Cataracts

You may be a patient, a relative or a family friend and are looking for information on cataracts. Firstly, we would like to reassure you that the majority of people with cataracts are able to get them treated; helping to improve your eyesight and also improving the quality of life for many individuals.

Cataracts are pretty common in adults; about 30% of adults aged 65+ will have a cataract that is affecting their vision and requires treatment. And cataract surgery (which is a relatively straightforward procedure) is the most common operation performed today in the UK, with about 350,000 surgeries performed each year.

So you may be wondering exactly what a cataract is and why you’ve got one (or two)…

A cataract is a clouding of the lens in your eye. As you age, proteins in your lens begin to break down and the lens becomes cloudy. Some people don’t even realise they have a cataract because it usually grows very slowly and may not impede vision early on.

Symptoms

You may experience one or more of the following symptoms with cataracts:

  • A decrease in vision clarity that can’t be corrected with glasses
  • Colours appear faded or washed out, sometimes with a yellow haze
  • Sensitivity to light, glare, and seeing halos around lights
  • Frequent changes to glasses or contact lens prescriptions

It’s best to see an optician if you think you have cataracts, they will perform a thorough eye check and be able to confirm whether cataracts are present in either, or both, of your eyes.

treatment-eye

Treatment

Surgery is the only effective treatment for cataracts and for most individuals this is a straightforward operation, which lasts about 10 minutes, without the need for any needles/injections, as the local anaesthetic is administered through eye drops.

During the operation the cloudy lens is removed and replaced with a new lens implant (called an intraocular lens, or IOL for short – click here for more info on IOLs). Your new lens implant will be chosen specifically to match the prescription required for each eye and can help correct long or short sighted vision, if required.

With the NHS, you will usually be offered monofocal lenses, which have a single point of focus. This means the lens will be fixed for either near or distance vision, but not both. If you go private, you may be able to choose either a multifocal or an accommodating lens, which allow the eye to focus on both near and distant objects. The information on this page is for NHS cataract patients – please click here if you would like more information on cataract surgery options for private patients.

Following surgery most patients experience improved vision, no cloudiness and colours you’re seeing should be back to normal.

The risk of serious complications developing as a result of cataract surgery is very low and most common complications can be treated with medicines or further surgery. There is a very small risk – around 1 in 1,000 – of permanent sight loss in the treated eye as a direct result of the operation.

We’ve put together a journey map for our patients to show the different stages from diagnosis through to treatment and what you can expect at each stage. You may be right at the beginning of your journey and not been diagnosed yet or somewhere in the middle and wondering what comes next. We hope you find this useful and that it answers some of your questions – please call us if you would like any more information about any of the stages or what to expect on your patient journey.

1. Getting a diagnosis

1. Getting a diagnosis

If you’re having trouble with your eyes and/or sight then you need to get your eyes checked as soon as possible by your local optician, who will examine your eyes and conduct a sight test to check the quality of your vision. The optician will be able to refer you to SpaMedica or another specialist, depending on what treatment or surgery you require.

FIND AN OPTICIAN

2. Choosing a provider

Most people don’t realise that as an NHS patient you can choose where you get treated. Think about what’s important for you – eg time to treatment, distance to hospital, consultant experience, quality of hospital. 98% of our patients choose SpaMedica because of our short waiting times – usually three to four weeks for surgery/treatment. Click here to view our ratings and reviews from patients for each of our hospitals on NHS Choices.

3. Getting a referral

You need to let your optician or GP know which healthcare provider and hospital you would like to go to and they will then send a referral to your chosen provider. You should hear back from your provider within two to three weeks following your referral. If you have not heard anything then you can contact the person who referred you, this will be your optician or GP.

If you have chosen SpaMedica as your preferred provider and are having difficulty getting an appointment at one of our hospitals please call your local CCG and let them know.

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4. Booking an appointment

Your chosen hospital/provider will contact you by phoning or sending a letter to book an appointment. Our SpaMedica Referrals team calls each of our patients within two to three days of us receiving your referral. We talk through the next steps with you, answer any questions you may have and you can choose an appointment date to suit you.

5. Confirmation of your appointment

You will receive written confirmation of your appointment date and information on cataract surgery. SpaMedica provides a comprehensive patient information booklet on cataract surgery, which includes what you can expect at each stage of your patient journey. You can download a copy of this booklet by clicking here.

6. Your pre-operative assessment appointment

The purpose of your first appointment at the hospital is to run a thorough check on your eyes to confirm that cataract surgery is the best treatment for you. Several eye tests will be conducted, with your appointment lasting about 1.5 to 2 hours (which includes about 40 minutes to allow your pupils to dilate – see below).

Dilating the eyes causes blurred vision and sensitivity to light, so you won’t be able to drive; so it’s important to make sure you organise a lift or arrange transport to/from the hospital. SpaMedica provides free transport for some patients, based on your location and other criteria – if you’re struggling to find transport please speak to a member of our Referrals team to see if you qualify for free transport.

Please feel free to ask any questions you may have about your surgery with the nurse and/or optometrist at your appointment.

You’ll need to bring your current glasses, a list of your current medications, record book (if you’re diabetic or taking Warfarin) and a contact number of a relative/friend. If you wear contact lenses these should not be worn for at least 48 hours before your appointment.

So what will happen at this appointment?

  • Welcome – You will be warmly welcomed and signed in by one of our friendly reception team members and directed to the assessment clinic. You will be seated in our clinic reception and offered complimentary tea, coffee and biscuits.
  • Vision test – The first test we conduct is to check your vision, this is done using a chart, the same as used in opticians, where we ask you to read letters from the top line downwards on the chart.
  • Eye pressure – It is important to test the pressure in each eye to check eye health and test for glaucoma. Anaesthetic drops will be placed in each eye before the eye pressure test, which is conducted using a handheld meter, which gently touches the surface of the eye and provides a digital readout of the pressure in the eye.
  • Pupils dilated – Drops are placed in each eye to dilate the pupils (this makes your pupils larger, so we can examine the eye). It usually takes about 30 to 40 minutes for your pupils to dilate and then we can examine your eyes. Dilating your pupils affects your vision and sensitivity to light for up to four hours, so you will not be able to drive yourself home after the appointment. And, of course, you will be offered more complimentary tea, coffee and biscuits while we wait for your pupils to dilate.
  • Eye diagnostics – There are two diagnostic tests conducted at all pre-operative assessments – the first takes a magnified colour photo of your eye and the second is called a biometry test, which measures the shape and size of the eye. The biometry test reading allows us to calculate the power of the intraocular lens (IOL) required for your cataract surgery. Click here for more information about IOLs.
  • Additional tests (if required) – About 10% of patients require some additional eye tests at their pre-operative assessment – for example, for those with pre-existing eye conditions or if you’ve had previous eye surgery or laser treatment. These include imaging tests; one takes a cross-section image of your retina and the other measures and checks the shape of your cornea. Two other tests that may be required are the A-scan and B-scan, these provide data on the length of your eye and provide a two dimensional, cross section of your eye.
  • General healthcare – One of our friendly SpaMedica nurses will conduct a routine blood pressure test and temperature check. They will discuss your current health and what regular medication you are taking (both prescription and non-prescription). They will also talk through your cataract surgery and what will happen on the day of your operation, explaining everything thoroughly and answering any questions you may have.
  • Optometrist check – All your test results are checked and analysed by a SpaMedica optometrist (eye healthcare specialist). They check to make sure that cataract surgery is suitable for you and will discuss the benefits and risks of surgery. If both your eyes require surgery the optometrist will talk about which eye we would recommend to operate on first, this is usually the eye with the worst vision, but the optometrist will discuss this fully with you to find out the best option for you.
  • Consent – We take time to discuss with each of our patients the details of your cataract surgery, the benefits that you should get from the surgery and also the risks of surgery. We’ll check that you understand everything and ask you to sign a consent form, which lets us know you give your permission for your surgery to go ahead. Please let us know if you have a lasting power of attorney (LPA) or require support for giving consent.
  • Booking your surgery – The final stage of your appointment is to book a date for your surgery. Our receptionist will give you available dates and you can choose a time and date to suit you – this is usually about two weeks following your appointment.

7. Your cataract surgery

Cataract surgery is a relatively straightforward operation and is the most common operation performed in the UK today.

SpaMedica is the 3rd largest provider of cataract surgeries and in 2017 we performed more than 15,000 cataract surgeries.

It is very normal to be apprehensive about your surgery, but please be reassured the SpaMedica team are very caring and extremely friendly and will support you through every step on your surgery day; they’ll put your mind at ease, explain what is happening at each stage, discuss any concerns you may have and make you as comfortable as possible throughout your stay.

Before you look at the details of your cataract surgery there are two very important things you need to know that should help put your mind at rest:

a. There are NO needles – all the anaesthetic and medication for your eyes is administered by eye drops and a tiny pellet is used to dilate the pupils, so there is no need to worry about any needles and injections.

b. Average time for cataract surgery is 5 to 10 minutes – you will be at the hospital on the day of your surgery for about 2 to 3 hours, but the actual surgery itself usually lasts about 10 minutes.

Advice and recommendations for your surgery day

  • The time given for your appointment is the time you should arrive at the hospital and NOT the time of your surgery – arriving earlier will mean a longer wait for you.
  • Please arrange transport to and from the hospital – your eyes will be dilated for surgery and this causes blurred vision and sensitivity to light, so you won’t be able to drive; so it’s important to make sure you organise a lift or arrange transport. SpaMedica provides free transport for some patients, based on your location and other criteria – if you’re struggling to find transport please speak to a member of our Referrals team to see if you qualify for free transport.
  • We recommend eating a light meal before you arrive at the hospital.
  • Please take all your medications as normal, unless we have specifically advised you not to.
  • You should wear comfortable and loose fitting clothing – you will not need to wear a hospital gown.
  • We recommend you wear dark coloured clothing – we use iodine during surgery and this can sometimes run down your neck and may stain lighter clothing.
  • Remove all make-up before arriving at the hospital.
  • Please try not to bring any valuables with you – we have lockers and areas for you to leave bags etc during surgery, but we cannot guarantee their safety.

And here’s some detailed information about what to expect during your surgery appointment – all the SpaMedica team are here to support you, make you feel at ease and make your surgery day as stress-free as possible.

  1. Welcome – You will receive a big smile and warm welcome from one of our friendly reception team. They will check you in and take you to the patient waiting area. You will be offered complimentary tea, coffee and biscuits for you and your family/friends/carer.
  2. Arranging pick up – Our reception team will ask contact details of the person who will be picking you up after your surgery and we will give them a ring when you’re ready to go home. Your family/friends/carer is also welcome to wait in the reception area once you are called through to the surgical ward – this is normally about a 2 to 3 hour wait.
  3. Nurse pre-surgery check – You’ll be called through to the surgical ward where you’ll be greeted by one of our skilled and friendly nurses, who will spend about 5 to 10 minutes with you. They’ll take your blood pressure and temperature and check all is OK for your surgery to go ahead. An arrow will be drawn above the eye you are having surgery on – don’t worry, this is standard procedure for all surgical operations. The nurse will make sure you understand what will happen next and you can ask any questions you may have to make sure you are happy with everything. A tiny pellet (click here for picture) is then placed in your eye – this is used to dilate your pupil. If required (most patients do not need this) the nurse will provide sedative medication at this time.
  4. Surgical ward – the nurse will show you through to the surgical ward. It is very important for your pupil to be fully dilated for surgery and so there will be up to 45 minutes waiting time on the surgical ward to allow the pupil to fully dilate.
  5. Pre-surgery – One of the surgery team will call you through to the surgery preparation room to get you ready for surgery. The nurse will remove the small pellet from your eye and administer anaesthetic drops to numb your eye. We give you a couple pieces of protective clothing to pop on before surgery – a cap and shoe covers. If you wear a hearing aid we ask that this is removed at this point and the nursing team will look after this and give it back to you straight after your surgery.
  6. Consultant pre-surgery check – Your consultant ophthalmologist will check through your details with you, discuss your surgery and what will happen next. Again you can ask the consultant any questions you may have and they will make sure you’re all OK with everything before taking you through to surgery.
  7. Your surgery
    1. The nursing team will take you through to the operating theatre and help get you comfortable on the operating bed.
    2. The area around your eye will be cleaned using an iodine based solution; this can stain light clothing, so we advise you to wear dark clothing on your surgery day.
    3. A sterile sheet is placed across your head and chest; this does not lie directly on your face or head, but is held above your face and body using a bar fixed to the operating bed. The sterile sheet sticks to the skin around the eye to create a sterile zone around your eye area.
    4. The surgeon uses a special microscope with a very bright light, which magnifies your eye. You will be looking at this very bright light throughout the surgery and this is all that you will be able to see.
    5. Obviously, we will ask you to keep still during the surgery and our patients don’t find this an issue and, if you need to move, to sneeze for example, that’s fine, just let the surgeon know – just think of it like the dentist where you have to keep your head still for a few minutes. And, as a matter of fact, many of our patients have said that they found cataract surgery a much better experience than going to their dentists!
    6. It’s important to keep the eye moist during surgery and so water is used to irrigate the eye and this sometimes runs down your face onto your ear or neck. This is why we ask that any hearing aids are removed before your surgery.
    7. The procedure lasts, on average, about 5 to 10 minutes, that’s all, and most of our patients are (pleasantly) surprised when our surgeon lets them know it’s finished!
    8. We have asked hundreds of patients to describe what they feel or experience during surgery and the feedback is that they just see a very bright light or bright colours and don’t feel anything. If you experience any strange or unpleasant sensation during surgery please let your surgeon know and they will give you some more anaesthetic drops.
    9. The sheet is removed very carefully from around your eye at the end of the surgery – this feels similar to a sticky plaster being taken off, so there is a small amount of discomfort, but this only lasts for a second or two.
    10. A clear eye shield will be taped over your eye to help protect the eye and prevent infection.
    11. One of the nursing team will support you as you get off the operating table and take you through for your post-op check.
  8. Surgery all done – take a deep breath and smile!
  9. Post-surgery check – you’ll spend 5 minutes with one of our nurses following surgery to check you are OK and talk you through your post-surgery care at home. You’ll be given a booklet with lots of useful information on dos and don’ts and advice about what to do when you’re back home. A very important part of post-surgery care is your eye drops – these help to prevent infection and reduce any swelling. The nurse will give you a bottle of eye drops to take with you, these are to be used four times a day over three weeks following surgery, but NOT on the day of surgery.
  10. Recovery time – you’ll need about 10 to 30 minutes following your surgery to rest back in the hospital reception. We recommend having a hot drink and a biscuit and these will be offered to you while you wait.
  11. Time to go home – we’ll call the contact you gave us to organise a lift home, if they’re not already waiting for you in the reception area. If you have organised a lift on our SpaMedica bus, you’ll be booked in with the driver, who will come and get you when the bus is ready to go.

8. Post-surgery care

There are some common symptoms following surgery, such as blurred vision, a scratchy feeling in the eye, your eye watering a little, a dull ache over the eyes and sensitivity to bright light – these are all normal and shouldn’t last more than a couple of days. If you experience any aches or pain after surgery we suggest you take painkillers, such as paracetamol, using the recommended dosage. You should avoid aspirin, unless this has been prescribed for you. You can wear sunglasses the day after surgery for light sensitivity, make sure these are cleaned well before wearing.

The most important thing following surgery is to protect the eye from infection and so it is important not to rub or touch the eye.

The eye shield should stay on for the day and night following surgery and it is designed for you to be able to sleep with it on. This can be removed in the morning, the day after surgery, but should be put back on before you go to sleep for the next seven nights, using micropore tape. Remember to wash your hands every time you remove and replace your shield.

You will begin using your eye drops on the day after your surgery, as prescribed by SpaMedica.

If your eye is sticky and your vision is blurred the day after surgery, or later on, then you can bathe your eye. You will have been given a pack of sterile swabs to use for bathing the eye. You should boil some water (this provides sterilisation), allow this to cool and then bathe the eye with the swab and water. Make sure you wash your hands before and after bathing your eye.  Soak the swab in the cooled water and wipe once across your eye while it is closed. Repeat with a new swab if needed.

If you are coming back to SpaMedica for your post-op appointment you will have chosen a date and time before you left on your surgery day. If your optician is a member of the SpaMedica accredited partner scheme then you should contact them to book an appointment for about 2 to 3 weeks after your surgery.

9. Post-surgery DOs and DON’Ts

The main thing to consider following eye surgery is to reduce the risk of infection in the eye, so it’s important to avoid any environments or activities that would increase this risk eg dusty gardens and swimming pools.

Urgent post-care – If you experience any of the following symptoms following surgery then please call our emergency helpline on 0161 838 0883 – if you have a general enquiry please call 0161 838 0870, the helpline is for emergencies only.

  • Throbbing pain in or around your eye
  • A severe headache with, or without, nausea and/or vomiting
  • Progressive deterioration of vision in your eye or loss of vision
  • Increasing redness in your eye with severe pain, sticky discharge or eyelid swelling


Glasses
– For most patients your vision will have improved following surgery and you will require a new prescription if you wear glasses. If you require surgery on one eye only then you can get new lenses/prescription for your glasses once you’ve had your 4 week post-operative visit. If you’re having surgery on both eyes then we recommend you visit your optician after your first eye surgery – they can make a temporary change to your glasses eg pop out lens (they’ll usually do this for free) or replace with non-prescription lens (there may be a small charge for this) if your vision is better in your treated eye. You should return to see your optician to get a new prescription for your glasses when your surgery is completed for both eyes, this could be at your 4-week post-operative visit if this is with your optician or following your 4-week post-op visit to SpaMedica.

Driving – It takes a few days for your eyesight to adjust, so you should wait at least 48 hours after surgery before driving or operating machinery. Please note that you cannot drive until your eyesight meets the legal driving requirement ie be able to read a car registration plate at 20 metres with glasses or contact lenses, if required.

Working – If your workplace is dust free with no physical activity then you can return to work one week after surgery. If this is not the case then you should wait two weeks before returning to work. Please let us know if you require a doctor’s ‘fit’ note to give to your employer if you need to be off work longer than one week.

Child care – It’s OK for you to look after children following surgery, UNLESS you were given a sedative before surgery, in which case you should not look after children alone for at least 24 hours.

Glaucoma – If you have glaucoma continue to take your glaucoma drops as normal, unless you have been told otherwise. Please use a new, unopened bottle following surgery and leave an interval of at least 5 minutes between the two different types of eye drops – it doesn’t matter which order you put these in.

Lubricating eye drops – If you experience overly dry or gritty eyes it’s OK to use lubricating eye drops, which you can get from your optician or local chemist. Leave at least 5 minutes between using the two different types of drops.

Dry eye drops – If you’re experiencing redness, grittiness and/or soreness it may be helpful to use ‘artificial’ tear drops, available from your local pharmacy, types of these include hypromellose, carbomer or polyvinyl alcohol. Leave at least 5 minutes between using the two different types of drops. If you already use ‘artificial’ tears medication please use a new, unopened bottle following surgery.

Make-up – You should NOT wear any eye make-up for 3 weeks.

Showers and baths – It’s OK to have showers and/or baths, keep your eyes closed when washing your face and remember not to rub your eye.

Hair washing – It’s OK to wash your hair after 24 hours of surgery, use a mild or baby shampoo, avoid getting soap in your eye and don’t rub the eye.

Cooking – If you’re feeling OK it’s fine for you to do everyday activities, like cooking, pretty much straightaway when you get home.

Reading/watching TV – It’s OK for you to read and watch television following surgery – your vision may be a little blurred for the first few days.

Sport and exercise – You should aim to keep any sport activities or exercise to a minimum for the two weeks following surgery – it’s OK to resume these after this time.

Swimming – Please do NOT swim until after you have attended your post-operative appointment and your eye has been checked. We recommend you wear goggles if swimming within one month of surgery.

Gardening – You should NOT garden until after your post-operative appointment.

Flying – It is OK to fly one week following surgery, but we would recommend you wait if you can until after your post-operative appointment.

Alcohol – It’s OK to drink alcohol following surgery, UNLESS you had a sedative for surgery, in which case you should wait 24 hours before having a drink.

Bending – It’s OK to bend down for a short while eg while tying shoes, but prolonged periods of bending should be avoided.

10. Your post-operative appointment and check up

Your post-op assessment will be booked at either your optician’s practice or a SpaMedica clinic:

  • This will be scheduled two weeks after your first eye surgery, if you are having surgery on both eyes.
  • Your post-op assessment will be scheduled for four weeks after surgery if you are having surgery on one eye only or after your second eye surgery.

The purpose of your post-op appointment is to check your eye health and test your vision following surgery. Several eye tests will be conducted, with your appointment lasting about 1.5 to 2 hours (which includes about 40 minutes to allow your pupils to dilate – see below).

Dilating the eyes causes blurred vision and sensitivity to light, so you won’t be able to drive; so it’s important to make sure you organise a lift or arrange transport to/from the hospital. SpaMedica provides free transport for some patients, based on your location and other criteria – if you’re struggling to find transport please speak to a member of our Referrals team to see if you qualify for free transport.

So what will happen at this appointment?

  1. Welcome – You will be welcomed and signed in by one of our friendly reception team members and directed to the assessment clinic. You will be seated in our clinic reception and offered complimentary tea, coffee and biscuits.
  2. Vision test – The first test we conduct is to check your vision, which should have improved following surgery. This is done using a chart, the same as used in opticians, where we ask you to read letters from the top line downwards on the chart.
  3. Eye pressure – It is important to test the pressure in each eye to check eye health and test for glaucoma. Anaesthetic drops will be placed in each eye before the eye pressure test, which is conducted using a handheld meter, which gently touches the surface of the eye and provides a digital readout of the pressure in the eye.
  4. Pupils dilated – Drops are placed in each eye to dilate the pupils (this makes your pupils larger, so we can examine the eye). It usually takes about 30 to 40 minutes for your pupils to dilate and then we can examine your eyes. Dilating your pupils affects your vision and sensitivity to light for up to four hours, so you will not be able to drive yourself home after the appointment. And, of course, you will be offered more complimentary tea, coffee and biscuits while we wait for your pupils to dilate.
  5. Eye diagnostics – There are two diagnostic tests conducted at post-operative assessments – the first takes a magnified colour photo of your eye and the second is called a biometry test, which measures the shape and size of the eye.
  6. Optometrist check – All your test results are checked and analysed by a SpaMedica optometrist (eye healthcare specialist). They check to make sure the health of the eye is good and everything is OK following surgery. They’ll let you know the results of your surgery and confirm next steps.
  7. Second eye surgery – If you’re having surgery on your second eye you will book a date for your surgery at this appointment. Our receptionist will give you available dates and you can choose a time and date to suit you – this is usually about two weeks following your post-op appointment.
  8. Final surgery – If this is your final post-op appointment (for surgery on one or two eyes), and the optometrist confirms all is OK, you will be ‘officially’ discharged from SpaMedica. A few patients may require a follow-up appointment in a couple of weeks and this will be booked in for you.

11. Time to enjoy a clearer, brighter future

You’re all done and should be experiencing improved vision and colours you’re seeing should be back to normal.

Many patients describe their cataract surgery experience as a positive and ‘life-changing’ experience; their vision is greatly improved, it’s helped with their confidence and independence and they are enjoying the vibrant colours that they can now see clearly.

Please download our Journey Map as a PDF.

DOWNLOAD JOURNEY MAP

If you would like this information sending to you in the post please send us your email and we will contact you within 2 days.

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