A cataract is an opacity (misting or clouding) of the lens in your eye and is a major cause of visual impairment. The most common cause of cataract is increasing age. Cataracts tend to progress over time and can affect the ability to carry out daily tasks including driving, for which there are legal minimum vision requirements. They can also affect a person's ability to get around in general and to carry out close-up activities such as reading and craft work.

Congenital cataracts are cataracts which are present at birth. Cataracts can also result from trauma to the eye.

The main symptoms for adult age-related cataracts are:

• reduced or blurred vision
• increasing problems with glare and bright lights
• increasing difficulty with seeing in low-light conditions
• colours may look faded
• double vision in one eye

You should consult your optician if you have any of the above symptoms.

Your optician will do a series of tests including a visual impairment test to measure how well you can see at various distances.

If your optician or GP thinks you have cataracts and they are significantly interfering with your daily activities, they may refer you to see an eye specialist for more tests or for possible treatment. However, if the cataracts are mild (“immature”) they may simply recommend follow up to monitor your cataracts.

Local commissioning policies are in place for this condition

If you are referred for cataract surgery, this is subject to NHS referral criteria which will need to be met. Cataract surgery will not usually be commissioned until the cataract causes significant visual impairment resulting in difficulties in everyday life. Cataract surgery is a procedure that usually takes 30 minutes. It will often be carried out as day surgery and is done under local anaesthetic.

In some circumstances your referral may be returned to your Optician or GP to provide more information or to advise them to monitor the progression of your cataract and re-refer when it meets the criteria for surgery. 

Things that may increase your risk of cataracts include:

• Increasing age
• Smoking
• Diabetes
• Hypertension
• Obesity
• Previous Eye Injury
• High myopia (Near-sightedness)
• Alcohol
• Sunlight exposure

Managing my condition

Mild cataracts can be managed with stronger glasses and brighter reading lights.

You can choose to put off having surgery for a while and have regular check-ups to monitor the situation.

There are no medicines or eye drops that have been proven to improve cataracts or stop them getting worse.

If you have cataracts, they may affect your ability to drive. You must tell the Driver and Vehicle Licensing Agency (DVLA) if you have cataracts in both eyes. You will not need to tell the DVLA if you only have cataracts in one eye unless you have a medical condition in the other eye or have a valid Group 2 licence. If you drive a bus, coach or lorry (Group 2 licence) you must inform the DVLA if you have cataracts in one or both eyes.

Please see here for more information from the DVLA.

Making a decision about surgery

Surgery is usually offered on the NHS if your cataracts are affecting your eyesight and quality of life.

The decision to have surgery should not be based solely on your eye test (visual acuity) results.

You may have other personal reasons for deciding to have surgery, such as your daily activities, hobbies and interests.

If both eyes have cataracts that meet the criteria for surgery, your Provider will usually operate on your worst cataract first and when you have recovered from that surgery will operate on your second eye. Some providers offer to operate on both eyes at the same time, this is called bilateral surgery.

NHS England have produced a Shared Decision Tool that you can work through with your Ophthalmologist (if you have an existing long term eye condition) or your optometrist (optician). 

Risks of Surgery

Surgery is not risk free and results are not guaranteed:

The risk of serious complications developing as a result of cataract surgery is estimated at around 1 in 100 cases.

These can include:

• blurred vision
• some loss of vision
• detached retina – where the the thin layer at the back of your eye (retina) becomes loose

Most of these serious complications can be treated with medicines or further surgery.

There is a very small risk – around 1 in 1,000 – of permanent sight loss in the treated eye as a direct result of the operation.

Benefits of surgery

After cataract surgery you should be able to:

• see things in focus
• look into bright lights and not see as much glare
• tell the difference between colours

If you have another condition affecting your eyes, such as diabetes or glaucoma, you may still have limited vision, even after successful surgery.

Video about My Cataracts

You should be able to go home on the same day as your cataract surgery.

Feeling should start to return to your eye within a few hours of surgery, but it may take a few days for your vision to fully return.

It's normal to have:

• grittiness
• watering
• blurred vision
• double vision
• a red or bloodshot eye

These side effects usually improve within a few days, but it can take 4 to 6 weeks to recover fully.

If you need new glasses, you will not be able to order them until your eye has completely healed, usually after 6 weeks.

When to seek help

Contact your eye surgery department as soon as possible if you experience:

• increased pain and/or redness
• decreased vision

All providers have 24/7 helplines, contact details are on the leaflet given to you on the day of your surgery.

Support for managing my Cataracts

The links below will take you to more support for patients who are affected by sight loss:

• NHS England Shared Decision Making Tool
• Gov.uk: Cataracts and driving - Visit the DVLA for more information about cataracts and driving law
• NHS.UK - More information about cataracts and surgery
• RNIB - More information about cataracts and surgery including a very detailed leaflet you can download