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Cataract Surgery

As we grow older, the lens dulls and increases its cloudiness. It may develop various imperfections over many years, which may limit eye sight. This is called a ‘cataract’.

Symptoms

Symptoms

The most frequent symptom of cataracts is dimmed or blurred vision. Reading may become difficult and you may have trouble driving, especially at night because of the glare of headlights. Another clue is a frequent need for changes in the strength of your glasses.
Once you have been diagnosed as having cataracts, it will be necessary for you to have regular eye examinations. Your eye doctor (ophthalmologist) can check the progress of the cataracts at each visit by checking your visual sharpness and examining the cataracts, usually after dilating your pupils. These ongoing visits will help you and your eye doctor make an informed decision about the need for surgery.

whentooperate

When to Operate

The decision to have surgery is reached by you and your doctor together. Its is based on your personal needs and your doctors recommendation about the best time for surgery.

Your doctor can monitor the progress of your cataracts, and help with advice as to the most appropriate time for surgery.

Your decision to have surgery depends on how much you feel the cataracts are interfering with your normal way of life and whether or not they are preventing you from doing things you like or need to do.

For some people, even a slight loss of vision is unacceptable. They like to sew, read or drive, and the decision to operate may come early. Others may choose not to have surgery because cataracts do not seriously interfere with their lives.

Age is not a bar to cataract surgery.

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surgery

Cataract Surgery

The treatment for cataracts is the surgical removal of the clouded lens. The eye, however cannot focus without a lens, so vision will be indistinct unless some device is employed to take the place of the missing lens. Since about 1980, we have achieved this by inserting a plastic lens into the eye (intraocular lens).

The cataract is usually removed by a small incision made in the outer white coating of the eye (the sclera) or through the cornea (clear corneal incision). You can see how this occurs by looking at Videos.

Most cataract operations are done under local anaesthetic, although general anaesthetic is sometimes used. The advantages of local anaesthetic are that the patient feels more alert sooner. Patients may have a general anaesthetic if they wish and are suitable medically. The choice of the type of anaesthetic used, is made between you, the anaesthetist and your doctor.
The surgery usually lasts about half an hour and you are usually only in hospital for a few hours. Hospitalisation overnight is not necessary.
Patients are advised of all costs involved in the procedure including hospital costs at their consultation. For those patients who do not have private health insurance Medicare will contribute towards some of the doctor’s fee. Any concerns in relation to fees and charges can be discussed with our Reception Staff who will only be too pleased to help you.

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The Artificial Lens

The intraocular lens implants come in different sizes and powers. Intraocular lenses have improved technically in recent years both in quality of the image they produce and with more options available.

The power of the lens implant is calculated using an A-scan BIOMETER. It measures the dimensions of the eye and the power of the implant is calculated using these measurements and a range of formulae.

Multifocal lenses are available and offer both distance, reading and intermediate vision without the need for reading glasses for most purposes. They have some distinct advantages for patients who wish to be spectacle non-dependent but are not suitable for everyone.

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aftersurgery

After Cataract Surgery

After the operation, there are no limitations on the patient. Usually two or three kinds of drops are required, each to be used three or four times a day after surgery to encourage healing and prevent infection. There are no particular restrictions upon activity except that any direct trauma to the eye would be highly undesirable. There are no restrictions regarding reading or watching television.

Upon discharge from hospital, please make sure that you have your drops and know how often to use them. You should also know the dates and times for your follow-up visits and bring all medication to each appointment.

If your eye remains sore, irritated or if you are concerned about something in relation to your operation, please contact our rooms.

You may experience problems with glare after surgery but this usually wears off. We recommend you wear sunglasses to reduce the glare in the meantime.

Glasses may be necessary for reading or for distance, or a combination of these functions, after surgery. Glasses are usually prescribed 3-4 weeks after surgery, by which time the eye has healed.

Sometimes, years after the operation, the vision may start to fade again and this can cause alarm. This is often due to a thickening of the posterior capsule of the eye. Do not be alarmed by this, simply contact the rooms for an appointment. This is easily treated with laser treatment performed in our rooms. This does not represent any failure of the original operation and is a common phenomenon, which has necessitated the production of a specialized machine, called the YAG laser, for its correction.

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Cataract Surgery Complications

Ninety eight percent of patients do very well from the surgery. However, like any surgical procedure, complications can occur.

These complications include:

Infection
Inflammation – swelling and irritation of the eye immediately after the operation
Haemorrhage in the eye
Change in the pupil shape or size
Droopiness of the upper eyelid
Macular edema (swelling of the retina, responsible for clear central vision) which may occur weeks, months or even years after an otherwise uncomplicated surgical procedure.
Retinal tears and retinal detachments
Previous asymptomatic or mildly symptomatic dry eye syndrome may develop after any eye surgery.

If you are concerned or want more information about the possible complications, please ask your eye doctor.

Whilst high expectations from surgery are normally fulfilled, visual results may be limited by co-existing disease of the retina at the back of the eye, such as age-related macular degeneration (aging damage of the retina affecting your central vision), diabetes, glaucoma or other diseases. Your eye doctor will endeavour you to inform you of any associated disease at the back of your eye, which may limit the visual improvement of otherwise successful surgical removal of the cataract.

After surgery, you may still need to wear glasses for distance and/or reading for extra clarity.

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Frequently Asked Questions

How to place drops and ointment in someone else’s eyes

Ask the person requiring the drops to tilt his/her head back and look towards their eyebrows.
Gently pinch a little skin beneath the lower eyelid, between your thumb and index finger. Pull forward and down very gently; this will create a little pocket.
Bring the dropper toward the eye from the patients chin; this will reduce flinching.
Place the drops into the created pocket of skin.
As soon as the drops are in, release the lower fold and ask the patient to close the eyes gently.

Tell me more about the ointment

Ointments can be applied using the same technique as for drops.
Using the pocket technique, apply approximately 1cm of ointment just inside the lower lid.
Ask the patient to close the eye and gently look up, down and sideways whilst the eye is closed. This will distribute the ointment.

How do I apply my own drops and ointments?

Stand in front of a mirror; some individuals find that being side on to the mirror provides a slightly better angle.
Using the pinch and pocket technique, apply the drops and ointment.
Release the pocket and close the eye.
Note: it is extremely important to wash your hands before and after applying medication to the eyes.

When should I use my eye drops?

Eye drops are usually used for 4 weeks after cataract surgery. Drops are usually tapered from four times a day down to once a day before being stopped. Spread the drops out evenly throughout the day during waking hours only. You do not need to use drops in the middle of the night. When you go out, you should take your drops with you so that you can continue to use them as prescribed. Also, we suggest you always use your eye drops as prescribed before you visit your eye specialist, or your own doctor, unless they tell you otherwise for that particular visit.

What happens if a drop is forgotten?

For most drops, it will not matter if you put an extra one in during the day. Thus, if you have a missed drop, you should use one immediately unless the next scheduled drop is nearly due, in which case it can be left out.

I have been prescribed to use different types of eye drops. Do I put them in together, or wait before putting in the second type of eye drop?

Ideally, you should wait 5-10 minutes between drops so that your eye can have maximum benefit from the drops.

If one is uncertain whether the drop went into the eye, should another be used?

Yes, it should. By keeping the drops in the fridge you can be more certain of feeling the drops on your eye by a cold sensation.

How long will the drops last?

In general, once a bottle of eye drops has been opened, it should be discarded four weeks later, even if there are still some drops remaining in the bottle. Fortunately, this fits in with the usual drop schedule following cataract surgery. Drops are usually required for 4 weeks and are usually tapered from four times a day down to once a day.

You should always carefully follow the doctor’s instructions and read the package insert supplied by the manufacturers. This will often point to side effects and problems with using other drugs, which you may have forgotten to tell your eye specialist or family doctor about. Please contact your doctor immediately and give full details of the other drugs you are using if problems occur.

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