Cataract Care

 

Cataracts are a fact of life for many older Australians. There are many known causes of cataracts, including diabetes, sunlight, medications, injury, smoking, dietary factors, short sight, and the aging process. There are over 70 cataract operations performed in Queensland every day, making cataracts one of the major causes of reversible sight loss.

A cataract is technically any variation on the lens inside your eye being completely clear and completely colour-free. Some cataracts start out as a mild “fogginess” to the lens, some involve “shapes” such as bubbles and icicle-shaped wedges, whereas others begin as a yellow tint, gradually becoming browner and more difficult to see through.

To put a really fine point on it, if eye practitioners look hard enough, they’ll find a “cataract” in most people over 40, even though these opacities may not be clinically significant. We usually start terming referring to opacities as "true" cataracts when they look like they might start causing problems in the not-too-distant future. Broadly, cataracts do worsen over time and for most people, they’ll need to be removed eventually. The timing of this can’t really be predicted with any real degree of accuracy, as some cataracts will take 20 years to become significant enough to warrant removal, whereas others will surprise us by changing significantly within 6 months.

The removal procedure is one of the most commonly performed operations on any part of the body, and the doctors are typically very good at it. If you have a cataract, chances are you have some friends in your age group who have had a cataract removed. Usually these people are not only pleased to be able to see well again, they are ecstatic that they can do so with far less dependence on their glasses than they may have had previously.

How is a cataract removed?
Generally this is done with local anaesthetic only, and many doctors provide a medication to make you completely relax for the procedure. Tiny tubes are used to break up the cataract and remove it from your eye. These days the instruments are so small that most cataract operations don’t require stitches afterwards. Another tiny tube is used to insert a plastic implant lens. This new lens is calculated to allow the patient to see well without glasses afterwards, although some may still need reading glasses. You’ll need some drops for a few weeks afterwards to help your eye recover from the procedure, and most people see very clearly immediately after surgery.

What are the complications?
Many people suffer from some dryness in their eyes after cataract surgery – this can be addressed with eye drops and other forms of dry eye treatment. For some people, the membrane left behind in the eye to support the implant lens can become traumatized and go frosty – this can happen within hours or after more than a year. The effect is similar to having had the cataract in the first place, and is easily addressed with a short laser procedure. There is a very low risk (around 1 in 1000) of infection inside the eye (“endophthalmitis”) a short time after the procedure. This is serious and needs immediate treatment should it occur. For this reason, anything outside the ordinary during recovery should be reported immediately to your doctor or to us.

What do I need to do?
If you have a cataract, regular eye examinations at ICU are recommended. For most patients with significant cataracts, we recommend a cataract examination every 6 months. These are designed to monitor the cataracts’ progression, assess the impact of the cataract on your vision and lifestyle, and to allow you and your optometrist to decide together when it’s time to have it assessed by a surgeon. At these cataract exams, your vision is reassessed, as well as the pressure inside your eye. Some cataracts can cause an increase in your eye’s pressure, called phacomorphic glaucoma. This often has no symptoms but can be a threat to your sight. Photographs of your retina are retaken at these examinations as well. This provides a glimpse from the optometrist’s perspective as to the impact of the foggy lens on your eyesight, as it will similarly impact on how easy it is to see your retina.

To make an appointment, please call us on 3368 3644 or click to make an appointment.