Cataract Surgery

About
Symptoms
Surgery

What is a cataract?

Inside your eye sits a natural lens, located just behind the iris - the coloured part of your eye. In a healthy eye, this lens is clear, and it works much like the lens in a camera: focusing light so that what you see is clear.

A cataract is a change in consistency of the lens, it commonly becomes cloudy. Over time, the lens loses its clarity, and light can no longer pass through it cleanly. The result is vision that may appear blurry, hazy, or duller than it used to be, with an increased sensitivity to bright light. Cataracts are a common and occur as a natural part of aging, and most Australians will have some degree of cataract by the time they reach 60.

Do I need cataract surgery?

Surgery is generally recommended when a cataract begins to interfere with your daily activities - things like driving, reading, using a computer, or pursuing hobbies. Your ophthalmologist will discuss your visual needs and the impact the cataract is having before making a recommendation.

Cataracts cannot be reversed with drops, supplements, or any non-surgical treatment. Surgery is the only way to remove them.

Cataracts: Symptoms and Causes

Cataract Symptoms

Cataracts often develop slowly and may not affect your vision noticeably in the early stages. You might first notice that your distance vision has changed, street signs at a distance are blurry or you need more light to read.

As a cataract progresses, you may experience:

  • Blurred or hazy vision
  • Sensitivity to bright light
  • Seeing halos around lights, particularly when driving at night
  • Colours appearing faded or with a yellowish tint
  • Frequent changes to your glasses prescription
  • Glasses that are no longer correcting your vision effectively
  • Double vision in one eye

Causes of Cataracts

Age is the most common cause. As the lens ages, it gradually changes in consistency and becomes less clear.

Other factors that can contribute to cataract development include:

  • Previous eye trauma or surgery
  • Previous eye inflammation
  • Prolonged use of steroid medications
  • Diabetes
  • A family history of cataracts
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Healthy versus cataract-affected vision.

Cataracts Diagnosis

If you suspect you have a cataract, the first step is to speak with an optometrist or ophthalmologist. Your specialist will examine your eyes using a slit lamp microscope, which allows them to look closely at every structure of the eye. This is done to ensure that it is “just the cataract” causing the blurred vision.

If a cataract is identified and it is not yet affecting your daily activities, your specialist may recommend monitoring it with regular check-ups rather than proceeding straight to surgery.

Cataracts do not resolve on their own, they need to be surgically removed. The timing as to when this needs to be done is based on how much it is affecting your daily activities.

Cataract surgery at Coastal Eye Surgeons

All three of our ophthalmologists - Dr Louise Robinson, Dr Khoi Tran, and Dr Liam Turner - perform cataract surgery. Surgery takes place at a day surgery based in Southport.

Your surgeon's rooms will confirm the location when your surgery is scheduled. For facility addresses and directions, see our Getting Here page.

Before Your Surgery

Pre operative Cataract Assessment

Before your procedure, you will attend a pre-operative assessment with your surgeon. During this appointment, your eyes maybe dilated and scans will be performed to assess the health of your macula and optic nerve.

An ultrasound measurement of the eye is taken to calculate the power of the lens that is specific to your eye.

Your surgeon will also talk with you about your visual needs - for example, whether you drive, work at a computer, or have hobbies that require fine detail or distance vision. These conversations are important in guiding the choice of intraocular lens.

Age-related macular degeneration
Age-related macular degeneration
Healthy macular

Intraocular lens options

When a cataract is removed, the clouded lens is replaced with a clear artificial lens called an intraocular lens (IOL).

Several types of IOL are available, and the right choice depends on your eye, your lifestyle, and your visual goals. This is a clinical decision your surgeon will work through with you directly - it is not a matter of simply selecting from a list.

The IOL types available at Coastal Eye Surgeons include:

  • Monofocal - corrects vision at a single focal point, either for distance or near vision. Glasses are likely to be needed for the other focal points.
  • Multifocal - designed with multiple focal points (near to far) to reduce dependence on glasses for both distance and near tasks.
  • Extended Depth of Focus (EDOF) - provides clear distance vision and useful vision at intermediate distances (such as a computer screen or car dashboard). Reading glasses may still be needed for prolonged close work or in dim lighting.
  • Toric - corrects corneal astigmatism in addition to cataract, reducing the need for glasses in patients who have astigmatism. All of the above lenses are available in “toric”.

Your surgeon will discuss which lens is appropriate for your individual situation at your pre-operative appointment.

IOL-Vertical

What happens on the day of surgery

Cataract surgery is performed as a day procedure, meaning you will go home the same day. You will need someone to drive you home and should arrange this in advance.

Before leaving home on the day of your surgery, you may be instructed to use a pre-operative eye drop as directed by your surgeon. You will be asked to fast for six hours beforehand - clear fluids are permitted up to two hours prior. Take your regular medications as usual unless your surgeon has advised otherwise.

At the surgical facility, nursing staff will begin eye drops to dilate your pupil. The anaesthetist will review your medical history and discuss your sedation - typically a relaxation medication similar to twilight sedation, combined with a local anaesthetic around the eye. You generally sleep through the procedure although some people are aware of light and some movement during the surgery, it is not a painful or scary sensation. It is important to stay as still as possible.

Your surgeon removes the clouded lens using phacoemulsification - an ultrasound technique that breaks up the cataract through a small incision of approximately 2mm. The new intraocular lens is then placed through the same incision. At the end of the procedure, a protective shield is placed over your eye. You will rest in the recovery area before being discharged with post-operative drops and written instructions.

If you have difficulty lying flat and still for approximately 30 minutes, please let your surgeon and anaesthetist know in advance.

Recovery after cataract surgery

You will leave the surgical facility with a protective shield over your eye. Start your post operative drops as instructed by your surgeon - your post-operative drop schedule and care instructions will be provided at discharge.

Some blurred vision, mild discomfort, and sensitivity to light are common in the first few days as the eye heals and adjusts to the new lens. Avoid rubbing or pressing on your eye during this time. Avoid getting soap or water directly in the eye, and wear your protective shield at bedtime for the first week.

Most people are able to return to light activities within a few days. The timing for driving and exercise should be discussed with your surgeon individually, as it will depend on how your eye is healing and your specific circumstances.

Your existing glasses will not work correctly for the operated eye after surgery. At your Day 1 follow-up, the practice can remove the lens from your frames if needed.

The post-operative follow-up schedule is generally:

  • Day 1 after surgery
  • One week after your first eye
  • Six weeks after your second eye (or six weeks after surgery if only one eye is being operated)

Can cataracts come back?

No. Once a cataract is removed and the new lens is in place, the cataract itself cannot return.

However, in around 80% of patients, within the first two years, a thin layer of scar tissue can develop behind the new lens - a condition called posterior capsule opacification. This can produce symptoms similar to the original cataract. If this occurs, it is treated in the clinic with a brief laser procedure called a YAG capsulotomy, which cleans the lens and removes the scar tissue. This does not require a return to the operating theatre. Once this scar tissues is removed it rarely returns.

Risks of cataract surgery

Cataract surgery is the most commonly performed eye surgery in Australia and has a high success rate. However, as with any surgical procedure, risks exist and should be understood before you proceed. Your surgeon will discuss these with you at your pre-operative appointment.

Risks include infection (affecting approximately 1 in 3,000 cases), the need for a further operation (approximately 1 in 200 cases), prolonged post-operative inflammation, retinal detachment, and, in rare cases, changes to vision. Most complications are manageable, though some may require additional treatment or a longer recovery period.

If you have other pre-existing eye conditions, your surgeon will take these into account when discussing what you can expect from surgery.

Additional Information

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