Cataract · Understanding and treatment

Cataract Treatment and recovery Understand surgery and prepare for a supported recovery. Dr. Nuno Lopes | Ophthalmology The crystalline lens is the eye's natural lens and helps focus images on the retina. When it loses transparency and becomes cloudy, a cataract develops. Ageing is the most common cause; cataracts can also develop in younger people, after injury or in association with diseases and medication. Clear natural lens Lens with cataract Clouding scatters light and may blur vision. Common symptoms Progressively blurred, misty or unfocused vision. Colours appear less vivid or have a different tint. Glare, especially in bright light or when driving at night. How is it treated? Surgery replaces the cloudy lens with an intraocular lens. Eye drops and exercises do not remove cataracts. The decision to operate depends on the effect on daily life and assessment of the eye. It is usually an outpatient procedure with local or topical anaesthesia. Other types of anaesthesia may be needed. Most patients improve, but the result also depends on the retina, optic nerve and other eye conditions. The lens is selected during consultation. Its power is calculated before surgery. Discuss distance and near vision options and reducing dependence on glasses, including each solution's benefits and limitations.

Preparation and the day of surgery 01 Report all medication and confirm instructions about adjustments and food. 02 Wash your face. Do not wear make-up, creams, lotions or perfume on the day of surgery. 03 Have an adult accompany you and bring sunglasses. 04 Before discharge, confirm when to start the drops and remove the dressing. Break up Aspirate Implant the lens The capsule is preserved to support the intraocular lens. In phacoemulsification, ultrasound breaks up the natural lens, which is then aspirated. The capsule is preserved to support the implant. A laser may assist some steps in selected cases; its mechanism differs from ultrasound. When should I start the drops? Time of surgery Protocol reference, unless instructed otherwise Morning Start the same day: early afternoon, mid-afternoon and before bed, as prescribed. Early afternoon Start the same day: mid-afternoon and before bed, as prescribed. End of the day Start the next morning, if this is the team's instruction. Eye dressing: if the eye is covered, remove the dressing at the instructed time, usually when applying the first drops.

Care during recovery Vision may temporarily be misty or fluctuate, with sensitivity to light. Recovery varies. Sunglasses can help while glare persists. The team should monitor improvement. Protection and hygiene Eye shield: if supplied, wear it during sleep and naps until the first appointment, or for the period advised. Avoid pressure: do not scratch, squeeze or rub the eye. Bathing: avoid running water, soap and shampoo directly in the eye. Exertion: avoid sudden movements, bending deeply and lifting weights for the period specified by the team. Activities and comfort Care to maintain Read, watch television and use a computer or phone as tolerated. Wear sunglasses outdoors if recommended, particularly with light sensitivity. You may wear your old glasses if comfortable, bearing in mind that your prescription may have changed. A new prescription is usually assessed around 4 weeks later, depending on stabilisation. FOLLOW YOUR PRESCRIPTION Use eye drops at the prescribed frequency and for the prescribed duration. You do not need to wake during the night unless specifically instructed; spread applications across your waking hours.

Eye drops, warning signs and appointments Applying drops correctly 01 Wash your hands with soap and water. 02 Do not touch the eye, eyelashes or eyelids with the bottle tip. 03 Observe the instructed interval between different eye drops. If no specific interval is given, wait at least 5 minutes. Follow the order on your prescription. 04 Brief mild stinging or burning may occur, particularly with anti-inflammatory drops. Persistent pain or worsening symptoms require contact with the team. 05 Continue your usual treatment for the unoperated eye unless advised otherwise. CONTACT THE TEAM OR EMERGENCY DEPARTMENT IMMEDIATELY Severe or persistent pain; sudden loss or a significant reduction in vision; worsening after initial improvement; increasing redness; purulent discharge; trauma or a blow to the eye. You do not need to lose vision completely before seeking help. Monitor symptoms Avoid pressure and injury Bring your medication Bring all the eye drops and medication you are using to your appointment. The team will confirm the regimen and assess recovery. NEXT APPOINTMENT Date: ____ / ____ / ______ Time: ____ : ____ Location: ___________________________________________________ This guide does not replace individual instructions or follow-up with your ophthalmologist.