Cataracts (1 of 7) What is a cataract? What can be done about a cataract? Lens

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1 i If you need your information in another language or medium (audio, large print, etc) please contact Customer Care on or send an to: salisbury.nhs.uk You are entitled to a copy of any letter we write about you. Please ask if you want one when you come to the hospital. If you are unhappy with the advice you have been given by your GP, consultant, or another healthcare professional, you may ask for a second (or further) opinion. The evidence used in the preparation of this leaflet is available on request. Please patient.information@ salisbury.nhs.uk if you would like a reference list. Cataracts (1 of 7) This leaflet sets out to answer some of the common questions asked by patients. We hope you find it useful. What is a cataract? A cataract occurs when the lens of the eye becomes cloudy. This prevents light entering and being focused into the eye properly and causes dazzle or blurred vision. Cornea Pupil Lens Conjunctiva Retina Optic Nerve The hazy lens (cataract) is in the middle of the eye behind the pupil. What can be done about a cataract? If a cataract is making your eyesight worse and bothering you, your eyesight can be restored by its removal. This operation takes less than half an hour and can be one of the most dramatic and rewarding events in the whole practice of medicine. When the cloudy lens is removed your eye will need help to focus. This is usually achieved by implanting a fixed focus (monofocal) artificial lens made of clear plastic. Author: Elizabeth Baynham Role: Nurse Date written: August 2004 Last revised: August 2017 Next review due: August 2020 Version: 2.5 Code: PI0776

2 Is there any alternative to surgery? No. The only option in treating a cataract is to perform cataract surgery. However some patients may choose not to have surgery, particularly if they can cope with their level of vision. Others may choose to forego surgery if they have other eye conditions and the chance of improving vision by surgery is limited. Delaying cataract surgery until a time when the vision severely affects your lifestyle will not cause any long term ill effects. What are the benefits of cataract surgery? The most obvious benefits are greater clarity of vision and improved colour vision. The lens implant is selected to compensate for any existing focusing problems, such as short or long sight. Pre-existing astigmatism may not be correctable. Most people find that their eyesight improves considerably after surgery. The greatest benefit is noticed in the distance vision. Reading/middle distance glasses will be necessary due to the inability of the new lens to change focus. Alternative technologies, including Multifocal Lens implants, are possible but are not available on the NHS. Please note that if you have another condition such as diabetes, glaucoma or age-related macular degeneration, your quality of vision may still be limited even after successful surgery. You should be aware that there is a small risk of complications, either during or after the operation. What are the possible complications during the operation? tearing of the supporting part of the lens capsule may disturb the vitreous gel inside the eye. This may result in reduced vision loss of all or part of the cataract into the back of the eye requiring a further operation bleeding behind the eye. Cataracts (2 of 7)

3 Possible complications after the operation Cataracts (3 of 7) Complications are rare and can usually be treated effectively. In a small number of cases further surgery may be needed. Very rarely some complications can result in blindness. The most common side effect is called posterior capsular opacification. It may come on gradually after months or years. A few cells grow behind the lens implant and cause the vision to become blurred. This can be cleared without pain using a laser beam to remove any cloudiness Infection in the eye, which can lead to loss of sight or even loss of the eye Detached retina, which can lead to loss of sight but can usually be repaired Clouding of the cornea which is usually temporary but can sometimes be treated with a corneal graft if persistent High pressure inside the eye which can usually be treated with medication Incorrect strength or dislocation of the implant Allergy to the medication used Bruising of the eye or eyelids. What about the anaesthetic? Most cataract operations are now done with simple local anaesthetic eye drops. Very occasionally a local anaesthetic injection is required. How long will I be in hospital? Most cataract operations are done as day cases and will involve being in hospital for 4 or 5 hours, after which you can convalesce at home. Before the operation Most of the measurements are done on your first visit to the eye clinic. If these have not been done you will be asked to attend a pre-admission appointment in the eye clinic. Patients with high blood pressure or

4 diabetes need to have this under control before surgery. If you take warfarin this needs to be in your therapeutic range and will be checked on the day of surgery. If you are not on a stable dose please arrange to have it checked a couple of days before. Eyes or eyelids that are red or sticky will need treatment before you attend for surgery. Any deterioration in your health may affect your operation. If this occurs before your operation you should see your GP and tell the Day Surgery Unit on ext 4550 between 7.30am 7pm. shampoo your hair the day before the operation. On the day of the operation have a light breakfast/lunch and take your regular medication and eye drops (if used) thoroughly wash your face and eyelids. do not apply make up wear comfortable clothing and take as little luggage as possible - it is advisable to leave valuables at home. In case light bothers you, bring sunglasses to wear on your way home if you wish. On arrival at hospital Make sure that a responsible relative or friend accompanies you and that they are available to collect you when you are able to go home by either car or taxi. eye drops will be put into your eye(s) to dilate the pupil local anaesthetic drops will be put into the eye before the operation the operation lasts minutes and mild discomfort may be experienced during the procedure. Will I need to take special care after the operation? Yes! Cataracts (4 of 7) wash your hands before putting in eye drops or cleaning the eye. an eye shield will be given to you. Wear this at night for the first

5 Cataracts (5 of 7) week. Stick it on with tape and wash it with soap and water each morning to remove any crusts on the lids, clean the eyelids with cotton wool soaked in tepid water. when wiping tears from the eye, wipe below the eyelids and not on the eye itself. Never rub! Be sensible about your physical activity. You should avoid excessive bending and avoid heavy lifting for about two weeks. What next? You will be asked to return to an optician or the Eye Clinic 4 weeks after your operation. At this appointment you will be advised when to change your glasses. Can I drive? We advise you not to drive for 2 weeks or until you are confident your vision meets the legal requirement of reading a number plate at twenty metres. Cancellation of appointment If you find that you are unable to keep your appointment, please let us know in good time so that we may offer it to someone else. At home We advise that you have a relative/friend available to assist you for the first night. Unless you are specifically told otherwise, after your operation you will need to use two different eye drops. One is called Chloramphenicol and you should put this in the operated eye(s) 4 times a day for 2 weeks. The other is called Maxidex and you should put this in the operated eye(s) 4 times a day for 4 weeks. you may suffer from some pricking or discomfort in your eye, if so it will help if you take 2 paracetamol tablets at 6 hourly intervals. if at any time your eye becomes painful, sticky or your vision

6 Cataracts (6 of 7) deteriorates, contact your GP immediately or telephone the Eye Clinic, ( ) between 8.30am 5pm on weekdays. After 5pm or weekends, telephone the Emergency Department, on Ext If you have any queries about your treatment that are not covered by this leaflet, then please ask a member of either the nursing or medical staff. The proper application of your eye drops is very important. If you have any questions, please ask your doctor, nurse or pharmacist.

7 Cataracts (7 of 7) How to find Day Surgery Dropoff point Day Surgery