Common Cataract Concerns & Questions

         

Cataracts are the cause of half of blindness and 33% of visual impairment worldwide.  

With there being so much information available on the internet these days about anything we want, it can be daunting and difficult to find the information that is most relevant to us.  

We often seek out information from family and friends who have been in the same situation and a good recommendation is often our preferred method of choosing the right doctor.  We definitely agree that a great word of mouth referral rarely steers you in the wrong direction and is the source of almost all of Dr Furness’ patients whether it be a patient’s recommendation or a health professionals’.

Our eyesight is one of our most precious commodities so we want to be secure in the knowledge that we are choosing the right doctor for the job and have received necessary education.  We have compiled some of the most common concerns and questions that we get from our patients when they come to us at Insight Eye Clinic to ensure you make the best possible choice for you and your eyes.

Understanding Cataracts

What is a cataract and why do they form?

Cataracts are most commonly age-related and are formed from a change of the proteins within the crystalline lens which sits just behind your iris inside of your eye.  This build-up causes a clouding of the lens which keeps light from passing through the eye. This causes reduced vision.  

Other causes of cataracts include:

• ● An inherited congenital condition – Approximately 0.4% of babies are born with congenital cataracts which are a result of one of many causes whilst in utero. They sometimes require immediate surgery and other times, are left until later in life once the foggy lens begins to effect the vision more.
• ● Traumatic – Occur secondary to blunt or penetrating ocular trauma.
• ● Medication – Long-term use of steroids and diuretics can cause an early onset of cataracts.
• ● Radiation – Exposure to toxic substances, ultraviolet light (specifically UVB) and microwave radiation is also found to be a cause.
• ● Underlying medical condition – Often, one medical condition will contribute to the development of others. Most commonly, diabetes is found to directly affect our eyes, whether it be contributing to or progressing the development of cataracts. Diabetic retinopathy is also a leading cause of blindness in those under 65.

Some common symptoms of cataracts are:

What happens during my cataract consultation?

A quick and easy consultation process with Dr Graham Furness is required prior to cataract surgery.  During your consultation, many measurements are taken to ensure the correct lens is selected for your eye using ocular diagnostic equipment.  Your pupils will be dilated using an eye drop that relaxes the iris in order to assess the cataract’s severity in detail. It also allows Dr Furness to perform a health check of the whole internal eye.

 Your pre-operative visual acuity will be tested and your tolerance for different visual outcomes will also be tested.  In some cases, a contact lens trial is required.

What visual outcome can I expect from my cataract surgery?

Monovision

Monofocal lenses are used to correct the dominant eye for distance vision and the other eye for near vision. It is unlikely you will require glasses after your procedure but in some cases, people require glasses for tasks such as needlework, very small print or long distance driving.  20% of people’s brains cannot adapt to this visual result and find they experience a sea-sick feeling or problems with depth perception.  

A contact lens trial is sometimes necessary and allows us to simulate monovision (not your surgical outcome).  Dr Furness can then determine if monovision is suitable for you. Other procedure types are available for those that cannot adapt to monovision.  For the 80% who’s brains’ do agree with this outcome, they are generally extremely happy.

Trifocal lenses

Trifocal lenses feature a series of rings which diffract light to allow you to have very good distance, intermediate and near vision.  The same lens is used in both eyes meaning that you will not experience the same imbalance that some get from monovision.  Dr Furness from Insight Eye Clinic has researched the most advanced and effective intraocular lenses to give his patients the best possible visual result possible. Follow this video link for a visual demonstration on how Trifocals could benefit you.

Distance vision in both eyes

Using a monofocal lens to correct both eyes for distance vision means that you will require reading glasses after your procedure, even if they were not required before.  Some people prefer both eyes for distance vision if they experienced an imbalance with monovision, a large amount of glare or halo’s with trifocals or are happy to wear reading glasses.  This visual outcome might also be preferable for occupational reasons.  For ex: truck drivers who rely heavily on sharp distance vision without risk of glare or halo’s at night.

How can I prepare for my cataract surgery?

Contact Lenses

Please do not wear a contact lens in your operation eye during the 3 days prior to surgery.

Eye Drops (Pre-operative)

You are required to apply an antibiotic eye drop (Chlorsig or Chloramphenicol) four times per day* for THREE DAYS PRIOR to your surgery date. If your surgery is on a Tuesday, you will begin your eye drop on the Saturday before.

*If you are having only one eye corrected or having your eyes corrected on different dates, only apply the drop to the eye having surgery.

You should have either purchased an eye drop bag from the clinic or received prescriptions to collect them yourself from a pharmacy.  The drop bags provided will also include your post-operative eye drops.

You should continue to use the eye drops on the day of surgery and take them with you to the hospital at your scheduled admission time.

Eye Drop Medication Chart

At the time of arranging your cataract surgery, you will be advised on the aftercare that is required which includes eye drops.  You will have been provided an ‘Eye Drop Medication Chart’ (see image at bottom of page) along with your other surgery paperwork.

What happens during my cataract procedure?

On the day of your surgery, your procedure is likely to take only 20-30 minutes. You will be at the hospital for approximately 3 hours in total.  During this time, you will be met by the nursing staff at Perth Eye Hospital or Joondalup Health Campus who will go over some pre-admission questions with you and prepare you for your procedure.

Anaesthetic and sedatives

Most patients have a local anaesthetic to numb their eyes which is in the form of an eye drop. Mild sedation is also provided to help with nerves or anxiety.  Some patients have a general anaesthetic for various reasons which may include, severe anxiety making them at risk of large movements, underlying health issues, preference and many more.  Your eligibility for a GA will be assessed by your anaesthetist.

Cataract removal and new lens insertion

Your doctor will guide you through the procedure and advise you where to focus.  You should NOT experience pain during your procedure. On occasion, you might experience a small amount of pressure, usually preceded with a caution from your doctor.  A 2mm slit is made in the cornea and Dr Furness will use a small instrument to break up and remove the cloudy lens from inside the eye.  Once removed, your doctor will then insert the new lens and position it in place.  No sutures are needed as the incision is so small. Your eye will begin to heal immediately.

Following surgery

A quick post-operative check is performed on the day of your procedure or the following morning to check the pressure of the eye. It is very common to see a temporary increase in ocular pressure after surgery.  Various solutions are available if you experience this so please do not be alarmed. (Click here for a video overview of cataract surgery)

What is the recovery time following cataract surgery?

Cataract surgery is commonly done one eye at a time although it is perfectly safe to have both eyes corrected at the same time.  In Australia, due to our Medicare ruling, if you have private health insurance and are covered for your cataract procedure, you will not be fully reimbursed* if both eyes are corrected during the same procedure.  Therefore, it is recommended having your procedures on separate dates (if both eyes require surgery). Your second eye surgery is usually completed 3-14 days after your first eye procedure.

Driving

You can drive as soon as your vision is comfortable following your procedure or once you meet driving standards.  Eye drops will be provided and are imperative to the healing process.  The clinical staff will provide you with a medication chart to track your eye drop usage and requirements.  Full aftercare information will be provided by Dr Furness’ team prior to your procedure.  Always ensure you contact them if you have any concerns or questions.
Follow this link for more information on aftercare eye drops.

What does cataract surgery cost and will my health fund cover it?

Private health fund

The limits and benefits of cataract and eye lens procedures change depending on your choice of hospital product, the level of cover you choose and how long you’ve been an eligible member with your health fund. Most health funds require a 12 month waiting period before you are deemed eligible for an existing health condition.

Some health funds require that you pay a small gap for your procedure.  It is important to enquire with your health fund as to your eligibility prior to surgery and what your likely gap is, if any.  They will require the provider number of your surgeon which you can get from contacting Insight Eye Clinic. They will also require the item number related to cataract surgery which the clinic can also provide you with.

Public waiting list

If you are not covered for your cataract procedure via your health fund or are uninsured, you may elect to go on the public waiting list for your procedure.  Wait times are subject to the severity of the visual impairment caused by the cataract and government allowance.  It is usually a minimum of 12 months wait for the first eye and up to a further 12 months for your second eye.  Please enquire with your preferred provider as to their individual waiting time.

Private uninsured

If you are uninsured and do not wish to wait for a surgery date via the public system, you can opt to go private uninsured.  If you are eligible for Medicare cover and your provider charges within the Medicare Benefit Scheme allowance, you should receive approximately $700 back from Medicare.  Please enquire with your provider about the exact cost of your procedure once benefits have been paid and what you are entitled to.