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Cataract FAQs

The most common cause of cataract is increasing age. The majority of people will develop a cataract at some point during their lifetime. Age-related cataracts normally develop in both eyes. Cataracts can also develop secondary to conditions such as diabetes, or as a side-effect of taking medications such as corticosteroids. They can also occur secondary to injury to the eye, or following eye surgery for another condition. 

The most obvious benefit of cataract surgery is restoration of vision and improvement in your quality of life. Cataract surgery will allow you to enjoy again the things you used to do such as reading and driving, as well as any hobbies affected by poor vision. 

Cataract surgery is also an ideal opportunity to correct any significant refractive error such as long-sightedness (hypermetropia)short sightedness (myopia), and/or astigmatism in order to provide better unaided distance vision. Should you so wish, you may choose to use this golden opportunity to also correct age-related poor near vision (presbyopia) with premium multifocal IOLs (link) and maximise your spectacle independence. It is important to realise that cataract surgery will only correct the vision loss due to the cataract, and will not reverse loss of vision due to other conditionssuch as glaucoma or macular degeneration.   

Standard-incision cataract surgery is performed through a 2.8 – 3.2 mm incision. I exclusively use the very latest micro-incisional equipment whereby your operation will be performed through a much smaller 2.0 mm incision instead. This approach induces less astigmatism (link to astigmatism below) and promotes quicker vision stabilisation than standard-incision cataract surgery.  

This very much depends upon your lifestyle choices and requirements. Monofocal lenses will give good distance vision and are a suitable choice for you if you really don’t mind always needing glasses for near and intermediate tasks. Significant astigmatism, if present,  will need to be corrected if you want good distance vision with a monofocal option. However, we find that more and more patients truly relish the idea of disposing with their distance, varifocal, bifocal or reading glasses for good and therefore choose to receive advanced premium IOLs. These are an excellent option that allows you to enjoy vision more akin to the vision you had when you were younger and did not need readingspectaclesThere is no perfect technologyhowever, that will make your eyes “20 years old again”.  Compared with monofocal lenses the vision with premium IOLs tends to be slightly less “crisp”, albeit generally much better than before cataract removal. Some patients also experience glare and haloes, or starbursts and other visual phenomenon (dysphotopsias)If present however, these generallysettle in the weeks to months after surgery with adaptation. Trifocal IOLs may not be suitable for patients who drive a lot at night or for a living, or who enjoy hobbies such as astronomy or who are significant perfectionists. Extended depth of vision lenses are reported to be associated with less of these symptoms but may not be totally free of these. Having said this, the overall satisfaction rate with multifocal lenses is very high, and the vast majority of patients would make the same choice again if they had to, in view of the significant freedom from irritating glasses that they now enjoy byhaving opted for premium IOLs. Finally, your eyes must be eligible to receive multifocal IOLs. If you have any significant other conditions such as glaucoma, or significant retinal disease, then these may not be the best option for you. In such cases, it would still be possible to implant an extended depth monofocal lens to give you better range of vision than a basic monofocal lens. All lens options will be discussed in depth with me and you will given information about the lens options before or at the initial consultation with me.  

Astigmatism is a type of refractive error that occurs in combination with either long- or short-sightedness and is common at all ages. It occurs mostly when the cornea at the front of the eye has an irregular slightly oval shape rather than being more spherical. This results in objects at any distance appearing distorted or skewed (link to animation). Normally, glasses fitted with special toric lenses or contact lenses are required to obtain good vision.  When cataract surgery is performed, a standard monofocal lens will not correct significant astigmatism. You will therefore still have some blurred vision, and will always require toric spectacles to see clearly at any distance. Cataract surgery provides the ideal opportunity to correct significant regular astigmatism by the implantation of astigmatism-correcting toric lenses, allowing the light to be properly focussed on the retina. Monofocal toric lenses will allow you to see clearly in the distance without spectacles, whilst multifocal toric lenses will allow you to see clearly for all distances in most cases with any need for bothersome spectacles.

Short-sighted, and in particular very short-sighted eyes can present particular challenges during cataract surgery. As a VR surgeon, I frequently operate on these eyes and am very experienced with the strategies required to result in a safe outcome. If you are very short-sighted, then choosing a VR surgeon to perform your cataract surgery may be more reassuring for you.  

Cataract surgery is one of the most successful surgical procedures and is associated with a very low risk of complications in experienced handsApproximately 98% of patients will experience no complications. Some eyes are more challenging than others, with the most complex cases generally referred to vitreoretinal surgeons. 

Minor complications include but are not limited to:  

  • Minor damage to the iris or cornea  
  • High or low pressure in the eye (usually temporary) 
  • Swelling of the retina or cornea which may require additional drops  
  • Prolonged Inflammation in the eye which would require an extended course of drops 
  • Rupture of the posterior capsule of the lens with or without vitreous loss, which would require further surgery at the time of the procedure. This is an area I lecturein, and regularly teach other trainees and Consultants as to how to treat correctly. 
  • Refractive surprise, resulting in unexpected short- or long-sightedness, or increasedastigmatism. This may require glasses or further surgery 
  • Temporary bruising and swelling around the eyelids 
  • Lid drooping which may very rarely persist 
  • Possible allergy to drops 
  • Double vision which is usually very temporary 
  • Glare, haloes or dysphotopsias with premium IOLs which usually settle over time in most patients.  
  • Thickening of the posterior capsule in the months or years following surgery.

Severe complications include: 

  • Retinal detachment. The risk of this is less than 1% but if it occurs, further surgery will be required to prevent visual loss 
  • Blindness in the affected eye due to post-operative infection or bleeding during the operation. The risk of this is extremely low (< 1 in 1000 cases)  
  • Loss of significant cataract fragments into the back of the eye causing severe inflammation and glaucoma. This can only be corrected with surgery by a vitreoretinal surgeon like myself 
  • Severe post-operative inflammation (usually managed with drops and tablets) 
  • Permanent clouding of the cornea requiring corneal graft surgery 
  • Treatment-resistant swelling of the retina resulting in reduced vision


All surgery is performed as a day-case procedure. You will attend the clinic and prior to surgery you will have dilating eye drops eye drops instilled. Mr Balaggan will see you before the operation to ensure you are still happy and comfortable to go ahead and to answer any questions you may have. Once you are ready you will be taken to the operating theatre  

I perform most cataract surgery using mainly just anaesthetic drops alone. Most of my patients prefer this as it avoids the need for a needle injection around the eye to numb it, and is generally well tolerated. In the unlikely event that you may feel some discomfort, I can very readily administer anaesthetic around the eye swiftly eliminating any discomfort. The advantages of a local anaesthetic approach are that there will be no requirement to starve before the procedure, you can go home very soon after the procedure, and there will be no risk to your overall health unlike with general anaesthesia. If you feel that you may be quite anxious during the operation then mild sedation can be provided by one of my team of highly-experienced private Consultant anaesthetists. This is an effective option which still retains the benefits of local anaesthesia. Some patients may still prefer general anaesthesia where you are put completely to sleep for the operation. For this option, you will be required to be nil by mouth prior to surgery and may require some pre-operative tests to ensure safe anaesthesia.  

After the anaesthetic is administered, your eye and face will be covered with a sterile drape. The whole cataract procedure will then be performed though a tiny 2mm incision. You will hear vibrating noises for about half of the procedure. This is the machine breaking up the cataract using ultrasound. You will not be able to see details of what is happening but may see just shapes or bright lights, or nothing at all. The operation will typically last from between 10-20 minutes. Whilst you will need to lie still for the duration of the procedure, you can feel reassured that if you do need to move, you can simply inform me and I will then allow you to make yourself comfortable again. At the end of the procedure I routinely administer some antibiotics and antiseptic to minimise the chance of infection in your eye. I will then place a protective eye shield your eye to be worn overnight.  

You will be able to go home 1-2 hours after a local anaesthetic, and slightly longer after a general anaesthetic. The eye pad is removed and you can start instilling your eye drops. There may be a small amount of discharge at this stage. Initially, your vision may be worse than before the operation. This is perfectly normal and you must not feel alarmed about this. Most people notice a significant improvement in vision in the few days after surgery followed by a gradual improvement in vision over 1-3 weeks.

There may be some discomfort initially which generally becomes less on a day-by-day basis. Simple oral analgesia such as paracetamol for a few days is usually sufficient, if required. It is common to experience mild itching for 1-2 weeks following surgery.  

Drops are prescribed to be used for several weeks following the procedure. Additional drops will be prescribed if the pressure in your eye is found to be excessively high at any point.  

I will arrange to see you on the day of your second eye cataract surgery and then again 3-4 weeks following second eye surgery. If additional visits are advisable, then I will arrange as many visits as required in order to maximise the safety of your eye and to achieve the best final result.

I generally employ modern sutureless microincision surgery for performing your cataract operation. It will be very unlikely that you will require stitchesIf stitches are required, these will be removed 3-4 weeks following the procedure in the outpatient clinic using anaesthetic drops.  

Normally, you should refrain from driving for 3 days following surgery. You may then start driving provided you have sufficiently good vision overall using both eyes to satisfy current DVLA visual criteria. In all instances, you must feel safe to drive. You will be advised whether you need to contact DVLA at your follow up appointments.  

It is generally not advisable to schedule any foreign travel for immediately after eye surgery. If necessary, you can fly 1 week following surgery. 

You can shower and wash your hair from the day after your procedure, however, it is advisable not to allow water to enter the eye for approximately 2 weeks following surgery. This can be avoided with simple measures including wearing swimming goggles during showering or washing your hair backwards in a sink similar to hairdressers.  

It is safe to perform light exercise after surgery. I will individualise the advice relating to more vigorous exercise when I review you at your post-operative visits.  

This will depend on multiple factors including your occupation, the level of vision in your other eye, and whether you must drive for a living. I will tailor this advice to your circumstances, but it is generally prudent to allow 1 week off from work. In most instances, it will be possible to continue to work from home.  

At all stages of your treatment pathway, you will receive my direct access telephone number. This will negate the need to go via any third party, such as a secretary or the hospital, in order to obtain any routine or urgent advice. I will be available 7 days a week for you in this regard. This is a very important aspect to the service I pride myself in providing, giving you the reassurance and confidence to make your journey through this difficult time as smooth and anxiety-free as possible.  

This and all other aspects of the service I provide have resulted in very high satisfaction levels from my former patients, rating my service an average of 4.9/ 5 on Trustpilot.

No-once you have had your cataract removed it is not possible to develop another one. 

There are no known treatments including drops that can prevent the development of cataracts.

Usually you will have surgery on one eye and the second eye will be operated on a few weeks later. 

This very much depends on the type of IOL you choose or are suitable for. Most patients who choose a monofocal lens may not require distance spectacles, but will still likely require varifocal, bifocal or reading spectacles following surgery. If you also have significant astigmatism and have a standard(non-astigmatism-correcting) monofocal lens, then you will likely require glasses for all distances.(links to animations etc) 

Your chances of enjoying spectacle independence will be much higher if you chose to have premium multifocal IOLs, in particular trifocal IOLs. In such instances, you can expect approximately a 90% chance of not requiring spectacles at all for regular near, intermediate and far distances. Pre-existing astigmatism can also often be corrected with toric IOLs. It is important to appreciate that a guarantee of spectacle independence can not be provided by any cataract surgeon or clinic. 

Yes. You can feel reassured knowing that you can spread out the cost of surgery with attractive 0% finance packages available at all the private hospitals I practice atmaking private cataract surgerywith all its advantages much more affordable and accessible.  

You will need to check on an individual basis with your insurers, but most PMI providers do cover the cost of cataract surgery with a standard monofocal IOL. You can be rest assured that I am fully fee-assured so that there will be no extra charges to you from me for standard surgery. PMI providers do not however cover the cost of premium IOLs nor any additional eye scans that may be required should you proceed with this option.

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