Cataract Surgery

Current waiting time: 2 weeks to assessment

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Introduction

Patient
Journey

What to
expect

FAQ

Useful
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Introduction

Just behind the pupil in your eye is the lens. This focuses the light entering the pupil so that it makes a clear image in the retina. The retina changes the image into a nerve impulse so that the brain can see it. Usually, the lens of the eye is crystal clear so that light passes through it easily. If any cloudiness develops in the lens then it starts to block the light passing through. This clouding of the lens is called a cataract.

If you have a cataract getting in the way of your daily activities and affecting your ability to drive or read, you may need cataract surgery.

Typical early signs of cataracts are:

  • blurred vision
  • dazzle from lights (such as oncoming car headlights)
  • increasing short sightedness (myopia)
  • colours become duller.

To remove a cataract, we replace the cloudy natural lens in the eye with a new plastic lens. This new lens is implanted into the space which was occupied by your natural lens.

Before your operation, you will be referred to see our specialist optometrist for an assessment. They will assess your suitability for surgery at N2S, ensuring your cataracts are within the NHS criteria as well as checking your general health and ocular history. Measurements will be taken of your eye to determine the strength of the replacement lens needed. We always aim to correct your distance vision and remove the need for glasses, but this isn’t always possible depending on various factors.

The purpose of this operation is to remove the cataract and improve the clarity of your vision, not correct your prescription. You WILL need reading glasses following the procedure.

The procedure itself is very quick, often taking less than 30 minutes. Local anaesthetic drops are applied to your eye to ensure you don’t feel anything. The surgeon will make a small, self-healing incision at the edge of your cornea, just a few millimetres across. The cataract is then removed through a process called phacoemulsification, which uses an ultrasonic probe to break down the cataract and aspirate it from the eye. It is at this point the new lens is inserted.

Following the procedure you will leave with a post-operative instruction pack and eye drops to use regularly.

Typical Patient Jouney

Step 1: Referral and Assessment

Day 1

Referral agreed during sight test at your opticians, which is sent on to the Cataract Referral Service.

The referral request is triaged by the Central Norfolk Cataract Referral Service (click here for the details of this process).

If appropriate the referral will be sent on to us (N2S). You will receive a letter with a booking reference from the Cataract Referral Service, usually giving you a date to contact us on if you haven’t heard from us in two weeks.

Day 7-14 (approx.)

Your referral is received and registered on our waiting list.

Patients with a mobile number/email address will receive an acknowledgement and an indication of waiting times at this point (wait times are on the homepage and updated when necessary).

Current wait – 2 weeks

A pre-op letter will be sent out with an assessment appointment when you get nearer to the top of the list.

This letter will come with information regarding the procedure and a questionnaire for you to fill out and bring with you to your appointment. Download the information pack.

Due to the number of patients waiting we can only reschedule your appointment once, so please do try and make any necessary arrangements to attend. Only you (the patient) will be allowed to enter the practice, unless agreed prior due to care needs.

Assessment

At your appointment you will see a health care assistant/nurse, who will go through preliminary checks and measure your visual acuity using a Snellen chart, as you will have had done at your opticians.

An OCT scan of the back of your eye will be performed. They will put some drops into your eyes to dilate your pupil, which will allow our optometrist to get a good view of your cataracts and retina.

You will then go through and see the optometrist/ophthalmic nurse, who will check the condition of your cataracts and eye health in general. The purpose of this check is to make sure your cataracts meet the NHS Clinical Commissioning Group (CCG) criteria and confirm that there isn’t anything else potentially affecting your vision.

At this point your eyes will be measured for a new lens, and a surgery date will be set (usually within 16 weeks, depending on surgeon availability). If your cataracts are not ready for extraction, or should they not be the reason for your limited vision, we will write to both your GP and optician to let them know.

You will be given some eye drops to take away, which are to be used on the day of your procedure to start dilating your pupil one hour before you are due to attend. Instructions are provided and can also be downloaded here.

Step 2: Procedure – what to expect on the day

You will receive a letter in the lead up to your surgery (approx. one week beforehand) with the instructions for the day. You can download a copy of the letter here.

On the day of surgery you will be given an arrival time. We are monitoring the amount of patients we have in the practice carefully, so please do not arrive any earlier than 10 minutes before your stated arrival time as you will be turned away.

Your temperature will be checked, and at this point you may be asked to leave should your temperature be above 37.5°C.

You will be escorted upstairs to the waiting area, where a member of the theatre team will check how dilated your pupil is and put in some more drops in preparation for the procedure. They will mark your eye and ensure anything of note (allergies, relevant health issues etc) is made clear for the surgeon. You will have another OCT scan before surgery.

For more general information on what to expect when you visit N2S, please visit our What to Expect on the Day page.

Once your eye is ready you will be brought through to theatre, where the procedure will take place. The procedure usually takes less than 30 minutes, often nearer 15-20 minutes.

If you’re interested in what happens in the theatre during the procedure, more information can be found here.

The operation:

DO NOT READ IF YOU WOULD PREFER NOT TO KNOW ABOUT THE OPERATION

All our patients have their operation carried out under a local anaesthetic. Anaesthetic drops are put into the eye and absorbed, making the eye numb.

You’ll be directed to sit on the chair, which will fold out into a bed (like a dentist’s chair). The skin around your eye is cleaned with antiseptic, and a sterile plastic sheet is placed over you, leaving just the eye area to be operated on. Oxygen is pumped under the sheet, so you’ll have no trouble breathing.

A small incision is made at the edge of the cornea, just a few millimetres across. This incision acts as a valve so that nothing can exude from the eye during or after the operation. The cataract is broken down with an ultrasonic probe and removed from the eye. The lens implant is then inserted in a capsule, which unfolds once in the eye and anchors into place. The operation usually takes less than 30 minutes, often around 15 minutes. No stitches are used, due to the valve-like incision sealing securely following the surgery.

Afterwards a member of the theatre team will collect you and perform a post-operative check to make sure everything seems to be okay. You will be given eye drops and several documents to take away with you: a guide for post-operative care with a diary to keep track of your drops, a certificate of exemption for wearing a face mask for two weeks after surgery (to avoid your breath going into your healing eye – example not provided to avoid abuse), and a form to take to your optician once you’ve healed and are ready for a new prescription which is usually six weeks after surgery. You are then free to go home.

For more information on post-operative care and what to expect after your operation, read our cataract FAQs below.

Step 3: Post-op

You will receive a phone call the day after surgery to check how you’re feeling. You will also receive a phone call the following week (usually eight days later – the date will be provided on the day of surgery). This second call is your formal post-operative review, so it is very important you make the time to take this call. You will either be put forward to have your second eye done, or be discharged back to your opticians.

If you do not answer the call we would expect you to call us back during our opening hours (09:00–12:00 Mon-Fri), and if we do not hear from you within two weeks we will assume everything is okay with your eye and discharge you.

Some patients will be offered a face-to-face post-op appointment; those with certain medical issues, complex procedures or memory problems. This will be discussed on the day of your procedure and a time and date agreed.

If put forward for your second eye, you will receive a date and time during your post-op call/appointment. If needed, more dilating drops will be posted to you. The process as above would start again.

If discharged you will be asked to visit your optician in about six weeks, as this should be long enough for your prescription to have settled. Please take the form you were given after your surgery with you, as they will then complete this and send it back to us for our records.

Cataract FAQ

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What should I expect after the procedure?

You may see a semi-circle in the corner of your eye following surgery. This is the edge of the lens, and will settle once your brain gets used to the new lens. Everything may appear very bright at first and colours may appear whiter or bluer – this is normal and will settle. You may also notice a few floaters in your vision. This is nothing to worry about, you probably had these previously and couldn’t see them due to the cataract.

Eyes can be itchy/gritty after using your eye drops, which is normal. If this becomes really uncomfortable for you, we recommend purchasing some preservative-free artificial tears and using these 15 minutes after your prescribed drops. You can purchase these from opticians, pharmacies or online.

It is important to clean and bathe your eyes with cooled boiled water and a cotton wool pad. This should be done at least once a day in the morning, and more often if required.

Will I still need glasses?
THIS IS AN OPERATION TO REMOVE YOUR CATARACT – NOT THE NEED FOR GLASSES.

We cannot promise you won’t need a distance vision prescription after surgery, although we try our best. You will DEFINITELY need a near vision prescription/reading glasses afterwards.

When can I drive?
DO NOT DRIVE until after your post-operative check to ensure you are at DVLA legal standards.

This appointment is scheduled eight days following surgery.

When can I fly?

Usually once you have received a post-surgery review approximately one week after surgery – ask the surgery team about specific flight lengths.

When can I go swimming?

Avoid swimming for three weeks to ensure the eye is fully healed.

When can I resume physical activity?

Avoid strenuous exercise for four weeks, including golf and bowls.

When can I wear makeup?

No makeup for six weeks post-surgery, especially mascara and eyeliner.

When can I wash my hair?

Wash your hair backwards for the first two weeks to avoid water going into the eye.

When can I have sexual intercourse?

You can resume your sex life two weeks following the surgery.

Do I have to wear my eye shield while sleeping?

The greatest danger to your eye following surgery is poking or rubbing, and a lot of people do this while sleeping, so please wear your eye shield at night for two weeks post-surgery.

Do I need someone at home with me in the first 24 hours?

It is best to have someone take you home following the procedure, ideally in a car and NOT by bus, train or walking. You may feel a little disoriented and out of focus, especially if you’ve only had one eye operated on so far. It is recommended to have someone stay with you while you feel like this, but not a necessity once you’re safely home.

Useful documents

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Pre-operation letter

Information pack

Eye drop instructions

Operation letter

Post-operation guide

Optician form

Contact us

If you have any questions, please get in touch:

PLEASE DO NOT SENT US MESSAGES VIA THE WEBSITE ABOUT URGENT MEDICAL MATTERS - Use the appropriate contact details provided at the time of your appointment.

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