My vision is misty and I’m worried I might be developing a cataract.

As an optician, hardly a day goes by where someone comes into my test room, complaining of blurred vison caused by a cataract developing in their eye(s). Cataracts are common especially if you’re over 65 but they can develop at a younger age too.

Cataracts are formed when the clear lens inside your eye becomes cloudy or misty. This is a gradual process that usually happens as we get older. It is important to note that a cataract is not a sign of ill health and everyone will get one at some stage in life. When we’re young, the lenses in our eyes are usually like clear glass, allowing us to see through them. As we get older, they start to become frosted, like frosted glass, and begin to blur our vision.

What are the symptoms of cataracts?
If you have any of these symptoms its best to arrange an appointment with your optician:

  • your eyesight is blurred or misty,
  • you find lights too bright or you are affected by glare. ie car headlights and streetlights appear dazzling,
  • you find it harder to see in low light or you may experience difficulty moving from shade to sunlit areas,
  • colours look faded or yellowed,
  • if you wear glasses, you may feel your lenses are dirty and need cleaning, even when they don’t.

Cataracts aren’t usually painful and don’t make your eyes red or irritated, but they can be painful if they’re at an advanced stage or if you’ve got another eye condition.

Who is affected by cataracts?
Cataracts mainly develop in those aged 65 or older. Younger people can develop cataracts following an injury to the eye. Some medical conditions such as diabetes, or taking some certain medications such as steroids, may also cause cataracts. Smokers are also more likely to develop cataracts than non-smokers and there may also be a link between UV rays (sunshine) and cataracts. A very small number of babies are born with a cataract.

How are cataracts treated?
Cataracts often simply mean your glasses prescription needs changing. However, if the cataract is still affecting your day-to-day life, and cannot be improved by updating your prescription in your glasses, it may be time to be referred to an ophthalmologist (eye specialist) for surgery. Your optician will request a referral to your nearest ophthalmologist through your GP. The ophthalmologist will confirm the diagnosis, assess the cataract and check your suitability for surgery. If you are a suitable candidate, you will then be placed on the waiting list for cataract removal. Surgery involves removing the cloudy lens (the cataract) and replacing it with a clear plastic one. If you have cataracts in both eyes, surgery will normally be carried out on one eye at a time. The operation usually takes from 15 to 40 minutes and you will be able to go home on the same day. It is carried out under local anaesthetic, so you will be awake, but will not have any sensation in the area around your eye.

What happens after cataract treatment?
Afterwards you will be given eye drops to use for the first few weeks after your operation. Nearly all of your vision will return within two days of surgery and many people are able to return to their usual daily routine 24 hours after the operation. During this time you are advised toavoid heavy lifting and strenuous exercise immediately after the operation, but you can carry on with most other activities around the home as normal. You should not drive until your ophthalmologist or optician advises you it is safe to do so. If you go out on a windy day, you may feel safer wearing sunglasses to prevent grit getting in your eye.

After cataract surgery most people need to wear glasses for either distance, reading or both. If you wore glasses before the operation, you will probably find that they will need changing after the operation, so it’s a good idea to book an eye examination approximately 3 weeks after surgery. You may find that it takes a few weeks to adapt to your vision with new glasses after cataract surgery. This is normal, as your brain adapts to a different prescription.

Will my cataracts come back?
After some months or even years, some people notice that their vision becomes cloudy or misty again in the eye where the cataract has been removed. This is not the cataract returning, but is due to the sac, which contains the replacement lens, clouding up. This cloudiness can be removed by painless laser treatment in a matter of minutes. Should this arise it is best to visit your optician and they can arrange a referral back to the hospital to have this procedure done.

Dr Brendan McCreesh, principal optician
Ph.D BSc MCOptom