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Cataracts are the leading cause of vision loss with more than half of over-65s suffering to some degree. The condition only worsens with time, so many people who go untreated are left unable to read, watch TV or drive. We are approaching Cataract Awareness Month, crucial to highlight the most common cause of reversible sight loss.
The number of people benefiting from cataract surgery has increased dramatically in recent years with the number of operations carried out by the NHS in Scotland rising from 19,454 in 2000 to 32,552 in 2012.
Pressure on the NHS will further increase due to the ageing population. Over the next ten years, statistics show that the proportion of over 75s in Scotland’s population will rise by more than 25 per cent.
Cataracts occur when the clear lens of the eye becomes cloudy, blocking the passage of light, which leads to blurred or dim vision. They occur as a normal part of ageing, usually developing in those over 50. However they can affect younger people, especially those with diabetes, or in people with other eye problems such as glaucoma.
Early signs of cataracts include glare, especially when driving at night, and needing better light for reading. The only treatment available is surgery, which involves a 15-minute procedure to remove the cloudy lens and replace it with an artificial one.
The story of the invention of artificial, or intraocular, lenses is remarkable. In the Second World War, injured Spitfire pilots were found to have small pieces of shattered plastic from the cockpit canopy in their eyes, without any adverse reaction. Sir Harold Ridley at St Thomas’ Hospital in London realised that the same material could be used to make an intraocular lens, reducing the need for thick glasses following surgery.
Cataract surgery is now one of the safest and most effective operations, with a quick recovery. Many options are now available – patients can choose to have surgery performed by their preferred consultant privately, where it can be tailored to their individual needs depending on their visual requirements.
Important choices include which lens to use. Traditional lenses will primarily improve distance vision, with spectacles still needed for near and intermediate vision.
More modern lens types include aspheric lenses, which reduce optical distortion and are particularly beneficial in dim light; toric lenses, which reduce astigmatism, a condition where the eye is shaped a little like a rugby ball; and multifocal lenses, similar to varifocal glasses in that they aim to provide good distance, intermediate and near vision.
One of the most modern is the Symfony lens, which can give an extended range of high quality vision and also correct astigmatism. This can reduce the need for glasses with less of the halo or glare effect some other lenses can cause. It’s important to know the signs and act quickly.Dr Andrew Tatham is an ophthalmic surgeon at The Edinburgh Clinic and NHS .