Cataracts are a very common condition, being the leading cause of vision impairments in the world. It is estimated that 2.36 million people over the age of 65 in England and Wales suffer from vision-impairing cataracts. Although you cannot prevent cataracts, there are treatments available – such as cataract surgery – to help remove them and prevent blindness.

What are cataracts?

Cataracts are cloudy patches of tissue that grow on the lens of the eye. The lens is the small transparent disc within the eye. They form due to the development of clumps of protein on the lens. As they become bigger over time, cataracts can cause fuzzy or blurred vision, and even lead to blindness. This can result in making daily activities such as driving and reading difficult.

Our consultant vitreo retinal and ophthalmic surgeon, Mr Roger Shimizu Wong explains, “cataracts usually occur in both eyes, but do not tend to develop at the same time. Although they are more common in older people, cataracts can also affect children and babies”.

Symptoms of cataracts

There are various symptoms and signs of cataracts , including:

  • blurred vision: your vision may be cloudy or dimmer than usual, with colours appearing faded
  • poor night vision: you may find it increasingly hard to see in the dark
  • requiring brighter lights: you may need stronger lights for activities such as reading
  • sensitivity to light: during the early stages of the condition, you may notice an increased sensitivity to bright light or glare
  • halos: you may see halos (bright circles of light) around light sources
  • double vision: caused by the cataract scattering the light coming into your eye
  • frequent prescription changes: you may need to change your glasses or contact lenses more regularly

A professional ophthalmologist should be consulted if you are experiencing any of these symptoms, as they can assess the cataract regarding severity and best management plan.

What causes cataracts in eyes?

Most cataracts are caused by normal changes in the eye as people get older. But that’s not the only potential cause. Other causes of cataracts include:

  • ageing: as you get older cataracts can develop. This typically happens around age 40 and above
  • steroids: such as treatments for conditions like arthritis and lupus
  • phenothiazine drugs: including treatments for bipolar disorder and schizophrenia
  • diabetes: as high blood sugar levels can cause structural changes in the lens that accelerate cataract formation
  • sun exposure: research shows that UV light can increase your risk of developing cataracts
  • trauma: injuries to the eye can lead to cataracts
  • surgery: surgical procedures on the eye can cause cataracts later in life
  • radiation treatment: can lead to cloudiness or partial opacity

Types of cataract surgery

There are various cataract surgeries available. A doctor will help to determine which treatment or surgery will be best, based on the symptoms and severity of the condition.

Phacoemulsification surgery

Phacoemulsification uses ultrasound energy to restore vision. The procedure is a modern-day type of cataract surgery that emulsifies the nucleus of the lens, breaking the lens into small pieces using ultrasonic waves from a handheld device. After being flushed with sterile fluids (the irrigation stage) the pieces are then suctioned with a vacuum (aspiration stage), removing them from the eye.

The final part of the procedure involves an intraocular lens implant (silicone or acrylic replacement lens) being inserted into the lens capsule (a thin membrane around the lens) to replace the lens that is damaged. Phacoemulsification requires a smaller incision with no stitches usually being needed. Following surgery, you will stay in a recovery room for around 30 minutes, before you can go home. As your vision will be cloudy for a period, you should arrange to be driven home from a family member or friend.

Extracapsular cataract surgery

Rather than fragmenting the cataract, extracapsular cataract extraction removes the cataract in one piece. This type of eye surgery removes the entire lens and leaves the capsule attached to accommodate the intraocular lens implant. The surgeon will make a small incision in the white of your eye, close to the cornea’s outer edges. Carefully opening the front of the capsule, the surgeon enters the eye to remove the nucleus.

If your cataract was removed as a single piece, stitches may be needed. Extracapsular cataract extraction is typically the type of surgery required for mature cataracts. You should be sure to arrange transport home after the procedure, as your vision will be cloudy for a while. You’ll be able to resume your normal activities in a few days.

Refractive lens exchange surgery

Refractive lens exchange (RLE) – or lens replacement surgery – replaces the natural lens with a synthetic intraocular lens implant. Whereas other types of cataracts surgery are used to correct blurred vision caused by a misty lens, RLE is done to reduce your dependence on glasses or contact lenses. It corrects short-sightedness and long-sightedness, as well as astigmatism (an imperfection in the eye’s curvature that can cause blurred vision).

After administering anaesthetic eye drops, your surgeon softens your natural lens with ultrasound, before it is emulsified and replaced with an intraocular lens. The procedure takes from 10 to 15 minutes to complete, and you will be able to return home on the same day.

What is the latest treatment for cataracts?

Cataract treatment has advanced significantly since the first cataract removal procedure was completed in 1747. The first intraocular lens was implanted at St Thomas Hospital by Sir Harold Ridley. Currently, there are no eye drops or medicines available that have been proven to effectively treat cataracts or slow down the process. Therefore, cataract surgery is a patient’s best option to help combat symptoms and improve their vision.

Get in touch

You should have your eyes checked regularly to ensure that any vision problems are identified and corrected. The ophthalmology team at Guy’s and St Thomas’ hospitals is comprised of leading, world class consultants offering a highly professional level of care and unparalleled service.

We provide a full range of surgical procedures for cataracts, as well as other treatments for visual impairments and eye conditions, such as glaucoma and retinal detachment. Get in touch with our dedicated customer service team to learn more.