The Struggle for Clarity
For pensioner Taslima Jan, the effects of cataracts in her eyes started to manifest themselves as she was reading the Qur’an.
A devout Muslim, she not only reads the Holy Book regularly but teaches it to young girls at her Birmingham home. A sudden deterioration in her vision though brought home the realisation that it might be more than just the natural aging process.
“It started when I was reading the Qur’an and very quickly, I would not be able to see the verses,” explained the 80-year-old.
“It started in the right eye, but it was affecting both eyes. The optician who checked me said that cataracts had formed in both eyes, and I would need surgery. They gave me general advice and information and referred me to hospital.”
The surgery, in 2022, was first performed on her right eye and three months later on the left. “They explained what they would be doing and gave some eye drops two or three times. During the surgery, they told me to keep my head very still or there could be problems if I moved it.
“Afterwards, they put a patch on the eye, and I had wear dark glasses, as well taking antibiotic eye drops. Once the right eye, was okay, they performed the surgery on the left eye. That was about 6 weeks later.
“There wasn’t any pain as such, but they told me to take some precautions afterwards, including not putting water directly into the eyes, during the recovery period. I was slightly worried and had some concerns at the first operation, which is natural. The second time they did it, there was no worry as I had already been through it.”
Most Common Surgery
Mrs Jan’s experience is not uncommon. According to UK Government figures, in the financial year ending 2023 there were over 516,073 admissions to hospital for cataract surgery in England, a significant jump on the 400,000 surgeries being performed every year pre-Covid pandemic.
Cataract surgery is the most common operation performed in the UK, with a success rate of about 99%. It has been estimated that, in the UK, about a third of people over the age of 65 have a cataract that affects their vision in one or both eyes. The majority of cataracts are age-related, and approximately 40% of patients needing surgery for them will have it in both eyes.
Thankfully, advances in medicine and the medical procedures used to deal with cataracts mean that the surgery is performed on an outpatient basis, a local anaesthetic is used so the patient remains awake, and most patients leave within an hour of arrival.
For Mrs Jan, the result is that she has been able to revert to her daily routines and the fulfilment of her religious duties, including reading the Qur’an, without difficulty.
“I do have reading glasses but, Alhamdulillah, everything is okay now. I can see and read clearly, and the only thing with the eyes now is that I have to take eye drops twice daily for dry eyes – that was something I had previously, but they did tell me it might increase after the operation,” she said.
The worries and concerns facing patients with cataracts are shared by their relatives. However, Mrs Jan’s son, Mohammed Haroon, is in the fortunate position where he fully understood the condition and the procedure needed to resolve it.
As a qualified optometrist – specialists who are trained to detect defects, disease or injury in eyes – of more than two decades, he is used to regularly seeing patients with developing cataracts.
“My late father had the same procedure in 2004, so when it came to mum there weren’t any real worries. With my father, his sight was being impaired while driving, he had difficulty seeing things clearly, so he was referred to surgery. That sort of decision is made when it’s affecting people’s everyday quality of life negatively and it’s symptom led.
“Cataracts develop slowly, so people can sometimes cope until they get more severe. It’s the patient’s decision if they want to go ahead with surgery or leave it. It’s really down to how much of an impact it has on them on a day-to-day basis.
“General reasons for making a referral for surgery are difficulties with reading, cannot watch television, or sometimes too much glare from sunshine or night lights, or going from light to dark or vice versa.”
Alleviating Concerns
“I spoke to my father in general terms, and he had successful surgery. If I had not known what the surgery was, then I might have been worried or concerned. If, for example, it was another procedure I was not familiar with, then I would have had the same questions as any relative. Because of my experience, I was a bit more relaxed.
“What I do have nowadays is patients’ relatives asking me the questions that I might haveasked then – what are the problems, will the surgery hurt, do they put needles in the eyes, what about afterwards, and so on.”
Mr Haroon said that cataract surgery – which replaces the cloudy lens inside the affected eye with an artificial one – was basically similar around the world, but in poorer communities across Asia and Africa, a lack of access to free medicines and medical care could hamper those needing treatment.
“It’s the most common surgery in the world and the success rate is very high but a lot depends on the experience of the ophthalmologist – the eye doctor who performs it – and having the right tools.
“I’ve seen cases done in poorer countries that have not been ideal – for example, the patient has been left needing prescription glasses or the iris (the coloured part of the eye that regulates the amount of light into the eye) has been distorted.
“Money is also a factor. We’re very fortunate to have the NHS in the UK, so treatment is free. In Pakistan, for example, treatment at the top hospitals is comparable to the UK but ultimately patients have to pay for it. In village hospitals, the staff may not have the experience or the right tools, so patients miss out.
“It’s very important that cataracts are dealt with. With patients who have diabetes for example, cataracts will not allow specialists to check the back of the eye to see how diabetes has affected it, so the cataract does have to be removed. So, cataract surgery is important not just for restoring clarity of vision but for detecting other conditions that can affect a person’s health and well-being.”
Factfile
• Cataracts are when the lens, a small transparent disc, of the eye develops cloudy patchesand limits vision.
• Cataract surgery replaces the cloudy lens in the eye with an artificial one.
• Phacoemulsification – a technique that uses ultrasound to break up the eye’s natural lens and remove the cataract – is the most common method of performing
cataract surgery, accounting for over 99% of NHS cataract surgeries in the UK.
• During the operation, the surgeon makes a tiny cut in the eye to remove the cloudy lens and replace it with a clear plastic one.
• Cataract surgery is quick, painless and only takes around 10 minutes to complete. It can take 2 to 6 weeks to fully recover the operation.
• 95% of cataract surgeries are carried out using local anaesthetic – meaning patients don’t need to be put to sleep for the procedure – and, in most cases, they can leave the hospital within 40 minutes of their operation.
• There are no medicines or eye drops that have been proven to improve cataracts or stop them getting worse.
• The risk of serious complications developing as a result of cataract surgery is estimated at around 1 in 50 cases. These can include blurred vision, some vision loss, detached retina. Most 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.
• Most people will need to wear glasses for some tasks, like reading, after surgery regardless of the type of lens they have fitted.
(source: NHS)
