Cataracts & Macular Degeneration Q&A: Ms Pratibha Veeramani

Cataracts

Q1. Understanding cataracts 

A. Cataracts are very common. If you're attending your optician for routine sight checks, these will probably get picked up at one of these routine checks. Symptoms that people often notice are gradual blurring and daily tasks becoming more difficult, like reading, looking at number plates in the distance, or recognising faces. It's not worrying to get a cataract, most people will get one at some point. It involves a natural clouding of the lens. If you think of the eye a bit like a traditional camera with a lens in the middle and a film at the back, the eye is much the same, and with time, the clear lens becomes gradually thicker and cloudier, allowing less light through to where the picture forms at the retina at the back. So, if you start noticing that things are not quite as clear as they were used to, it could be time to consider getting a check for cataracts and talking about the options we have available here. 

Q2. When should I have cataract surgery? 

A. The time to have a cataract operation is really when the symptoms are affecting your day-to-day life. So if you're finding things difficult that didn't used to be it's probably a good time to consider the surgery.  

The assessment is very thorough. We take lots of images of the size of your eyes, the measurements of lenses you would need, and more importantly, talking through your lifestyle and what your needs will be before and after the operation. 

Q3. Lens options for cataract surgery 

A. There are many lens options available. And during your assessment we will talk through which is the right option for you. Broadly speaking, there are lenses which correct your distance vision, and that's a very good option if you're happy to still wear glasses for closeup work like reading.  

There are also newer technologies available to enable an extended depth of focus, so less dependence on glasses, but really this depends on your daily requirements, and that's what we'll talk about in the assessment. 

Q4.  What to expect from cataract surgery 

A. On the day of the surgery itself you'll spend a couple of hours in the hospital, the pre-assessment will involve some checks and anaesthetic drops. The operation itself lasts about 20 minutes on average, and we take plenty of precautions to ensure this is comfortable for you. Most commonly people have the operation awake with plenty of numbing drops to the eye, if you need more than that, we can offer options such as sedation or very occasionally putting to sleep with a general anaesthetic.  

After the operation, you'll spend a short period of time in recovery on the ward, and then we'll give you some drops to go home with. It's always helpful to have a friend or family member with you to go home with. Things should be comfortable on the day. You'll have drops to use for about a month after the operation. You'll have a check, typically two weeks afterwards to ensure everything's in place and talk about whether you need a further glasses prescription. 

Macular Degeneration

Q5. What is age-related macular degeneration? 

A. Age related macular degeneration is the commonest cause of sight loss in the UK, typically affecting people over the age of 50. There are two sorts of macular degeneration, dry and wet macular degeneration. The dry form is more common and less severe and typically causes a gradual onset of loss of central vision. Wet macular degeneration is less common, but more severe and can progress more quickly, causing very rapid deterioration of the central vision. 

Q6. Treatment options for dry and wet macular degeneration 

A. The treatments for macular degeneration have progressed hugely in the last 20 to 30 years, and we're now fortunate to have many treatment options available.  

For dry macular degeneration, there has been a lot of research over recent years to show that there are precautions that can be taken to reduce the rate of progression, these involve antioxidant vitamins, which are available in diet as well as supplements, and lifestyle measures such as stopping smoking can really reduce the rate of progression. These are all things we'll discuss in assessment.  

Wet macular degeneration is less common, more severe, and the central vision can very rapidly deteriorate. Often this is picked up at an optician or if you notice the symptoms yourself, we can see you straight away. There are a range of injection treatments currently available, which typically are done over a period of time to reduce the leakage of fluid at the back of the eye.