View a Video on Cataract Surgery
What is Cataract Surgery?
Welcome to St James’s Hospital Eye Department. Every year around 5,000 Cataract Operations are performed in Leeds Teaching Hospital’s NHS Trust. This information video will give you an idea of what to expect during your visits with us if you are considering having Cataract Surgery.
You will have been referred by your GP or optometrist usually because you have become aware that your vision is not as good as it used to be, and this is now causing you enough problem problems that you would be interested in considering Cataract Surgery. If it were felt that this would improve your sight, so what exactly is Cataract our eye is like a camera in that there is a lens inside that focuses the light. As we get older the lens becomes less clear and our vision correspondingly becomes less clear and, in some cases, we experience glare or are dazzled by lights such as car headlights in the evening or bright sunlight the natural lens you were born with. It’s located within a clear bag called the lens capsule inside the eye.
In Cataract Surgery we remove your lens which has become cloudy from this capsular bag and replace it with a clear synthetic lens. To remove the Cataract, we make a tiny incision near the front of the eye. The Cloudy cataract is broken up using ultrasound energy and remaining pieces of lens are sucked out through a narrow tube and the clear replacement synthetic lens is inserted in its place.
Having been referred by your GP or optometrist, our first job is to make sure that it is just the Cataract that is giving you visual problems, you will be examined by an eye doctor as there can be other reasons for the vision to have become poor such as clouding of the cornea the Clear Window at the front of the eye or aging changes in the retina.
The film at the back of the eye once it is determined that you have Cataract and that there is a good chance that REM moving this will improve your vision. We then need to decide what power of lens to choose to place into the eye.
When replacing the Cataract with a synthetic lens we can choose any power of lens we wish to set the focus of the eye. Most people prefer to aim for Clear Vision in the distance without glasses they would then expect to need glasses for reading occasionally. Someone who is used to reading without glasses prefers to stay in this situation, we can then therefore aim to leave their eye focused for near objects, but glasses will then be needed to see clearly in the distance for activities such as driving or even watching television.
Despite careful lens selection around half of patients find that they do still need glasses for both near and distance Vision after Cataract Surgery and many opt to use bifocal or very focal glasses. The problem is with my vision is when I’m driving, I can’t see properly because my eyes they like blurred is other headlights and I feel it’s dangerous, so that’s why I’ve been asked if I can have a Cataract Operation as with any operation.
There are risks involved with Cataract Surgery these will be clearly explained to you when you are seen in clinic, and you’ll be asked to sign a consent form to show that you have understood the procedure and are happy to go ahead. Although the majority of people are delighted with the results of their operation.
There can be disappointment particularly when there are other eye problems. Such as age-related macular degeneration glaucoma or diabetic eye disease. Once it is decided that you want to proceed with Cataract Surgery details will be recorded of your General Health and any medication you may be taking your eye will also need to be carefully Measured. To permit us to select the right lens for your eye, this is all done by our pre-assessment nurses, when you arrive the ward, you’ll be greeted by the nursing staff who will prepare you for Surgery in order to maximize efficiency.
In theatre we ask everyone to arrive early at the start of the list so that any problems can be dealt with to prevent delays. Unfortunately, this does mean that those who are near the end of the operating list may wait up to 4 hours before going in for the Surgery.
I’m nervous I’m nervous because uh I’ve been thinking about it and it’s nothing really, it’s just me doesn’t mean I’ve had Open Heart Surgery, and everything done, and I don’t know what’s making me be nervous. Well, I’m looking forward to having it done to for improving my sight yeah uh little anxious but little nervous about it but uh it nervous it’s scared you know nervous.
I think CU I don’t know what’s going to happen I think that’s you that’s amazing yeah, I’ve been up since about half 6 um didn’t sleep very well and uh you I just want to get it over with. After you have been prepared for the operation, which will involve putting in some eye drops and checking all your details and paperwork are correct.
You will be taken through to the operating theatre, more eye drops to numb the eye will be put in and the area around the eye will be cleaned. Sometimes we may opt to give an aesthetic injection in addition once the eye is numb, you’ll be taken into the theatre we try to ensure you are in a comfortable position.
On the bed as you have to lie fairly still for the next 15 minutes or so. A sterile sheet is placed over your eye which sticks around the eye but is is lifted away from your mouth and nose, so you have plenty of air to breathe.
The operation typically takes 15 minutes but can take up to 45 minutes as some Cataracts are easier to remove than others. You shouldn’t feel pain during the Surgery although you will feel the surgeon touching around the eye and you may occasionally feel pressure on the eye itself. If pain is experienced, then we can give additional eye drops during the operation to further numb the eye.
After Surgery you will return to the ward where our nurses will explain how you should look after the eye and will give you the eye drops you will need for the next few weeks. To help the eye settle down many patients will be given a shield to protect the eye after the operation, but this is not strictly necessary in all cases you should certainly avoid rubbing the eye directly for a fortnight or so.
After Surgery but you can wipe the eye gently if it is watering. The vision typically improves within the first few days after Surgery in most cases, although the eye can take over a month to settle down in some cases. If at any point following the Surgery your vision starts to deteriorate or the eye becomes painful you should contact us and arrange for prompt review.
It’s different to what I expected the only thing that I felt the pressure a little bit of pressure when he’s putting that. I don’t know it’s a clip or something wasn’t it but when he’s going to put your lenses in, I didn’t even know you’d put it in. There’s no pain at all and now I’ve come back from the theatre, and I can tell you that there’s writing on the wall and I couldn’t even see that, it’s only what quarter of an hour since I had the operation isn’t it.
Heck I can’t believe that better than I expected just a bit uncomfortable keeping that eye still a funny sensation, just like someone pouring a bucket of water all the time, may what feel it running down. Excellent I never felt the thing I always come up together no problems.
As far as I’m concerned at all I had it done in the at um about 4:00 on a Friday night it was very blurry and Scratchy. Saturday it sort of ached it was a bit bro but by Saturday night it had cleared and after that I really had no trouble at all and it has been.
After it I say on Sunday my vision was a lot better you can see things you couldn’t see before and everything’s sharper. I can see further ahead much clearer I hadn’t realized; it was as bad as it was until you have it done and then you realize what you can’t see the day after my operation.
I can’t believe what I can see, I never believe that I’ve gone all this time not seeing things even my friend next door. She said I can’t believe it I couldn’t even watch television properly and things I’ve missed I couldn’t even see my watch, see photographs but my goodness how I’ve put up we’ve not seen properly all these years. I cannot believe and I’ve got to 26 and I’ve got a new lease of life.
I really have and I recommend it to anybody well I just opened my eyes in the morning, and everything was beautiful again and I could see everything. Vision wise, uh it was just like I was back to normal with before. I walks just a bit of AEG obviously with what you what you get around, where the B is it was it was just amazing really. It was in the first day or two after your operation it is normal to expect the eye to water and blood staining of the water from the eye is not uncommon. The eye may ache and feel gritty. Normal painkillers such as Paracetamol and Ibuprofen may be taken if required, some patients notice double vision or blurred vision and others report discomfort with bright lights and opt to use sunglass glasses on the morning after your operation.
You should remove the Eye Shield if you have been given one and wash the eyelids gently with clean tissues and cool previously boiled water to remove any stickiness from the eyelashes. The eye drops should be put in as prescribed; some may wish to use the Eye Shield at night for the first few days after Surgery and it may then be discarded. You should wipe the eye with clean tissues and avoid the use of a handkerchief.
After Surgery you are advised not to poke or rub the eye. The wound can take a few weeks to fully heal, so rubbing the eye risks opening the wound and possibly letting infection in. You should refrain from heavy lifting or gardening for 2 weeks after the operation and avoid eye makeup for 2 weeks, also swimming or getting your hair dyed or perm should be avoided for 6 weeks. You may shower or bathe as normal but avoid getting soap or shampoo in the eye. Light housework or shopping are permissible, as are reading or television watching you may wear your old glasses but often you will find that these are no longer suitable, and you will need to wait until you have been seen back in clinic before you can go to an optician.
To see about new glasses after the operation please contact us if your eye becomes painful despite the use of painkillers, especially if the vision is reducing or the eye is sticky. You will be given contact details for the Eye Department along with your eye drops after Surgery.
What to expect on the day of your surgery:
- Increased watering of the eye (blood staining is normal).
- Your eye may ache, take simple over the counter painkillers if needed.
- Your eye may feel gritty/prickly, this may last for a few days.
- Double / blurred vision.
- Sensitivity to light (photophobia).
The morning after your operation:
- Gently remove your eye shield (if one was used).
- Wash your hands.
- With fresh clean tissues or cotton wool, clean your eye with cool boiled water. Wipe from the nose outwards. If required, you may gently pull down your eyelid to do this.
- Instil your eye drops as prescribed.
You are advised:
- Do not rub, poke or apply pressure to the operated eye. (The wound is self-healing, pressure may cause wound to open and be prone to infection).
- Avoid strenuous exercise, gardening, heavy lifting for 2 weeks.
- Do not wear eye make up for 2 weeks.
- Do not perm/ colour your hair for 2 weeks.
- Do not go swimming for 2 weeks (wear goggles to swim for 1st month).
- Do not return to work for 2 weeks if your job involves heavy lifting, or you work in an unclean environment.
- Do not use handkerchiefs to wipe your eye. Use a clean tissue each time.
- Do not drive after surgery until you can comfortably read a car number plate 20 metres away in good daylight. At this point it is likely to be legal to drive so long as you have no other eye problems such as double vision. Just because it is legal does not mean it is safe and we advise extreme caution in returning to driving. If there is any doubt, wait until you have been reviewed by an eye health professional either at the hospital or in the community.
You can:
- Wash your hair, but with head backwards.
- Shower/bathe as normal, avoid getting soap/shampoo in the eye.
- Do light housework and shopping.
- Read, watch TV.
Contact us if:
- Your vision deteriorates.
- If you experience severe pain, not relieved by painkillers.
- If you develop a sticky green/yellow discharge from the eye.
- If you experience new floaters.
- If you injure your eye.