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Cataract Surgery

The development of cataracts is normally related to the natural process of ageing. About half of all people over 65 have started to develop a cataract in one or both of their eyes. People with diabetes are likely to develop cataracts about ten years earlier than those without the condition. Surgical treatment is quick and can greatly improve vision.

A cataract is a clouding of the part of the eye, called the lens, which is normally transparent. When cataracts exist, the cloudiness interferes with the way that light passes through the lens to the back of the eye. People find that their vision is blurred, or they may "see double," their colour vision may change, or it may be difficult to see in bright light. These symptoms often develop very gradually over months or years.

The most common treatment for cataracts is an operation to remove the cloudy lens and replace it with a clear artificial replacement.

So far, no medication or diet has been found to slow down the growth of cataracts, and there is no medication that can clear a clouded lens.

Wearing glasses may improve vision for those in the early stages of cataract development, but – as all cataracts tend to get worse over time – this will provide only a temporary solution.

Left untreated, the lens will eventually become so clouded that it is impossible to see any detail at all, although some light will always be distinguishable.

The operation
Cataracts typically occur in both eyes, but they are usually treated one at a time, to allow the first eye to recover.

The most common cataract operation is known as "phacoemulsification". It involves only a tiny incision on the surface of the eye and the use of an electric current to liquefy the cloudy lens, which can then be removed. An artificial replacement lens is inserted through the same incision.

Phacoemulsification is most often performed as a day case, without the need for an overnight stay in hospital. A more traditional procedure, with a larger incision, is still performed in some hospitals and generally requires a longer stay.

Phacoemulsification usually takes place with a local anaesthetic, which means the patient stays awake during their operation, without feeling any pain. Avoiding a general anaesthetic also results in quicker recovery and lower risks. A sedative may also be given to help people relax during the procedure.

Before the operation, eye drops are given to dilate (open) the pupil. It will not be possible to see out of the eye as it is being treated, although some light will be visible. During the operation the person lies on their back with their head held in a fixed position.

Once the local anaesthetic has taken effect, the surgeon will make an incision at the edge of the iris – the coloured ring of the eye. This incision is usually so small that no stitches are required. The surgeon works with very fine instruments while looking at the eye through a microscope. The procedure usually takes from 15 to 20 minutes

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