Cataract Treatment

AN OPACIFICATION OF THE EYES’ NATURAL LENS
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IN THIS VIDEO I PROVIDE A BRIEF EXPLANATION OF CATARACTS

Everything you need to know about cataracts

FIND OUT MORE ABOUT CATARACTS AND WHAT YOU ARE DEALING WITH

Cataracts are responsible for 51% of world blindness, which represents about 20 million people per year (WHO, 2010).

A cataract is the cloudiness of the natural crystalline lens inside your eye. It can feel as though you are looking through fog or a dirty camera lens.

Initially, your eye prescription starts to change. Later, your vision becomes misty and cloudy. At this stage, you cannot correct your vision with glasses.

When a cataract starts to impair your vision significantly, the only treatment is the surgical removal of the lens affected and the insertion of a new artificial lens.

  • Difficulty seeing in dim lighting or darker conditions like night time driving
  • Colours appear dim and faded
  • Vision becomes progressively worse, and you may find your glasses are no longer useful
  • Bright lights may be dazzling, and halos or rings may appear around them
  • You may feel as if you are looking through a misty window with a yellow or brown tinge

The back of the eye is called the retina; this works like the film in a camera. Both the cornea (the transparent front window of the eye) and natural crystalline lens act like the lens in the camera. When light is focused and hits the retina, an image is taken and sent to the brain.

When you are young, the lens in the eye is elastic and moves very well. This movement is called accommodation and is comparable to the autofocus function in a camera. Accommodation enables you to read the small print as well as see distant objects comfortably. As you age, the lens loses its elasticity and is no longer able to see small print. You will typically notice this at around the age of 40 and above. 

Most people, when faced with this challenge, begin to use reading glasses. The power of reading glasses must increase with increasing age. However, there is a limit. Eventually, when the lens loses its elasticity, it begins to opacify (cloud over) and lose its clarity. This typically occurs when you are around 50. At this stage, you might start to lose some contrast sensitivity and the ability to see vivid colours. A cataract can develop in both eyes and can vary in their developing between the two eyes.

Types of Cataracts include:

Age-related cataract

An age-related cataract is the most common cause of blindness. Cataract formations occur when the natural crystalline lens inside your eye becomes cloudy or misty. It may feel as though you are looking through a dirty camera. Developing a cataract is a part of the natural ageing process along with presbyopia (the loss of close-up vision). An age-related cataract usually occurs in those over the age of around 60, it can happen in one eye or both your eyes and tends to get progressively worse with time.

A traumatic cataract

Traumatic cataract can appear when there is damage that affects the natural crystalline lens. Damage is usually a result of an eye injury. This kind of cataract can impede the vision in the same way. We can remove it with surgery.

Congenital cataract

Congenital cataract has the potential to lead to blindness and irreversible damage to the visual system if not addressed within 6-8 weeks of birth. Cataracts in new-borns are rare and affect 3-4 per 100,000 children in the UK. It accounts for 5% to 20% of blindness in children worldwide.

A developmental cataract

A developmental cataract starts at a young age and can progress to become visually significant enough to require surgery. Any cataract or lens opacity that is present in a child less than 12 years of age could lead to permanent loss of visual potential in the affected eyes unless treated. Sometimes, we use occlusion therapy by patching the unaffected eye to sufficiently stimulate the eye affected by cataract. Surgery ultimately becomes necessary.

A secondary cataract

A secondary cataract develops at any age and is usually the consequence of a disease, irradiation or medications. Glaucoma and diabetes are known conditions that contribute to cataract development. Steroids are one of the medicines that are known to cause a cataract, mainly posterior subcapsular cataracts (a type of cataract where the opacity lies along the back surface of the lens). Diabetes control can slow down the progression of cataract, but we cannot reverse cataract development. At this stage, surgery becomes the only option.

How to prepare for cataract surgery

Before cataract surgery, it is essential to have a thorough consultation.

At the consultation, we will:

  • Perform a comprehensive eye exam to check your overall eye health
  • Identify any risk factors or reasons why you should not undergo surgery
  • Discuss aspects of your occupation, hobbies and lifestyle to ensure your expectations of the treatment are attainable
  • Perform several tests and scans to accurately determine the amount of short-sightedness, long-sightedness and astigmatism you have before surgery.
  • We will also take additional measurements so that we can select the best implant for you.

The first step in cataract surgery is to ‘wash out’ the cataract using a technique called phacoemulsification. This method involves using a tiny device that vibrates at ultrasound speed to break the lens into small particles. I then remove the particles through a tiny slit no larger than 2.40 mm using a little vacuum.

I use the best available microscopes and the most advanced phacoemulsification devices to ensure the best and safest outcomes.

After I remove the cataract, I implant an intraocular lens inside the eye’s capsule bag (that is the capsule or shell left after I removed the cataract). I determine the type and power of the lens implant in advance.

During the pre-operative consultation, I will discuss with you your intraocular lens implant options. Depending on your needs and goals, I might use a monofocal lens implant, a multifocal lens implant or another type of implant.

Can you prevent the incidence of cataracts?

  • Certain nutrients and nutritional supplements may reduce the risk of cataract development. For example, vitamin E is found in almonds, spinach and other green leafy vegetables. Sunflower seeds, carotenoids lutein and zeaxanthin from food and nutritional supplements can also help.
  • Antioxidants like vitamin C and omega-3 fatty acids may also lower the risk or delay cataract formation.
  • UV light is known to accelerate the development of cataract and therefore, wearing protective sunglasses can be useful.

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