Cataracts affect many people. In fact, more than half the population of over 65’s develop this sight changing condition which is generally associated with age.
What are Cataracts?
The transparent lens across the front of the eye allows light to pass through to the back giving clear vision. People with cataracts develop cloudy patches across the lens caused by a build-up of protein. These make it harder for light to pass through. Gradually the patches increase in size making vision blurry and cloudy.
Cataracts can affect just one eye or both, so regular eye tests every two years (even for people without prescription glasses or lenses) can detect the condition at the start and a suitable treatment can then be discussed.
Types of Cataracts
There are four main types of cataracts:
- Nuclear – these start at the centre of the lens and initially the person could become nearsighted. Over time, the lens gradually yellows and eventually could turn brown, making recognition of colour difficult.
- Cortical – affecting the outer edge of the lens, this cataract starts as whitish streaks. Gradually causing issues like glare, the streaks extend to the centre of the lens allowing less light to pass through.
- Posterior Subcapsular – forming near the back of the lens, this cataract starts as an opaque area and can cause issues with reading, reduced vision and halos.
- Congenital – possibly caused by an infection during pregnancy, some people are born with, or develop, cataracts at an early age. These are normally removed if they cause a problem with sight.
Symptoms and Causes
Along with cloudy or blurry vision other symptoms include:
- Small dots or spots in line of vision
- Sight affected if light is dim, in artificial light or if very sunny
- Yellowish tinge around vision
- Double vision
- Colours can appear faded
- Feeling uncomfortable with glare when looking at bright lights
- A halo effect around street and car lights
- Daily activities like watching TV or reading can be impaired
Although cataracts develop as people get older other causes to be aware of are:
- If there is a history of cataracts in the family
- Poor diet
- Overexposure to sunlight
- Taking steroids for a long period of time
Less common causes can be due to diabetes, an injury to the eye or other eye conditions like uveitis.
After an eye test and consultation, the ophthalmologist will recommend an initial treatment. This could be as simple as prescription glasses if the person is in the early stages of cataracts. However, if the cataracts are affecting daily life, e.g. driving, going out, reading, work or watching TV, further options will be discussed including surgery.
What Does Surgery Involve?
Using local anaesthetic drops administered to the eye, the surgery can then proceed. The lens of the eye, along with the cataract, is removed using ultrasound or laser. The natural lens is then replaced by an intraocular lens or IOL, an artificial clear, plastic lens.
The replacement lens is prescriptive so can alleviate the requirement for glasses following surgery. Monofocal, multifocal, accommodating and trifocal lenses are available when undergoing private treatment.
Can Cataracts be Treated on the NHS?
Surgery for cataracts can be performed through the NHS but not all lenses are available. Depending on the patient’s prescription, private eye surgery may be the only way to remove the cataracts and acquire the lens required to improve sight. Furthermore, with technological advances within eye surgery, there are now many private specialists available with expert knowledge and modern equipment to assess and treat the patient according to their individual needs. With laser technology giving patients a more accurate and precise removal and lens exchange, this in turn provides a better chance of a speedy recovery and reduces the risk of any infections.
What are the Costs?
Removal of cataracts on the NHS is free, however glasses may be required after surgery unless the patient’s PCT (Primary Care Trust) is able to fund replacement lens surgery. Multi-focal and accommodating lenses are usually not funded, but patients are advised to contact their local PCT directly to discuss options.
As with all private surgery, there is a cost involved, however many eye clinics do offer 12 month interest free payment schemes (or 24 month interest incurred) to help spread the charges. For cataract surgery with lens exchange, patients can expect to pay from £1,700 per eye. A deposit may be required for the prescriptive lens. For patients requiring Implantable Contact Lenses (ICL) these can cost from £2,495 per eye.
What are the Risks?
All surgery involves an element of risk. After cataract surgery, a patient can expect to feel slight discomfort and pain in the eye, slight bleeding and they may contract an infection.
More serious complications are retinal detachments, severe bleeding and corneal abrasion.
Always find out the facts, risks and cost implications before entering into any surgery regardless of whether it is performed privately or via the NHS.