Cataract

Get back to enjoying life in all is wondrous colours within a few days after cataract surgery.

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Introduction

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Modern cataract surgery involves not only helping to make your sight clearer but also to minimise your dependence on glasses after surgery. In expert hands, using small incisions and lenses specifically designed for each individual eye one can achieve the desired visual outcomes with a high level of predictability.

Choosing exactly what you would like to achieve with cataract or lens replacement surgery can often be a tricky task and can include a lot of technical jargon including monovision, presbyopia, trifocal lenses, toric lenses, limbal relaxing incisions etc.

The aim of the information below is to help you understand as clearly as possible what to choose and the exact option or options you can consider.

I also offer a free mini-consultation service to help you understand your options better prior to making a decision.

Often, it is best to hear directly from patients who have been through the process. You are welcome at any one of my open evenings or book in for a free mini-consultation.

Call the clinic on 01422 324069 to arrange this or click the button above.

How do we see?

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Sight is an important contributor to the quality of our lives. Seeing well enables us to live more independently and enjoy a fuller range of hobbies and activities. There are a range of problems that can occur with good vision. Some of these require the use of glasses or contact lenses; others require different forms of treatments. With the help of a series of videos we will focus on some of the common problems with sight including presbyopia, long and short-sightedness, astigmatism and cataracts.

In order to understand your options it is crucial to understand how our visual system works. Light enters the eye through the transparent front window, the cornea, a static or fixed lens which contributes to two thirds of the focusing of the eye. The light then passes through the crystalline lens which in a youthful state can change shape and adjust the focusing in the eye enabling a seamless transition from near to distance vision.

After passing through the lens, the light is focused onto the retina. Analogous to the film, or rather the electrical sensor at the back of a camera, the retina converts the light energy to electrical energy which is then transmitted along the optic nerve to the brain which in turns interprets the signal enabling us to visualise the world around us.

What is Cataract?

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Modern cataract surgery involves not only helping to make your sight clearer but also to minimise your dependence on glasses after surgery. In expert hands, using small incisions and lenses specifically designed for each individual eye one can achieve the desired visual outcomes with a high level of predictability.

Choosing exactly what you would like to achieve with cataract or lens replacement surgery can often be a tricky task and can include a lot of technical jargon including monovision, presbyopia, trifocal lenses, toric lenses, limbal relaxing incisions etc.

The aim of this guide is to help you through the minefield to choose the exact option/options you would like to consider. I also offer a free mini-consultation service to help you understand your options better prior to making a decision. Often, it is best to hear directly from patients who have been through the process. You are welcome at one of the open evenings or book in for a free mini-consultation.

Myopia

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Myopia or short-sightedness describes the condition when objects close to us appear in focus but objects in the distance are blurred. In high myopia glasses are required to read or help with intermediate vision, such as using a computer screen as the eyes optimal focus is set to within a few centimetres of the eyes.
Eyes that are short-sighted are generally longer than normal. This means that the light is focussed in front of rather than at the retina. Contact lenses or glasses that diverge or separate the light rays before they enter the eye are required to correct your sight.

When performing lens replacement or cataract surgery, an intraocular lens, that is a lens placed inside the eye, can be selected that corrects the eyes natural defocus error. Lenses can be made to cover a very large range of short-sightedness from as low as -0.5 all the way up to -30 and beyond! This could enable you to enjoy good vision with minimal dependence on glasses.

Single focus and multifocal lenses are available to correct nearsightedness. If your eyes are suitable, multifocal lenses may allow you to go about your daily activities without the need for glasses.

Hyperopia

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In hyperopia or farsightedness the eye has better ability to see distance objects than objects that are close. Lenses that help converge or bring the light rays closer together are required.

Eyes that are far-sighted are generally smaller than normal. This means that the light is focussed behind rather than at the retina. Contact lenses or glasses that converge or bring the light rays closer together before they enter the eye are required to correct your sight.

When performing lens replacement or cataract surgery, an intraocular lens, that is a lens placed inside the eye, can be selected that corrects the eyes natural defocus error. Lenses can be made to cover a very large range of far-sightedness from as low as +0.5 all the way up to +30 and beyond! This could enable you to enjoy good vision with minimal dependence on glasses.

Single focus and multifocal lenses are available to correct farsightedness. If your eyes are suitable, multifocal lenses may allow you to go about your daily activities without the need for glasses.

Astigmatism

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In astigmatism, the light entering the eye rather than being focused at a single point is focused at multiple different points. This causes distorted or blurred vision. Objects appear bent as well as being out of focus.

Astigmatism can take a number of different forms however the commonest cause is due to an unequal curve of the main lens of the eye, the cornea. If the cornea is steeper in one direction compared to the other an ’astigmatic’ focus will be caused.

When performing lens replacement or cataract surgery, an intraocular lens, that is a lens placed inside the eye, can be selected that corrects the eyes natural defocus error.

Lenses can be made to cover a very large range of far-sightedness from as low as +0.5 all the way up to +30 and beyond! This could enable you to enjoy good vision with minimal dependence on glasses.

This can be corrected during lens or cataract surgery by simply placing extra incisions (limbal relaxing incisions) during surgery for relatively low levels of astigmatism; or by placement of a special intraocular lens, a toric lens.

After specialized scanning of your eye has been performed, a toric lens specific to correct the specific astigmatism can be calculated.

Toric lenses are available for single focus as well as multifocal lenses.

If your eyes are suitable, multifocal lenses may allow you to go about your daily activities without the need for glasses.

Presbyopia

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Presbyopia is an age related condition. As you get older the lens in the eye gradually loses its ability to change shape and adjust the focusing power of the eye.

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Most people begin to experience this in their forties and often initially adjust by holding objects further away to have them in focus. With time, glasses become increasingly necessary to read or use a computer. Presbyopia gets worse with time and you may find yourself having to increase the strength of your reading glasses to compensate.

The good news is that the latest developments in lens design may give you the opportunity to recover this natural deterioration in your sight and allow you to virtually dispose of your glasses.

Increasingly people are opting to have lens surgery before they develop cataracts in order to correct for the loss of reading vision and at the same time correct for any glasses they need for distance vision by having multifocal lens implants.

Have a read on our Trifocal Section for more information.

Monovision

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Monovision is a way of helping patients with presbyopia to do routine near tasks without reading glasses. The dominant eye is set for distance vision and the non-dominant eye is set for reading vision. The two eyes still work together as a team so you can see clearly at all distances; it’s just that one eye sees more clearly than the other at a certain distance. Though monovision might sound difficult to adjust to, most people adapt to it easily and don’t even notice which eye is their “distance eye” and which is their “near eye” when both eyes are open.

Prior to any surgical monovision correction, a contact lens trial will be required. You should know within one to two hours if you are likely to adapt to monovision. Thereafter you should wear your lenses for one to weeks to help determine whether or not your visual requirements have been met.

Post Operative Care

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Do’s and Don’ts after your Eye Surgery

How will my eye feel after the operation?

As the anaesthetic wears off, there can be a dull ache or a discomfort like something in the eye, felt in and around your eye. Your eye will also be slightly red, watery and your vision may be blurred. You may want to use your normal pain relieving tablets when you get home and during the first 24 hours. Your eye usually settles over two to four weeks after the operation although some patients take slightly longer. A slight feeling of grittiness in your eye can last several months after the operation, as the small wound gradually heals. Please contact me if the pain, redness or blurred vision is getting worse rather than better.

How do I put in the eye drops?

You will be shown how to clean your eye and put in the eye drops correctly. In some circumstances, family and friends will be taught how to do this so they can help you.

How to put in the drops:

1. Tilt your head back

2. Gently pull down your lower lid with one hand

3. Look up and allow drops to fall inside lower lid

4. Do not let the tip of the bottle come in contact with your eye

The eye drops help reduce the risk of infection and inflammation after surgery and may be necessary for one to two months. My usual post-operative medications for cataract or lens replacement surgery consist of: Betnesol – anti-inflammatory steroid to be used four times a day for four weeks Chloramphenicol – antibiotic to be used four times a day for two weeks Nevanac – anti-inflammatory non-steroidal to be used three times a day for two weeks.

Is there anything else I have to do to care for my eye?

You should avoid rubbing or touching your eye. This is extremely important in the first one to two weeks after the operation. You might find you are sensitive to light, so it is useful to have a pair of plain dark glasses in case you need them. You should avoid gardening and swimming for four weeks after the surgery. You should avoid strenuous physical activity for the first two weeks but you can resume light physical activity within a day or two. Depending on your occupation, you should be able to return to work a few days after your operation. If you perform manual work, or a job which requires a lot of use of the eyes, you may require a longer time. The doctors and nurses in clinic will advise you. Your eye takes a few weeks to settle and for best vision to be achieved.

When can I wash my face and hair after the operation?

You are advised to be careful when washing: do not directly splash water into your face in the shower or immerse your head in the bath for one week after surgery, but a clean face cloth can safely be used. Some people find that large swimming or scuba goggles are useful if having a shower.

When can I see my optician for an update to my spectacles?

You will be advised about tests for spectacles to improve vision (refraction) at your clinic appointment after the operation, you can usually have your eyes checked for new glasses by your own optician about six weeks after the operation. During the time until you have your new glasses, or between having the first and the second eye operation, you may experience some vision difficulties especially if there is a big difference in the glasses prescription between the two eyes. You may choose whether or not to use your old glasses, or for your optician to remove the lens on one side of the glasses until your final pair of glasses is ready or you have had the operation in both eyes.

Does the cataract recur?

No, but you can develop a thickening or clouding of the posterior capsule membrane behind your new lens implant in the months or years following your surgery.
This occurs in approximately one in 10 cataract surgery patients and is called posterior capsular opacification and causes blurring of vision.
This can be treated with an outpatient laser procedure, known as YAG laser capsulotomy. It is usually very effective, painless and quick. The risks of YAG laser treatment are much smaller than the risks of the original cataract procedure and will be detailed at your consultation.

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surgery location

Spire Elland Hospital
Elland Ln, Elland, West Yorkshire
HX5 9EB

01422 324069

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contact number

01422 324 069

Your eyes are important, don’t leave it too late, call us today.