What is a cataract?
A cataract is a clouding of part of your eye called the lens. Your vision becomes blurred because the cataract is like a frosted glass, interfering with your sight. It is not a layer of skin that grows over your eye, despite what you may have heard.
If your doctor or optometrist/optician has told you that you have a cataract, don't be alarmed. Many people over 60 have some cataract and the vast majority can be treated successfully. Early cataracts may not affect your sight and do not need treatment.
How the eye works
The function of the lens
The lens is a clear tissue found behind the iris, the coloured part of the eye. The lens helps to focus light on the retina at the back of the eye to form an image. To help produce a sharp image, the lens must be clear.
The effect of cataracts
Blurry sight
This is very common. You may notice that your sight has become blurred or misty, or that your glasses seem dirty or appear scratched.
Dazzled by light
You may be dazzled by lights, such as car headlamps, and sunlight.
Change of colour vision
Your colour vision may become washed out or faded.
These eye problems may be a sign of other eye conditions. If you suffer from any of these symptoms, please see your optometrist/optician. Regular eye tests with your optometrist/optician can catch an eye condition in the very early stages.
Causes of cataract
Cataracts can form at any age. The most common type of cataracts is age-related cataract. These develop as people get older. In younger people cataracts can result from conditions such as diabetes, certain medications and other longstanding eye problems. Cataracts can also be present at birth. These are called congenital cataracts.
Although researchers are learning more about cataracts, no one knows for sure what causes them. There may be several causes and some studies have linked smoking, excessive exposure to sunlight and poor diet with cataract development. Sometimes cataracts are caused by other health problems such as diabetes.
Treatment
The only effective treatment for cataract is an operation to remove the cloudy lens.
Timing a cataract operation
In the past, eye specialists often waited until the cataract became "ripe" and your vision was very poor before suggesting you had the cataract removed.
Nowadays, with modern surgery the operation is usually done as soon as your eyesight interferes with your daily life. This includes having any difficulties with looking after yourself or others, cooking, driving, getting out and about, being able to read, work or do the things you enjoy.
If you are a driver you must reach the visual standard required by the Drivers and Vehicle Licensing Authority, and it may be necessary to have the cataract removed in order to keep your license.
Before the operation
Before the operation, you and your eye will be carefully checked to decide the details of the operation. This may require a separate visit before your surgery. This is called a pre-operative assessment.
The operation
Almost everyone has a local anaesthetic. With a local anaesthetic, you will be wide awake but feel nothing in your eye.
Usually the eye specialist will explain what is happening as the operation goes along, and a member of the health care team may also be there to hold your hand if you wish and make sure you are comfortable and relaxed. You may vaguely see some movement but no details of the operation.
If, however, you do have a general anaesthetic you will be completely unconscious, and it will be like sleeping through the operation.
The eye specialist does the operation with the aid of a microscope, through a small opening in the eye. This opening is so small that stitches may not be necessary.
The operation often takes about 15 to 20 minutes, although it can last longer.
During the operation the lens with the cataract is removed and replaced with a clear plastic lens, so that the eye can see clearly after the operation. This plastic lens is called an intraocular lens implant and remains permanently inside your eye. There is no risk of your eye rejecting the new lens.
A pad or shield will probably be put over your eye to protect it from accidental rubbing and bumping after the operation.
The operation cannot be performed with laser, although laser treatment is sometimes needed afterwards if the lens casing (the capsule) becomes cloudy.
We want to reassure you that your eye is not taken out of its socket during surgery.
After the operation
Most people notice an instant improvement in sight, although complete healing may take several months. You may still need glasses, especially for reading, because the new intraocular lens implant is normally set up for distance vision and not close-to vision.
If you were wearing glasses for distance vision (short-sightedness) before surgery your glasses prescription will probably change following surgery. This is because the new intraocular lens can be set up to correct short-sightedness. Your ophthalmologist would be able to explore the different options with you.
You will be given eye drops to use for up to two months after your operation. It is a good idea to have some help at home, especially if you find it difficult to put your eye drops in.
Most people will have the operation and go home on the same day, and will probably be able to carry on with normal daily activities - but do think about the following:
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avoid rubbing your eye; discuss wearing an eye shield with hospital staff if you are a restless sleeper
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don't do any very heavy lifting, and avoid strenuous exercise and swimming
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take care if it is windy, in case anything blows in your eye, although you don't need to stay indoors
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take care washing your hair; avoid getting soapy water in your eye(s)
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avoid wearing eye make-up until the hospital are happy with your recovery.
The eye specialist or a nurse in the eye clinic will be able to answer any questions you may have, and advise you when to have an eye check to get new glasses. They can also tell you when you can go back to work, drive and fly again.
Possible problems
Cataract surgery is one of the most successful operations. Fewer than two per cent of patients have serious, unforeseen complications. If you have any concerns after the operation ring the eye clinic or the doctor on call in the eye unit.
One of the most common and easily correctable complications is a thickening of the lens casing - the part of the eye that holds the lens in place. As mentioned earlier, this can easily be corrected with laser treatment.
If you are worried about anything not covered in this general information, please contact the staff of your eye clinic or family doctor (GP).
What next?
Talk to someone
The RNIB Helpline is your direct line to the support, advice and products you need. We'll help you to find out what's available in your area and beyond, both from RNIB and other organisations.
Whether you want to know more about your eye condition, buy a product from our shop, join our library, find out about possible benefit entitlements, be put in touch with a trained counsellor, or make a general enquiry, we're only a call away.
RNIB Helpline
Telephone: 0303 123 9999
Email: helpline@rnib.org.uk
We are ready to answer your call Monday to Friday 8.45am to 6.00pm and Saturday 9.00am to 4.00pm. Outside these times leave us a message and we'll get back to you as soon as possible.
Unfortunately, RNIB can only answer email enquiries from the UK. But you may find an organisation for people with poor sight in your country through our organisations database.
Get information
RNIB's guide to Adapti ng to sight loss offers ideas for people with sight problems on making life easier and ways of getting the most out of life.
You may also find the following useful:
Useful contacts
Royal College of Ophthalmologists
The Royal College of Ophthalmologists is unable to comment on individual patient care.
Drivers and Vehicle Licence Agency (DVLA)
Drivers Customer Services (DCS)
Correspondence Team DVLA
Swansea SA6 7JL
Telephone 0870 240 0009
About this guide
Information sources
We do all we can to ensure that the information we supply is accurate, up to date and in line with the latest research and expertise.
The information used in RNIB's Understanding series of leaflets uses:
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the Royal College of Ophthalmologists guidelines for treatment
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clinical research and studies obtained through literature reviews
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information published by specific support groups for individual conditions
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information from text books
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information from RNIB publications and research.
For a full list of references and information sources used in the compilation of this web page, email publishing@rnib.org.uk or call 020 7391 2006.
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RNIB's Understanding series
The Understanding series is designed to help you, your friends and family understand a little bit more about your eye condition. Other titles in the series include:
All these leaflets are also available in audio, print and Braille formats. To order please, contact RNIB's Helpline on 0303 123 9999 (all calls charged at local rate), email helpline@rnib.org.uk or visit our Online Shop.
In 2010, three new titles will be added to the series:
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Understanding Charles Bonnet syndrome
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Understanding dry eye
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Understanding posterior vitreous detachment.
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RNIB Helpline
Telephone0303 123 9999
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if you, or someone you know, is living with sight loss, we're here to help.
This leaflet has been produced jointly by the Royal College of Ophthalmologists and Royal National Institute of Blind People, with sponsorship from Alcon Laboratories (UK) Ltd.
RNIB and the Royal College of Ophthalmologists have full editorial control over the content of this leaflet.
© RNIB and RCOphth
RNIB registered charity number 226227
RCOphth registered charity number 299872
Printed November 2009. Review date July 2010.
ISBN: 978 1 85878 711 4
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