Cataract: Symptoms, Surgery and Recovery

Reading the newspaper has become harder. Headlights at night have a glare around them. Colours look a little dull and yellow, and you have changed your glasses three times in two years. Many older people, and many people with diabetes, accept this as just part of getting older. It is very often a cataract, which is the commonest cause of curable blindness in the world. The good news is that a short, safe operation can give you back clear vision.

What is a cataract?

The lens inside your eye is normally clear, like a window, and focuses light on the back of the eye. In a cataract the lens gradually becomes cloudy, so vision looks as if you were seeing through a dirty or misty window. It usually develops slowly, in both eyes but not always at the same speed. It is painless.

Cataract symptoms

• Blurred, hazy or cloudy vision
• Glare and halos around lights, particularly when driving at night
• Colours that look faded or yellowish
• Trouble reading small print, even with glasses
• Needing brighter light to see
• Double vision in one eye
• Frequent changes in the glasses prescription
• In some people, a temporary improvement in near vision, called “second sight”

Causes and risk factors

• Ageing, by far the commonest cause. Most people over 60 have some degree of cataract.
• Diabetes, which brings cataracts on earlier
• Long-term use of steroids as tablets, eye drops or creams, see our guide on glaucoma
• Smoking and heavy alcohol use
• Too much exposure to sunlight (ultraviolet rays) without eye protection
• Eye injury or past eye surgery, and long-standing eye inflammation
• Family history, and in babies, conditions present from birth

Do eye drops or supplements dissolve a cataract?

No. Despite advertisements for eye drops, herbal products and “natural cures”, nothing taken by mouth or put in the eye dissolves a cataract. Strong glasses and brighter lighting may help for a time, but surgery is the only effective treatment. Please do not waste money or delay while the vision gets worse, and avoid unproven drops, especially steroid-containing ones.

When is surgery needed?

There is no need to wait until a cataract is “ripe”. That is an old belief. Modern surgery works well at any stage. You and your eye doctor should consider surgery when the cataract interferes with your daily life, such as reading, driving, cooking, working or recognising faces, or increases the risk of falls. A cataract that is causing other eye problems may need earlier surgery.

The operation

Cataract surgery is one of the safest and most successful operations in medicine.

• In phacoemulsification, the commonest technique, a tiny cut is made, the cloudy lens is broken up with ultrasound and removed, and a clear artificial lens (intraocular lens, or IOL) is placed in the eye.
• It is usually done as a day case under local anaesthetic drops or an injection, and takes about 15 to 20 minutes per eye.
• Most people go home the same day, and see better within days. More than 9 in 10 people have good results.
• Different lens types are available, including lenses that also correct short or long sight and astigmatism. Your surgeon will help you choose.
• Choose a reputable eye hospital or an experienced eye surgeon with sterile theatres. Free eye camps can be good, but make sure that they are run by qualified surgeons with proper follow-up.

Before surgery

• Keep your blood sugar and blood pressure under control. See high blood pressure.
• Tell the surgeon about all your medicines, including blood thinners and any prostate medicines such as tamsulosin, which can affect surgery.
• Follow the instructions about eating and drinking on the day.

Recovery and eye drops after surgery

• You will be given antibiotic and anti-inflammatory eye drops to use for several weeks. Use them exactly as prescribed.
• Wear the eye shield at night as advised, and wear sunglasses outdoors.
• Do not rub or press the eye. Avoid getting water, soap, dust or smoke in the eye for the first week or two, and avoid swimming.
• Avoid heavy lifting, hard exercise and bending over for the period your surgeon recommends.
• Attend all follow-up visits, and have your glasses checked after a few weeks.
• Mild irritation, a gritty feeling and watering are common. Dry eye is common after surgery too, and lubricating drops help. See dry eyes.

Contact your eye doctor straight away if you have increasing pain, redness, sudden drop in vision, flashes of light, new floaters or a curtain over your sight. These can mean infection or other complications that need urgent treatment.

After surgery: clouding of the capsule

Months or years later, some people notice their vision becomes cloudy again, because the thin membrane behind the new lens thickens. This is not a new cataract. A quick, painless laser treatment in the clinic clears it.

How to lower your risk

• Wear sunglasses with UV protection outdoors
• Do not smoke, and limit alcohol
• Keep diabetes and blood pressure well controlled
• Avoid steroid eye drops and tablets unless an eye doctor prescribes them
• Eat plenty of vegetables and fruit
• Have your eyes checked every one to two years after the age of 40, and each year if you have diabetes

When to see an eye doctor

• Blurred, cloudy or glary vision that glasses no longer fix
• Difficulty driving at night or reading
• Sudden loss of vision, eye pain or redness, which needs urgent care
• You have diabetes and have not had an eye check in the past year

Key takeaways

• Cataract is a clouding of the eye’s lens that causes blurred, glary, dull vision without pain.
• No drops or supplements dissolve a cataract. Surgery is the only cure, and it is safe and quick.
• You do not need to wait for it to become ripe. Operate when it affects daily life.
• Use the post-operation drops exactly as prescribed and report pain or sudden vision loss at once.

Related medicines on Medimart

These are commonly prescribed by eye surgeons after cataract surgery, only as directed:

• Moxifloxacin: an antibiotic eye drop to prevent infection
• Tobramycin and dexamethasone: an antibiotic and steroid eye drop
• Nepafenac: an anti-inflammatory eye drop
• Carboxymethylcellulose eye drops: lubricating drops for dryness and irritation

Prescription medicines are supplied only against a valid prescription. Please take them only as advised by your doctor.

Browse eye infection medicines and dry eye care on Medimart with delivery across Pakistan. Prescription medicines are supplied only against a valid prescription.

This guide is for general information and does not replace advice from an eye doctor. Please have blurred vision examined.