Laser Eye Surgery Frequently Asked Questions

As a cataract develops, the lens becomes increasingly milky, causing a greenish cloudiness. It may also cause a glare in bright lights and change in the focus of the eyes, resulting in the need for frequent changes in glasses prescriptions.

Eventually, the sight does not improve with a change of glasses. As cataracts develop slowly, many people are not aware of this creeping change. They only appreciate how poor their vision had been after the restoration of vision with cataract surgery.

The only way to remove the cloudy vision caused by a cataract is with surgery. You have different options for how the eye focuses after cataract surgery by choosing a replacement lens that matches your individual preference.

Your two main options are to aim for clear vision with or without glasses after surgery.

When we strive for clear vision with glasses after surgery, you could either have both eyes focused for distance and have glasses for reading or vice versa.

For clear vision without glasses after surgery, there are three possible options:

• You could aim to have one eye focused for reading and one for distance, which we call monovision;
• You could have laser refractive correction after cataract surgery, called Presbyond;
• You could have a multifocal lens implanted.

No, we cannot treat cataracts with a laser. We remove a lens with cataracts using ultrasound. Many people assume modern cataract surgery by ultrasound is done by laser. There are new lasers which help in some of the steps of cataract surgery, but ultrasound is still required to complete the surgery.

It is alright to resume normal activities within a few days of cataract surgery, depending on how you feel. Most people can resume gentle exercise such as returning to the gym, yoga and running within a week. The one exception is swimming, where we advise you to wait at least a week to reduce the risk of infection.

Some patients worry about being hit in the eye during sports such as squash, tennis and golf. However, the risk of being hit in the eye by the ball, stick or racquet, is the same as prior to surgery.

Once a cataract has been removed, it cannot recur. However, the capsule – the fine, natural support on which the replacement lens implant rests – can become cloudy. This may cause your vision to deteriorate again. If this happens, we can remove this cloudiness with a laser. We perform this laser procedure in the outpatient’s clinic. It is painless and takes about 2 minutes.

Most people are able to drive the next day, but tend not to as they are quite busy with drops and taking it easy.

If you have cataract surgery at My-iClinic you can wash your hair 24-48 hours afterwards. We recommend that you do so with your head tilted backwards. This is to prevent shampoo or soap getting in your eyes. A splash of shampoo would not damage the eye, but as the eye would be more sensitive than usual, it could be quite uncomfortable.

You can bend and stoop straight away after cataract surgery. We recommend you take things easy initially. We find that patients who don’t rest after surgery tend to take longer to heal.

You can cook straight away after cataract surgery. However, we recommend you take things easy initially and allow your friends and relatives to pamper you at least for the first few days after your surgery. We find that patients who don’t rest after surgery tend to take longer to heal. If you experience any pain or blurring or have any concerns, you should call the eye clinic or mobile number we have given you for advice.

If you have to cough or become uncomfortable during the surgery, speak, and we will stop.

Some people worry they won’t be able to keep their eyes open. We have a little device that supports your eyelids for you, so you don’t have to worry about keeping them open.

The anaesthetic may begin to wear off a couple of hours after your surgery. We advise that you take your usual painkillers in the first 24 hours after your surgery.

Most people notice an improvement in their vision within two days of having cataract surgery. This change depends on how bad the vision was before surgery. It takes most people about six weeks for their vision to completely settle. We advise you to wait about six weeks before seeing your optometrist to continue your eye health care and upgrade your prescription if required.

Nothing in life is risk-free. However, it is more dangerous to live with cataracts than to have cataract surgery.

The intended benefit of cataract surgery is to improve vision. 95% of patients have improved vision if no other eye problems are present. There is a 5% risk of rectifiable surgical or refractive problems. There is also a very low risk – less than 1 in a thousand – of infection or haemorrhage, that could result in severe or permanent loss of vision.

After a few months, some patients get membrane thickening behind the lens implant, which we can easily treat. You may need new reading glasses and/or distance glasses after surgery.

There is no restriction on flying after a cataract operation. Remember to bring all your post-op eye drops with you and use them as instructed. ‘It’s essential that you prioritise attendance at your post-op appointments when making any travel arrangements. If there is no urgency, it’s best to wait till after your routine post-op appointment, which typically would be between 2 and 4 weeks after surgery.

Patients report that things are much brighter, possibly with a blue hue. If you experience any unexpected pain or blurring, or have any concerns, ‘don’t hesitate to call the eye clinic or mobile number ‘you’ve been given for advice.

The greatest danger is poking or rubbing the eye, as this can cause the valve to open, making the wound leak. Because some people rub their eyes in their sleep, we advise you to wear a protective shield (provided by the clinic) at night in bed for the first week only. After this time, you may gradually get back to full normal activities.

Most patients are able to drive the next day. However, many prefer to rest for the first few days.

• Of black African origin;
• Have a close relative with glaucoma;
• Short-sighted;
• Diabetic;
• Have high eye pressure

Anyone with one or more of these risk factors should have their first check for glaucoma much earlier, perhaps as early as 25 years old. There is a risk of sight loss with late presentation of glaucoma.

Patients only become aware of tunnel vision when severe and irreversible damage has occurred. Even in the late stages, some patients remain unaware. However, friends and relatives may observe that the patient has become more clumsy and prone to accidents with a greater tendency to trip and knock things over.

Thankfully, if you regularly attend your sight test and comply with the recommended treatment, you will retain your vision.

A full glaucoma assessment includes:

• General history and detailed questions asked relating to your eye health;
• An assessment of how wide and detailed your field of vision is;
• An eye pressure check;
• A thorough examination of your eye with a bright microscope and sometimes a special contact lens examination called gonioscopy;
• Various scans and images of the front and back of your eyes.

After all these tests, we will review the results and discuss your diagnosis and treatment plan with you.

• Eye drops;
• Laser treatment called trabeculoplasty;
• Eye Surgery

The treatment chosen for you would be personalised to the severity of your glaucoma, your general health, and any allergies or sensitivities you may have. We usually start treatment with eye drops. If the response to initial treatment with eye drops is inadequate, we may offer additional glaucoma drops, laser treatment or surgery.

The treatment aims to maintain your vision. You must comply with your recommended treatment and attend your clinic appointments regularly.

Narrow-angle is more common in older age as the natural lens gets thicker, particularly in long-sighted people. Your optometrist may observe this narrowing on routine examination and refer you to the hospital for further tests and treatment.

• Severe eye pain;
• Redness;
• Seeing halos around lights;
• Nausea and vomiting.

If untreated, this would result in loss of vision.

Angle-closure glaucoma is more common in:

• Older people;
• Long sighted people;
• Women

• Be compliant with your prescribed treatment. To achieve this, use your eye drops every day without fail, as prescribed;
• Attend all your clinic appointments regularly;
• If you are a smoker, it is beneficial to reduce or stop smoking altogether. Consider attending the smoke cessation clinic for support;
• If you are diabetic, make sure you have good control of your blood sugar;
• Ensure your blood pressure is optimally controlled. Too low or too high blood pressure are bad for glaucoma.

Factors your specialist considers when setting your target pressure includes:

• Your age at the time of diagnosis;
• Your life expectancy;
• Your race and family history of glaucoma;
• The severity of your glaucoma;
• The condition of your other eye;
• Side effects of treatment and your preferences.

Treatment aims to stop or at least slow down the rate of progressive loss of sight from glaucoma, such that good useful sight outlives you.

In the age-related group, there are two main types, dry and wet. The wet type is so-called because fluid leaks out of the blood vessels at the macular and this damages vision. However, there is an effective treatment for wet type macular degeneration, which involves injecting a drug into the eye.

The dry type is characterised by a process best described as “wearing out” of the retinal cells at the macular, so you can no longer see. Currently, there is no effective treatment for the dry type.

People who suffer from macular degeneration will always have enough vision to get about and will never be entirely in the dark. However, they may not be able to read, drive or see the fine detail that they enjoyed previously.

This could be as a result of:

• Short-sightedness, when close up items are clear and far items are blurred;
• Long-sightedness, when far items are clear and close items are blurred;
• Astigmatism, when objects do not come into single focus.
• Glasses are also sometimes needed to help control a squint.

The need for glasses in children is determined by genes they inherit from their parents, defects before birth and environmental factors. If you are concerned that your child has an eye problem, visit your local optometrist for an eye test.

There is a greater risk of vision, limiting retinal problems later in life with high myopia.

• For every 20 minutes of close work, look into the horizon for 20 seconds.
• Spend at least 2 hours every day outdoors in daylight
• If you are concerned about your child’s eyesight, get them an eye test as soon as possible at your local optometrist’s.

Low-dose atropine eye drops are currently considered to be the most effective intervention for controlling myopia.

Research on the long term effects of atropine and other interventions are ongoing, and no conclusions have been reached. Other helpful interventions are:

• Lifestyle changes
• Adopting the 20-20-2 rule
• For every 20 minutes of close work;
• Look into the horizon for 20 seconds;
• Spend at least 2 hours outdoors daily.
• Use of special multifocal contact lenses;
• Use of night-time contact lenses also called orthokeratology.

There is a great risk of vision-limiting retinal problems later in life with severe or high myopia. We believe the risk of permanent long term damage from myopia is reduced with successful myopia control treatment compared with no treatment.

The common side effects of 1% atropine are mainly blurred vision, sensitivity to light and, less common, erratic behaviour, skin rash, dry mouth, nausea and dizziness. Atropine eye drops may be preserved so that they last 28 days. Preservatives may cause red eyes, discomfort and changes to the ocular surface, especially if used for long periods of time.

Don’t ignore these signs and think they are just habits of children. Early recognition and care can have a significant impact on the health of your child’s eyes.

There will also be the option of low-dose atropine drops. Atropine has the power to slow down the progression of myopia. Children all around the world have begun to receive treatment in clinics that have these drops.

The lenses and drops that we prescribe can correct the blurry distance vision caused by myopia and relieve associated symptoms of myopia such as headaches, eye strain and squinting.

No! As your child may be new to contact lenses or eye drops, sometimes there can be discomfort while they get used to them – this is natural. Over time they will become more comfortable with the treatment.