Thank you for the kindness and care shown to me and my husband during our cataract operations. You gave us confidence and we are both recovering well
By Mr Ramy Bassily | August 1st, 2017
The eye contains within it a clear lens much like the focusing lens of a camera. It serves to focus light onto the retina (the back of the eye) allowing us to see the image in front of us clearly. Its role depends on its transparency, all people will at some point in later life start to develop opacification of this lens. We tend to call this opacification a cataract once it begins to be visually problematic to the patient.
Modern cataract surgery is performed through micro incisions, the procedure can take up to 20 minutes and involves the “phacoemulsification” of the cataract (high frequency break-up of the cataract) to allow removal through tiny incisions. The new lens is injected into the eye and positioned carefully to allow for clear focus again.
The implanted lens is carefully calculated and available privately is the option for premium lenses. These also attempt to correct the spectacle prescription even more precisely to eliminate astigmatism and increase your chances of spectacle independence. Also available privately are extended depth of focus lenses, these allow the patient to view distance and close up things without the need for additional reading glasses. If you are a good candidate for these lenses your consultant will discuss them with you in detail.
The Impact on Quality of life
Many studies have been published to demonstrate the impact that worsening cataracts have on quality of life and general happiness, for this reason it is becoming more and more the standard to offer surgery while the cataracts are still very early in development. Assessing the impact cataracts have on a person cannot be established just by how well they read letters on a chart. Unfortunately, the NHS criteria only considers the level of vision achieved on a sight test chart when considering if a patient will benefit from surgery. As such in waiting to be eligible patients have to live with a reduction in quality of life for sometimes several years.
If you have noticed your vision is not as good as it was in your young adult life, the chances are you have underestimated its overall impact on your quality of life. Patients often after surgery remark on how clear and bright everything is, but what I hear just as often is how confidence is also restored. Patients feel more confident that they will maintain their independence for longer, that they are safe on the road again, or hobbies and pastimes are much more enjoyable again. For those with balance issues who are at risk of falling they comment on how they feel less frightened when moving around independently.
Night time driving
If you have lost confidence in night time driving it may well be from your cataracts. Patients lose contrast sensitivity very early on and only a minimal amount of cataract is required to give glare. Glare is very disabling as it means oncoming headlights become so dazzling that driving becomes dangerous, even if they are within the DVLA criteria to remain driving. Such patients have much to gain from surgery.
For these reasons when deciding whether to offer someone cataract surgery it becomes much more than a sight test assessment, it is an understanding of its impact on quality of life that determines if the benefits will outweigh the risks. If you are unsure if you may benefit from cataract surgery your first port of call should be your optician or GP who can advise you and if necessary refer you on for a detailed assessment and discussion with a consultant ophthalmologist at the Nuffield Hospital.