Cataracts: when to have surgery, and what to expect after

What it is

The lens inside the eye, clear at birth, slowly yellows and clouds. Light scatters through it: glare from headlights, colours dulling, reading needing more light, glasses that never seem right for long. It’s not a film over the eye and it can’t be seen by looking; it shows on the eye test in seconds.

When

There’s no threshold. The hospital operates when the cataract is affecting your life — driving, reading, work, confidence on stairs — and when the benefit outweighs the small risk. So the honest answer is: when it bothers you. If night driving has become frightening, that counts. If the glasses need changing every year, that counts. Say so to us and we’ll say so in the referral; “not ready yet” often means nobody told the hospital how much it was affecting you.

The operation

About twenty minutes, under local anaesthetic, as a day case. The cloudy lens is removed and a clear artificial one put in. Most people see well the next day. One eye at a time, a few weeks apart. Free on the NHS; also available privately if the wait is long.

After

Colours come back — people are startled by how blue the sky is. Your glasses prescription changes completely; we retest about four to six weeks after each eye and dispense new lenses. Depending on the lens the surgeon chooses, you may need glasses only for reading afterwards. A small proportion get a “second cataract” — a haze behind the new lens — months or years later, cleared in minutes with a laser.

Meanwhile

Anti-reflection lenses for the glare, sunglasses outdoors, and an honest test against the driving standard so you know where you stand.

The short version

• The lens clouding; nearly universal with age
• Surgery when it affects your life, not at a number
• Twenty minutes, local anaesthetic, free on the NHS
• New glasses six weeks after each eye

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