Cataracts

Cataracts are very common, affecting 50 percent of people over the age of 65 in the UK. This goes up to 70 percent in people older than 85 years. Although they're much more common in the elderly, babies and young children can get them too. 


What are cataracts?

Cataracts are clouding of the lens inside your eye. The lens is crucial for our vision, helping us focus on near or far objects. The clouding of the lens causes light rays to scatter, disrupting our vision.


What are the symptoms?

Usually cataracts develop gradually and affect both eyes. Sometimes, they develop more quickly in one eye than the other. Symptoms of cataracts include:

• Misty or blurry vision. Some compare it to looking through a bathroom window or seeing an Impressionist painting

• Gradual loss of vision that's painless

• Seeing colours less vividly than usual


What are the causes?

While age is the most significant risk factor in developing cataracts, the following make the risk of cataracts higher:

• Excess exposure to sunlight

• Smoking

• Excess alcohol

• Diabetes

• Taking steroid tablets frequently. These are often used medically to treat autoimmune issues, including asthma and arthritis. Steroids taken for bodybuilding also put you at risk of developing cataracts

• Malnutrition

• Eye trauma

Women also get cataracts more frequently than men. Cataracts can run in families, which means that if you have close relatives with cataracts, you are more likely to get them when you're older.

Childhood cataracts are less common, but can occur for a number of reasons:

• Genetic conditions, such as Down's syndrome

• A genetic fault inherited from one of the parents

• Certain infections picked up by the mother during her pregnancy, such as rubella or chickenpox

• Eye trauma after birth


How are cataracts diagnosed?

Your optician will be able to run a series of visual tests to check if you have cataracts. If the optician thinks you may have cataracts that require treatment, you'll be referred to a specialist eye doctor. The specialist will decide whether you require surgery, which is the only recognised treatment for cataracts.

Babies are assessed for cataracts within the first three days of birth. They're assessed again at 6-8 weeks of age. On rare occasions children may still develop cataracts later. It's important to seek advice if you have any concerns about your child's eyes or vision.


How does having cataracts affect my life?

Mild cataracts won't have much impact on your daily life, however, they'll eventually get worse and you may need surgery. Cataracts develop at different rates for different people, so you may find that your symptoms are manageable for a long time before surgical intervention is necessary.

Because of the effect of cataracts on vision, there are some important considerations concerning driving with cataracts. To be able to continue driving, you must be able to meet the standards of vision for driving – you should refer to the DVLA website or contact them directly for the most up-to-date rules. Your optician may also be able to advise you.


What is the treatment for cataracts?

There are no medicines or eye drops that have been proven to treat cataracts. The only treatment available is having surgery. Cataract surgery is the most common operation in the UK and has a high success rate. Your optician will be able to advise you whether this is a suitable treatment for you.

If so, it's still your decision whether to have surgery. You may decide to delay the operation for a while, but you should still have regular follow-ups with your eye specialist. 


What happens during cataract surgery?

Cataract surgery lasts for about 30 to 45 minutes and is usually carried out under local anaesthetic, so you won't be fully asleep during surgery. You'll often be allowed to go home on the same day of the operation.

The surgeon makes a small slit in the thin capsule surrounding the lens and removes the cloudy lens. This is replaced by a clear plastic one. 

The pre-operation assessment will help to decide which type of lens is most suitable for you. If you wore glasses before the surgery, you may no longer require them, or you may need to be tested for a new pair appropriate for your new lens.

If you need cataracts surgery for both eyes, you'll probably have two operations on different days for each eye. Operations are usually done at least 6-12 weeks apart.

You're likely to have some grittiness and redness in your eye and some blurred vision for a few days after the surgery. This can last for 4-6 weeks. You'll need to apply eye drops and take special care of the operated eye after the surgery.


Next steps

• Have your vision tested regularly by an optician who'll be able to identify cataracts early on, change your glasses prescription if necessary and refer you to an ophthalmologist (a specialist eye doctor) when required

• Use sunglasses when outdoors and brighter lights when indoors if you are struggling with cataracts. Check that you are still capable of driving

• Consider having surgery to treat cataracts. Your ophthalmologist will be able to give you more information about the operation