A cataract is when the naturally clear lens inside the eye becomes cloudy. It is made up of protein much like the white of an egg. If you break open an egg into a frying pan, you see the yellow yolk in the middle and this is surrounded by a clear substance (this is just like the clear normal lens). As the egg starts frying, so the clear part becomes cloudy or opaque, changing from clear to eventually being brown and then black. This is exactly what happens when a cataract forms: the proteins in the lens coagulate and the lens becomes cloudy. Cataract extraction involves removing this cloudy lens and replacing it with a clear artificial lens called an "IOL" resulting in improved vision.

Symptoms

You can be aware of reduced or blurred vision in all situations if the cataract is dense. If the cataract is still relatively early, then you may find that vision in certain conditions is still satisfactory but in other situations (driving at light with oncoming headlights shining towards you for example) it is not good enough. Some people with cataracts feel as if their glasses lenses are dirty and despite cleaning their glasses, see no improvement in their vision.

When should I have my cataract removed?

You should have your cataract removed when you feel that the quality of vision that you now have is impacting on your quality of life. If you feel that you are still seeing quite well, then you can delay surgery and have the vision checked again every 6 months or so. If you wish to drive, then your vision needs to be 6/12 or better and this would be taken into account when you are having your cataract assessment. The important rule of thumb remains: If the cataracts are causing sufficient blurring so as to reduce the quality of vision to the point where it is impacting on your quality of life, then it’s time to do something about it. The old adage of "the cataract needs to be ripe" does not apply to modern cataract surgery.

How is the cataract removed?

The cataract is removed through a very tiny incision (smaller than 2.8mm) in the cornea (clear part of the eye). It is performed under topical (drops only) or sub-Tenons anesthesia (no needles) most commonly. Some people prefer having the surgery under general anesthesia where they are fast asleep and that can be arranged very easily. Once the cataract is removed using ultrasound or phaco-emulsification to give it its proper name, the cataract is replaced with an intraocular lens implant or IOL.

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