Cataract

What is a cataract?

Cataract is a condition when the natural lens in your eye becomes progressively cloudy.

What causes cataract?

The most common cause of cataract is ageing. The two preventable causes of cataract formation would be:

  • Smoking
  • UV radiation (sunlight) exposure

Cataract can also occur at a younger age if you:

  • Have poorly controlled diabetes
  • Take certain types of medication such as corticosteroid, etc.
  • Are born with it (congenital)
  • Experienced previous trauma to the eye

What are the symptoms?

The most common symptoms of a cataract are:

  • Cloudy or blurry vision
  • Poor night vision
  • Colours seem faded
  • Glare and haloes
  • Frequent prescription changes in your eyeglasses or contact lenses (“power” keeps changing)

These symptoms can also be a sign of other eye problems. If you have any of these symptoms, check with your opthalmologist.

How is a cataract detected?

Cataract is detected through a comprehensive eye examination by an opthalmologist.

When do I need cataract surgery?

If the amount of cataract is little and does not disturb your vision or your daily activities, (e.g. driving or reading), it can be left alone. Eyeglasses may help at this stage to allow you to see better. If using eyeglasses does not help, your ophthalmologist may suggest doing a cataract surgery.

Generally, there is no such thing as a cataract being “ripe” or “unripe” for removal. What matters is whether the cataract interferes with your vision. A cataract needs to be removed when vision loss interferes with your everyday activities such as driving, reading or watching TV. Your ophthalmologist will discuss this with you. Once you understand the risks and benefits of surgery, you can make an informed decision about whether cataract surgery is right for you.

You will be directed to the following areas when your cataract surgery is confirmed:

  1. Listing room – In the listing room, you will decide on the date of surgery. Payment methods will be explained, and you will also be advised on how to prepare yourself for the surgery day.
  2. Pre-operative tests – Various tests will be carried out within three months of your surgery date. The tests include blood pressure, urine test, electrocardiogram (ECG), blood sugar and eyeball length measurements.

How is cataract surgery performed?

In cataract surgery, the cloudy cataract lens is removed and then replaced with an artificial lens implant. Cataract surgery is the main surgery performed at the Singapore National Eye Centre. The main technique used to remove a cataract is phacoemulsification. In phacoemulsification:

  • A small opening between 1.8mm and 2.75mm is first created on the cornea.
  • An ultrasonic device is then introduced through this opening into the eye. This device breaks the cloudy lens up into small pieces and facilitates removal from the eye.
  • After the cataract lens is entirely removed, an artificial lens implant is inserted to the same position.
  • Most of the time, the wound does not require any stitching.
  • This method of cataract surgery takes less than 30 minutes.
  • This is a day surgery procedure hence there is no need to stay overnight in the hospital.
  • An anaesthetist is with you during surgery to provide sedation to make you feel comfortable and relaxed during the surgery. Depending on the individual, you may not be totally asleep during surgery, however, you will remain comfortable. Anaesthetic eye drops and injections will be given to keep pain to a minimum. It isimportant to cooperate by not talking or moving your head and body during the surgery.

What are the types of artificial lens implants?

Monofocal and multifocal artificial lens implants are available. With monofical implants, you would require eyeglasses to read after your surgery. With multifolical implants, you have a good chance (about 90 per cent) of not needing any eyeglasses for distance viewing and for reading newspaper font after surgery.

Your ophthalmologist will discuss with you and recommend the type of implant that is most suitable for you.

What happens after my cataract surgery?

After the operation, you will need to:

  • Apply eye drops in your operated eye.
  • Clean your eye for the first one (1) week.
  • Keep your eye covered with an eye shield on the day of the surgery and every night while sleeping for one (1) week.
  • Prevent contaminated water from entering the eye.

After cataract surgery, depending on the choice of lens implant:

  • You may need eyeglasses for reading only.
  • You may need to wear eyeglasses for seeing far and for reading, or you may not need eyeglasses at all.

You will take two to four weeks to recover. Any eyeglasses needed should be prescribed between three and six weeks after surgery.

What are the risks of cataract surgery?

As with any surgery, cataract surgery poses risks such as infection and bleeding.

Before cataract surgery, your ophthalmologist may ask you to temporarily stop taking certain medications that increase the risk of bleeding during surgery.

After surgery, you must keep your eye clean, wash your hands before touching your eye, and use the prescribed medications to help minimise the risk of infection. Serious infection can result in loss of vision.

Possible complications during surgery: Rupture of the lens capsule (“bag”) that supports the lens resulting in the implant being placed in the wrong position.

Possible complications soon after surgery include:

  • Infection (Endophthalmitis)
  • Inflammation
  • Bleeding
  • Retinal detachment
  • High eye pressure for a few days
  • Leaking wound which may require stitching
  • Cloudiness of the cornea
  • Swelling of the retina
  • Sensitive to eye drops
  • Displaced lens implant
  • Droopy eyelids

What eye drops do I need after cataract surgery?

You will need antibiotic and steroid drops after surgery for several weeks. It is common to have an occasional itch, sandy feeling, and/or tearing for a few days or weeks after your cataract surgery. Artificial tears can be used to relieve this sensation.

Can i make my cataract go away or stop it from getting worse?

No. There is no eye drop that can do this.

Isn’t cataract surgery done by laser?

Cataract is removed by an operation. The procedure requires surgical skill and takes an ophthalmologist many years of specialist training to ensure that the surgery is done safely and efficiently.

Cataract is not removed by having a laser directed at the eye to make it disappear. The laser that is commonly and mistakenly referred to is the ultrasound device that is introduced into the eye to “soften” and “suck” out the lens.

Can a cataract come back after surgery?

After cataract surgery, it is not possible for a cataract to come back because the lens, where the cataract grows, has been removed. The new lens implant will last a lifetime and will not need maintenance or replacement.

It is possible, however, for a cloudy film to grow on the lens capsule (“bag”) that is located behind the lens implant. This occurs usually some months or years after surgery. If the cloudiness of the lens capsule (“bag”) affects your vision, it can be cleared with a 5-minute, painless laser treatment. The cost of the laser treatment is not included in the cataract surgery cost.

Why should I have my cataract surgery done in SNEC?

We emphasize Quality and Quantity

  • Our opthalmologists are well-trained and have gone through strict and lengthy guided training.
  • We also handle complicated cataract surgery encountered in children, after trauma and in a variety of congenital and medical conditions.
  • We have experienced paramedical staff to perform eye measurements which are crucial in obtaining good outcomes after cataract surgery.

We emphasize Safety

  • We ensure safety through strict training of opthalmologists.
  • We keep ourselves updated by constantly carrying out research and trials to evaluate what is suitable for our patients.
  • We are strict and diligent in preventing infection.
  • We keep track of our performances and results.