Facts
The term cataract derives from the view we get when looking through a waterfall.
- A cataract is the clouding or opacity of the lens inside the eye. The lens has the shape of a lentil and lies behind the coloured part of the eye, the iris.
- In a normal eye, this lens is clear. It helps focus light rays on to the back of the eye, the retina, which sends messages to the brain allowing us to see. When a cataract develops, the lens becomes cloudy and prevents the light rays from passing to the retina.
- Cataracts usually form slowly and people experience a gradual blurring of vision.
“I didn’t know that I had a cataract until my doctor told me!”
Some people may not be aware that a cataract is developing. It can start at the edge of the lens and initially may not cause problems with vision. Generally, as cataracts develop, people experience blurring or hazing of vision. Often they become more sensitive to light and glare.
I seemed to have to go to the optician more to get new glasses.
There may be a need to get new prescriptions for glasses more often when a cataract is developing. When cataracts worsen, stronger glasses no longer improve sight. Objects have to be held close to the eye to be seen. The hole in the iris, the pupil, may no longer look black. It may instead look white or yellow.
Questions & Answers
Do cataracts spread from eye to eye?
No. But often they develop in both eyes at the same time.
Has my cataract been caused by overuse of my eyes?
No. Cataracts are not caused by over use of the eyes and using the eyes when the cataracts start will not make them get worse.
Are there different kinds of cataract?
Yes. Cataracts can be caused by injuries to the eye. This type of cataract is called a traumatic cataract.
Can children have cataracts?
Yes. Babies can be born with this condition. This is called congenital cataract.
Is there a link between diabetes and cataracts?
Yes. Cataracts are more common in people who have diabetes.
Are cataracts just a part of getting old?
Most forms of cataract develop in adult life. The normal process of ageing causes the lens to harden and become cloudy. This is called age-related cataract and it is the most common type. It can occur at any time after the age of 40.
When do I have my cataract treated?
When the cataract progresses to the point that it is interfering with daily activities and normal lifestyle, cataract surgery is usually the next step. Cataracts don’t grow back after surgery.
Could anything have been done to stop me developing a cataract?
There is no known prevention for cataract. Advanced modern cataract surgery using a small incision is highly successful for the great majority of patients.
Are cataracts removed by laser?
No. Surgery is the only effective way to remove a cloudy lens. It is removed with highly sophisticated state of the art equipment available at Moorfields Eye Hospital Dubai.
I have a cataract developing in both eyes, are both treated at the same time?
No, the second eye is operated on a few weeks later.
Do I need any special tests before the operation?
Yes. We will carry out precise measurements of the eyes. Here at Moorfields Hospital we use the IOL Master, one of the most accurate instruments available at this time.
What kind of anaesthetic is necessary?
Most operations for cataracts are performed under local anaesthetic, drops alone or anaesthetic around the eye. You will be awake during the operation and aware of a bright light, but you will not be able to see what is happening. Occasionally a sedative agent is given to make you feel more relaxed. General anaesthesia is seldom necessary.
Will I have to stay in hospital?
No. All routine operations for cataracts are performed on a day care basis. This means you are admitted to hospital, have your operation and are discharged in the same day.
What does the operation involve?
Modern small incision cataract surgery at MoorfieldsisperformedwithPhac-oemulsification. This technique uses sound waves to soften the lens, which is then removed through a small tube. The natural Lens is replaced with an Artificial Lens also called IOL.The operation takes between 10-20 minutes.
Are there any complications?
There are some possible complications during the operation such as:
- Tearing of the back part of the lens capsule
This is however rare and should be less than 1/1000 in experienced hands.
- Inflammation of the eye
The eye may become red and ache. This is a condition called uveitis and can be treated effectively with drops.
- Blurring of the central vision
An accumulation of fluid in the back of the eye (retina) may occur, causing blurring of the central vision. This is known as cystoid macular oedema. This usually resolves itself within a few weeks.
Serious complications are uncommon following cataract surgery. However, like any kind of operation, problems can occur.
After the operation problems with infection and inflammation can present a few days later. If you experience any of the following contact us immediately:
- Pain
- Light sensitivity
- Red eye
Aftercare
Questions & Answers
Will my eyes need to be covered following the surgery?
Your eye will be covered with a protective plastic eye shield. Some patients may also have an eye pad.
Will I feel any pain after the operation?
As the anaesthetic wears off, there can be a dull ache felt inside and around the eye. You can take paracetamol or other general painkillers that suit you best.
Can I bend down to pray?
Yes, from the following day but you have to be very careful not to injure your eyes or apply any pressure on them.
When will the doctor see me after the operation?
The doctor will see you the day after the operation.
How do I put the eye drops?
A nurse will teach you how to look after your eyes before you are discharged. You will be shown how to clean your eyes and put in the eye drops correctly. Eye drop treatment prevents infection and helps reduce.
Is there anything else I have to do to care for my eye?
You should avoid rubbing or touching your eye. You may find you are sensitive to light, so it is useful to have a pair of plain dark glasses in case you need them. The majority of patients can resume normal physical activity within a week. You should be able to return to work the day following your operation depending on your job, check with the doctor to confirm.
Will I need glasses?
Generally, you will still need glasses for reading and occasionally for distance. You can also choose to have a MULTIFOCAL or an ACCOMODATIVE lens inserted to improve your unaided near vision.
Usually you will have a check-up for your glasses with our Optometrist after 4 weeks. If you would prefer not to depend on the glasses for near vision ask your surgeon about what is available.
Will the lens implant last forever?
Yes. However, 1 in 10 patients will have a thickening of the membrane behind the new lens. This occurs in the months or years following surgery. This is called capsular opacity, and can be effectively treated with the YAG laser in the hospital.
Facts
- Common condition that causes inflammation of the eye lids and can affect people of all ages.
- It usually affects the rim of the eyelids of both eyes and usually is not serious but still irritating and uncomfortable.
- Eyelids may become crusty and scaly and eyes may feel gritty and very tired with increasing irritation when outdoors in sunshine or around any polluted or smoke filled environment.
- Can be associated with skin conditions such as rosacea and eye conditions like conjunctivitis.
- The symptoms can re-occur at any time but home treatment can calm the symptoms and eyesight is generally not affected.
Treatment
You might be prescribed a combination of treatments described below depending on the type of blepharitis: anterior or posterior.
Cleaning of the lid margin
Dip a clean cotton bud in the solution* and clean away any crusts present on the eyelashes. A mirror may be helpful. Do not clean inside the eyelids as this will make them sore. Repeat the process twice a day.
Wipe along the Lid Margin
*Solution
- Bicarbonate of soda
- Baby shampoo solution
- Normal saline
Use the antibiotic - Hot compresses
Soak a clean gauze in boiled water and hold it on your lids with your eyes closed, for 5 minutes twice a day, being careful that the temperature is not too hot. - Lid massage
Roll your finger/cotton bud towards the margin 10 times each for the top and bottom lid, twice a day. - Antibiotic drops
Apply as directed by pulling the lower lid off the eyeball and letting the drop fall into the pocket without touching the lid. - Antibiotic ointment
Apply as directed, by squeezing 1 cm out of the tube onto your index finger and rubbing it onto the lid margin. It is very important that you follow the instructions in the order shown above.
Top lid, roll downwards
Bottom lid, roll upwards
You must be careful not to touch the eyeball with the cotton bud.
What are the effects of Atropine?
Atropine has two effects when instilled in the eyes:
- Dilates the pupil (makes the black part of the eye larger).
- Stops the eye from focusing properly – blurring the child’s near vision temporarily.
Why has my child been prescribed Atropine?
Atropine has been prescribed to enable an eye care specialist to check the back of your child’s eyes andto determine if glasses are required. Atropine drops / ointment may be used when:
- A child’s eyes have failed to dilate sufficiently with Cyclopentolate drops used in the clinic.
- Your child has very dark coloured eyes; the additional pigmentation makes dilation more difficult.
Atropine can also be used on occasion to help ‘relax’ your child into their new glasses or to treat amblyopia (lazy eye).
Facts
- Astigmatism is a treatable eye condition that can cause blurred vision and headaches.
- It is a refractive condition in which the eye’s optical system is incapable of forming a point image for a point object (images are misconstrued).
- The refractive error of the astigmatic eye stems from a different degree of refraction in different meridians; for example, the image may be clearly focused on the retina in the horizontal plane, but not in the vertical plane, or not on the retina in either plane.
- It occurs when the front surface of the eye is uneven; an irregular shaped cornea or lens prevents light from focusing properly on the retina, the light sensitive surface at the back of the eye. As a result, vision becomes blurred at any distance.
What are the symptoms?
Severe astigmatism:
- Vision blurred or distorted whether the person is reading close up or looking further into the distance.
Mild astigmatism:
- Vision blurred at certain distances
- Tired or dry eyes
- Struggle to focus or read
- Headaches, especially when trying to focus
How is it diagnosed?
Astigmatism should be diagnosed by a qualified Optometrist and/or Ophthalmologist.
A full optometric examination should be done to assess the degree and extent of the problem.
Small children, who may not be able to answer the optometrist’s questions about what they can see, can be assessed using a test called retinoscopy that involves reflected light.
What is the treatment?
In most cases, astigmatism can be corrected by wearing properly fitted spectacles or contact lenses.
Milder astigmatism may not need treatment unless the person has a job that strains their eyes, for example, computer work.
In some cases, astigmatism can be corrected by laser surgery which reshapes the cornea.
Aqueous shunts are devices that are used to reduce the eye pressure in glaucoma by draining the aqueous humour (natural fluid of the eye) from inside the eye to a small blister or bleb behind the eyelid.
Draining the aqueous humour, using a shunt, reduces the pressure on the optic nerve that causes loss of vision in glaucoma. The purpose of lowering the eye pressure is to prevent further loss of vision. Control of the eye pressure with an aqueous shuntwill not restore vision already lost from glaucoma.
Aqueous shunts have various other names such as tube implants, glaucoma tube shunts, glaucoma drainage devices and glaucoma drainage implants. These all refer to the same thing. Although there are many types of shunts available, two main typesare in use at Moorfields Eye Hospital Dubai and they function in a similar fashion.
These are called the Ahmed Glaucoma Valve and The Baerveldt Glaucoma Implant.
What is Amblyopia?
Lazy eye – the medical term is Amblyopia – is a common eye condition amongst younger children. It means that one eye is not developing properly and becomes ‘lazy’ because the brain is working harder with the good eye to compensate. The problem is that if the brain ignores the lazy eye, the cells in the brain that create vision do not develop properly. Generally, Amblyopia affects just one eye but sometimes both eyes can have a problem.
What causes a ‘lazy eye’?
For children, the most important period for the development of vision is from birth to the age of 6 and if there is any interference with development during this period, then this can lead to amblyopia which is commonly caused by a squint (strabismus) in one eye, anisometropia (different vision/prescriptions in each eye), and/ or obstruction of an eye due to cataract, trauma, lid droop, etc.
Why does my child need to wear a patch?
The best and simplest way to treat lazy eye is to cover or patch (known as occluding) the other eye so the vision in the lazy eye can improve and develop the pathways to the brain.
The patch is worn over the good eye and the amount of time the patch must be worn is decided by the Orthoptist/Ophthalmologist and relates to the extent of the visual problem.
With early treatment by patching, vision can develop successfully but this becomes more difficult with older children and the level of vision achieved may not be as good.
My Child’s Treatment
Patient name:
Patient number:
Glasses must be worn
Please patch the eye RIGHT LEFT
For hours a day.
If the child wears glasses, he or she should continue to wear them even with the patch.