What is cataract?

Cataract is the progressive opacification of the natural lens of the eye. It is not actually a disease but a natural aging process, which affects everyone at a certain age. That age is different amongst people, though most persons developing visually significant cataract are usually over 60. A small percentage have cataracts in a younger age (even children might have cataracts), due to inheritance, secondary to other eye diseases or due to certain medications, such as steroids.

The main symptom is gradual deterioration of vision. Initially this can be small and evident only in reading or driving, but progressively it worsens and affects all aspects of everyday life. Generally both eyes are affected, though at a different degree. People with cataracts might also have increased sensitivity to light, might frequently change their spectacle prescription or even start reading without glasses as they age!

The only treatment is cataract surgery. The surgery consists of emulsification of the cataract inside the eye(phaco/ultrasound or laser) and replacement of the lens with an artificial plastic lens. Contrary to the older days of cataract surgery, it is much better for the operation to take place earlier rather than later, because less energy is employed inside the eye. The operation is usually carried out under topical anaesthetic (just drops) through a small incision that does not require sutures. It is such a safe operation, that many people choose the same operation to get rid of their spectacles in cases of short-sightness or long-sightness. After the operation, patients need glasses for reading (usually not for distance), unless they choose a multifocal lens that works inside the eye like multifocal spectacles (see: presbyopia).


For patients with significant astigmatism (>0.75 diopters), this can be corrected during catarct surgery, if a toric (astigmatic) lens is used. Surgery is exactly like conventional cataract surgery with the difference that at the end of surgery the toric lens is positioned in a way, so the axis of the lens to coincide with the axis of the astigmatism. It is possible then to have clear vision without spectacles after surgery.

Toric lens (marks show astigmatic axis)

Dr George Kampougeris will discuss with you the best choice for your individual needs. Remember that modern cataract surgery not only allows immediate visual rehabilitation from the cataract but also spectacle independence!


Simulated vision with an eye with moderate cataract
G. Kampougeris, MD, MRCSEd (Ophth), PhD Consultant Ophthalmic Surgeon, x Consultant, Moorfields Eye Hospital NHS Trust

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