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Cataracts

Dear Patient,

I have provided this information sheet because you have a cataract and considering surgical treatment.

There is a lot of information, but the more you know the better prepared you will be when the time comes for surgery.

WHAT IS A CATARACT?

The human eye has two lenses, the front lens, the cornea, and an internal lens, behind the pupil.



When the internal lens clouds, it is known as a cataract.

A cataract is not a growth over the eye as some are led to believe, but rather, the naturally clear lens becoming opaque.

Each person’s cataract appears a little different to the next. However, regardless of the type of cataract you have, or the length of time you have had it, several issues are important.

BEHAVIOUR OF CATARACT

All cataracts to a greater or lesser extent will worsen, therefore, causing vision to deteriorate to the point of requiring surgical removal.
All cataracts, in their early stage will be without symptoms and therefore, not require treatment.
Cataracts do not cause eye pain and should not be blamed for eye irritation, redness etc. It follows, that after cataract surgery eye complaints that are not caused by the cataract, will remain unchanged.
“Cataract surgery” is appropriate when visual function is affected and surgery is likely to improve your sight.

CATARACT SURGERY

Despite what you may hear or read in the popular press, cataracts are not removed by laser!
Cataract surgery is a major eye operation and therefore must be performed in a fully equipped operating theatre of an accredited hospital.
Except in rare circumstances, the operation is performed under local anaesthesia.
Before the eye is put to sleep, the anaesthetist will give you sedation and for the short moment you drop off to sleep, he/she will put a small injection around (not in) the eye. This will give me control of the eye and you will not feel discomfort, although you will be aware that I am touching around the eye.

The eye and surrounding tissue will be asleep for 2 to 4 hours.
When the eye “wakes up” you will initially have blurred and double vision which, by the next day will be well underway to recovery.
Usually there is no bruise, but some people who have tendency to bruise will have so for about one week.
The risk of complications in the hand of skilled anesthetists is slight.

Once the eye is asleep, you will be brought into the operating theatre where I will clean the eye to be operated on and place a cover over the top of the surrounding tissue to keep it sterile.
From this point onward, until the operation is complete, you will need to stay still and silent. If you feel uncomfortable, you will be able to let us know so that we can help you.
I will then make a tiny cut into the eye, that you will not feel, and I then remove your cataract and replace this with an artificial lens of a power suitable for your eye.
At the end of the procedure, I will ensure the wound is secure, usually sutures are not required.
I then instill drops, pad the eye and cover the top with a shield.

The method of caring for the eye for the first night will be provided by my staff in the form of a green information sheet to come to you before surgery.
If there are concerns after hours, you should ring me on the mobile phone number provided or simply leave pad alone until you see me the next morning.
When drops are commenced, you should discard the pad and retain the plastic eye shield. This can be used to protect the eye from harm at night for the first week after surgery. Simply tape over eye with medical tape such as micropore.

RISKS OF SURGERY

Cataract surgery has developed a reputation for being rarely complicated. However complication may occur, the following being a reasonable list of risks.

Major Complication.
These occur 1 every 1500 cases
If they occur you may lose part or all sight in this eye and very rarely lose the eye.

Minor Complications
Perhaps a little more common, but, do not affect final visual outcome.
Bruise
Irritation lasting more than a week
Glare with bright lights and when driving at night.
Reaction to eye drops used to settle eye after operation
Transient elevation of eye pressure requiring drops or tablet to treat.

WHAT TO EXPECT AFTER CATARACT SURGERY

  1. A common visual symptom that many of us have is a floater. This is unrelated to the cataract. This dark, floating spot in our vision has, at times, a different appearance following cataract surgery.
  2. A cataract is only one cause of reduced vision. In assessing your eye it may become evident that there are other reasons why your vision is not 100%. Therefore, after cataract surgery, your vision may not recover to a high level.
  3. After cataract surgery 60% of people will not need to wear spectacles for distance, but only 10% will get by without spectacles for reading, especially when trying to read fine print.
  4. The people who tend to require distance spectacles after cataract surgery are those with pre-existing astigmatism.
  5. The most common symptom following surgery is an irritation at the outer edge of the eye. Usually mild and it slowly fades with time. The healing wound causes this.
  6. A few will notice a faint shadow at the extreme outer vision. This again fades with time. It is not serious and is caused by the wound.
  7. Both the irritation and shadow will rarely persist.
  8. Vision improvement after cataract surgery is usually evident within 2 days and usually shows further improvement over the next week.
  9. Vision remains stable after three weeks and usually at this time new spectacles are ordered.
  10. Months or years after cataract surgery, visual blur may occur from the formation of an opaque membrane behind the lens implant. This is cleared with laser if required.


If you have questions, or wish further information, please don’t hesitate to ask.

Dr Mark Chehade
Eye Specialist and Surgeon

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