will discuss the impact of any such problems with you.
Most patients will require glasses for fine visual tasks although some patients can get by without them for certain activities.
Cataract surgery is very safe and has high success rates. However it is important to understand that complications can occur during or after the surgery. If you experience even the slightest problem after surgery, please contact your surgeon immediately.