Nuffield Health Bournemouth Hospital, Lansdowne Road, Bournemouth, UK
For inquiries about cataract surgery, macular degeneration, or retinal disorders, please call 01202 702841.
About cataract surgery
What is a Cataract?
A cataract is a clouding of the natural lens inside the eye. The lens normally helps focus light onto the retina to produce a clear image. When it becomes cloudy, vision becomes blurred or hazy.
Cataracts are very common and usually develop gradually with age, most often affecting people over 60 years. They typically affect both eyes, although one eye may be worse than the other.
Symptoms of Cataracts
Cataracts can cause a range of visual symptoms, including:
- Blurred or misty vision
- Increased glare from bright lights or sunlight
- Difficulty driving at night
- Colours appearing faded or yellowed
- Needing more light for reading
- Frequent changes to glasses prescription
Cataracts are not painful and do not damage the eye permanently.
What Causes Cataracts?
Most cataracts are age-related, but other factors can increase the risk, including:
- Diabetes
- Long-term steroid use
- Previous eye injury or surgery
- Strong sunlight exposure over many years
- Smoking
- Family history
How Are Cataracts Diagnosed?
Cataracts are diagnosed by an optometrist or ophthalmologist during a routine eye examination. Tests include:
- Vision testing
- Examination of the lens using a microscope (slit lamp)
Do Cataracts Always Need Treatment?
In the early stages, cataracts may be managed by:
- Updating glasses
- Improving lighting
- Reducing glare
Cataract surgery is usually recommended when vision is affecting daily activities, such as reading, driving, or recognising faces. There is no benefit in waiting for a cataract to become “ripe”.
What is Cataract Surgery?
Cataract surgery is a common and highly successful operation. It involves removing the cloudy natural lens and replacing it with a clear artificial lens, known as an intraocular lens (IOL).
In the UK, cataract surgery is usually carried out as a day-case procedure under local anaesthetic.
What Happens During Surgery?
The eye is numbed with drops (you remain awake)
A small incision is made in the eye
The cloudy lens is broken up and removed
A clear artificial lens is inserted
Stitches are rarely needed
The procedure usually takes 20–30 minutes.
Intraocular Lens (IOL) Choices
Most patients receive a standard monofocal lens, which provides clear vision for either distance or near (usually distance), with glasses still needed for some tasks.
Other lens options may be available in certain cases, but these are not routinely provided by the NHS. Please see the section below for further information on intraocular lens (IOL) choces. Your surgeon will discuss what is appropriate for you.
Benefits of Cataract Surgery
Most people experience:
- Clearer, brighter vision
- Improved colour perception
- Reduced glare
- Improved quality of life
Vision often improves within days, although full recovery may take a few weeks.
Risks and Complications
Cataract surgery is very safe, but all surgery carries some risk. Possible complications include:
- Infection or inflammation
- Swelling of the retina (macular oedema)
- Raised eye pressure
- Retinal detachment (rare)
Serious complications are uncommon, and the vast majority of patients have a good outcome. There is a 1:1000 risk fo a serious complication, which can cause permanent loss of vision in the eye. Fortunately this is very rare.
After surgery:
- You will use eye drops for several weeks
- Vision may be blurry initially
- Mild discomfort or grittiness is common
- Avoid rubbing the eye and heavy lifting for a short time
- You will be given clear instructions before going home.
When to Seek Urgent Advice After Surgery
Contact your eye unit urgently if you experience:
- Increasing pain
- Sudden drop in vision
- Increasing redness
- Sensitivity to light
These symptoms may indicate infection or inflammation and need prompt treatment.
Posterior Capsule Opacification (“After Cataract”)
Months or years after surgery, some people develop clouding behind the artificial lens. This is common and is not a cataract returning.
It is treated quickly and painlessly with a YAG laser procedure, usually as an outpatient.
Driving and Cataracts
You must meet DVLA vision standards to drive. You should not drive immediately after surgery and should wait until your vision is clear and safe. Your eye care professional will advise you.
Most people regain good functional vision after surgery and return to normal activities.
Intraocular Lens (IOL) Choices
Intraocular Lens (IOL) Choices for Cataract Surgery
When you have cataract surgery, the cloudy natural lens in your eye is removed and replaced with a clear artificial lens, called an intraocular lens (IOL).
Different types of IOLs are available, and each has advantages and limitations. This leaflet explains the main lens options to help you understand what may be suitable for you.
Standard Monofocal Lenses
What is a Standard Monofocal Lens?
A standard monofocal lens provides clear focus at one distance only. It is the most commonly used lens in cataract surgery.
Usually, the lens is set to give clear distance vision, meaning glasses are needed for reading and close work. Less commonly, it can be set for near vision, with glasses needed for distance.
Advantages
- Reliable, high-quality vision at the chosen distance
- Excellent contrast and clarity
- Lowest risk of unwanted visual effects (such as glare or halos)
- Widely used and well established
- Routinely provided by the NHS and the most common lens used in the private sector
Limitations
- Glasses are usually required for either near or distance vision
- Does not correct astigmatism unless combined with a toric design
Who is it Suitable For?
- Most patients having cataract surgery
- People happy to wear glasses for some activities
- Those who prioritise clarity and visual quality
Toric Lenses
What is a Toric Lens?
A toric lens is a type of monofocal lens designed to correct astigmatism, a common condition where the eye’s shape causes blurred or distorted vision.
Toric lenses are carefully aligned during surgery to reduce or eliminate astigmatism.
Advantages
- Clearer vision for people with moderate or significant astigmatism
- Reduced dependence on glasses for distance vision
- Similar quality and clarity to standard monofocal lenses
Limitations
- Usually still requires reading glasses
- Must remain correctly positioned in the eye
- May not be suitable for all types of astigmatism
- Often not routinely funded by the NHS (availability varies by area)
Who is it Suitable For?
- Patients with significant corneal astigmatism
- Those wanting the best possible unaided distance vision
- People who would otherwise still need strong glasses after surgery
Multifocal Lenses
What is a Multifocal Lens?
A multifocal lens is designed to provide vision at more than one distance, usually distance and near (and sometimes intermediate). It aims to reduce dependence on glasses for most activities.
Advantages
- Reduced need for glasses for distance and near tasks
- Greater independence from spectacles
- Convenient for reading, computer use, and daily activities
Limitations
- Increased risk of glare, halos, or starbursts, especially at night
- Reduced contrast sensitivity compared with monofocal lenses
- Not suitable for everyone
- Adaptation period may be needed
- Not routinely provided by the NHS
Who is it Suitable For?
- Highly motivated patients wishing to minimise glasses use
- People without other eye conditions affecting vision
- Those who understand and accept the potential visual trade-offs
Important Considerations
Other Eye Conditions
Multifocal lenses are usually not recommended if you have:
- Macular degeneration
- Diabetic eye disease
- Retinal vein occlusion
- Advanced glaucoma
These conditions can reduce the benefits of multifocal lenses.
Driving
Some people with multifocal lenses notice glare or halos when driving at night. This is an important consideration if you drive frequently in low light.
NHS and Private Treatment
Standard monofocal lenses are routinely provided by the NHS
Toric and multifocal lenses may involve additional cost and are often offered as part of private or self-funded care
Your surgeon will explain what is available locally and any costs involved
Making the Right Choice
Choosing an intraocular lens is an individual decision based on:
- Your eye measurements
- The health of your eyes
- Your lifestyle and visual needs
- Your willingness to wear glasses
- Your tolerance for visual side effects
