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A cataract is one of the most common eye conditions worldwide and, in the vast majority of cases, it is directly linked to the natural ageing of the eye. The condition is characterised by the gradual clouding of the eye’s natural crystalline lens, which under normal circumstances is completely clear. As the lens loses its clarity, light can no longer be focused properly on the retina, resulting in a progressive decline in visual acuity.
The only treatment for cataract is surgery. However, deciding on the timing of cataract surgery, preparing properly and understanding the procedure are vital for the best possible outcome after the operation.
What to Look Out For: Early and Late Symptoms
Cataract usually develops slowly and painlessly. In the early stages, the change in vision may not even be noticeable. As the clouding of the lens progresses, however, patients should be alert to the following clinical signs:
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Gradual decline in visual acuity: Vision becomes blurred, as if looking through a dirty window pane or a waterfall (hence the name of the condition in Greek, “katarraktis”, meaning waterfall).
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Marked sensitivity to light (glare): Sunlight or the headlights of oncoming cars at night seem excessively bright and cause discomfort. “Halos” (bright rings) often appear around light sources, because the cloudy lens scatters light instead of focusing it.
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Difficulty with night vision: Brighter light becomes essential for reading or other close-up tasks, while driving at night becomes dangerous.
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Altered colour perception: Colours lose their vibrancy, look faded and often take on a yellowish or brownish tint.
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Frequent changes in glasses prescription: Patients may find that they keep needing new lenses, as the refraction of the eye changes due to the hardening of the natural lens (myopic shift).
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Monocular double vision: Multiple images in the same eye, even when the other eye is closed.
The appearance of these symptoms calls for a full eye examination, to confirm the presence of cataract and to rule out other conditions of the back of the eye.
The Pre-operative Assessment: Why Precision Matters
Cataract surgery is not simply the removal of the cloudy lens; it is also a refractive procedure. This means that the aim is for the patient to become as independent of glasses as possible after the operation.
Before the operation, detailed imaging and measurements are required:
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Biometry (optical or ultrasound): The length of the eyeball and the curvature of the cornea are calculated with great precision, so that the exact power of the intraocular lens (IOL) to be implanted can be chosen.
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Corneal topography: This detects corneal astigmatism and helps in choosing a suitable toric lens, if one is needed.
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Optical coherence tomography (OCT): An examination of the macula to make sure there are no coexisting conditions that would limit the visual result after surgery.
Choosing the intraocular lens: Today’s ophthalmologist has various types of intraocular lens available (monofocal for distance vision, multifocal or EDOF for all distances, and toric lenses to correct astigmatism). The choice is strictly tailored to the anatomical features of the eye and the everyday needs of each patient.
The Procedure: What You Need to Know
The modern surgical technique is called phacoemulsification and is one of the safest, quickest and most successful medical procedures performed today.
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Anaesthesia: In the vast majority of cases, the operation is performed under local anaesthesia (drops only), without the need for general anaesthesia or injections around the eye. The patient is awake and feels no pain, but is aware only of light and movement.
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Operating time: The procedure itself usually takes less than 15 to 20 minutes.
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The technique: Through tiny incisions (about 2 millimetres) in the cornea, the surgeon inserts a special probe that emits ultrasound. The ultrasound breaks up and suctions out the hardened lens. A foldable artificial intraocular lens is then implanted in place of the natural lens (in the same capsular bag).
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Stitches: Because the incisions are so small, they seal on their own, so no stitches are needed.
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Hospital stay: This is a day-case procedure. The patient goes home a short time after the operation is completed.
Recovery after Cataract Surgery: The Basic Rules of Protection
The success of the operation also depends to a large extent on following the post-operative instructions. Although recovery is extremely quick, with vision clearing noticeably within the first 24 to 48 hours, the eye needs time to heal fully.
What you should do:
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Using eye drops: Strictly follow the drop schedule (antibiotics and corticosteroids) prescribed by your doctor to prevent inflammation and infection.
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Wearing a protective shield: It is recommended to wear it while sleeping for the first few days, to avoid accidental pressure on the eye.
What you should avoid:
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Rubbing the eye: This is the most important rule. Any mechanical pressure on the eye is strictly forbidden for at least two weeks.
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Exposure to water and dust: Avoid letting tap water run directly into the operated eye when washing your hair. Avoid working in dusty environments.
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Lifting heavy weights and strenuous exercise: For 1 to 2 weeks, avoid lifting heavy objects or making sudden movements (such as bending down low) that increase intraocular pressure.
In the hands of a specialist surgeon, cataract surgery is a definitive solution to the problem, restoring clear vision and radically improving the patient’s quality of life.
Questions about your case?
Dr. Skouteris will examine you at his practice in Neo Psychiko and explain your options.
Ophthalmic surgeon trained at the John Radcliffe University Hospital in Oxford and Fellow of the European Board of Ophthalmology (FEBO).
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