A cataract is the clouding of your eyes natural lens. The lens is just behind the pupil of your eye, and it helps to make a clear image on your retina. Usually, this lens is crystal clear.
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;
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.
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 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.
Modern cataract surgery is done by using ultrasound to break up the lens, which is then washed out through a small incision. At My-iClinic, we remove cataracts using the latest technology through the smallest incision. We then choose the best-matched lens for your eye to bring your sight into your desired focus.
We use anaesthetic drops, and anaesthetic infusion to numb your eye, so that cataract surgery does not hurt. After the anaesthetic, most patients experience no pain but can feel movement. You would feel the hands of the surgeon on your forehead, and many people describe seeing a kaleidoscope of bright lights.
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 patients stay awake at the time of their surgery because it is usually over in less than 30 minutes. Occasionally, some patients are so relaxed that they fall asleep. If this happens, we would wake you gently. This is because we want to avoid any sudden movements that could occur if you were startled from a deep sleep.
On the day of your cataract surgery, you will be in the clinic for 2-3 hours in total. We advise that you organise for a friend or relative to bring you in and pick you up after your surgery. It helps if they also plan to spend some time to settle you in at home immediately 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.
The lens replacement after cataract surgery is permanent and does not need to be replaced. After a few months, some patients get membrane thickening behind the lens implant, which causes cloudy vision. We can treat this easily in the clinic with a quick, non-invasive laser procedure called a YAG laser capsulotomy.
Yes, it is all right for you to have a light meal a few hours before your cataract surgery, as we perform the surgery under local anaesthetic. Avoid having anything heavy which may make you feel uncomfortable, as you need to lie flat for about 30 minutes for your surgery. If you have reflux, remember to take all your usual medications.
You should take all your medication as usual on the day of cataract surgery, particularly your high blood pressure tablets. It is all right to continue to take aspirin and warfarin. If you are on warfarin, please get your INR checked to confirm ‘it’s in the correct range within a week of your planned surgery. Please show your warfarin anticoagulant record book and a list of all your current medication to the nurse at the time of your admission.
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.
On the evening of your surgery, your eye may feel a little bit gritty as the numbing drops wear off. It is advisable to take your usual painkillers. Your vision may be blurred in the first 24 hours because of the dilating drops and also because you may have had some antibiotic eye ointment. In the next couple of days, the grittiness should wear off.
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.
You should take things easy for the first few days. You may bend and stoop, but it is probably better to avoid heavy lifting for about ten days.
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.
Once a cataract has been removed, it cannot recur. However, the fine membrane on which the implant rests can occasionally become cloudy, causing the vision to deteriorate again. If this happens, we can remove this cloudiness with a laser. We do this in the outpatient’s department; the treatment is painless and takes about 2 minutes. There is a misconception among some people that this laser can remove a whole cataract; it cannot, but it can remove the cloudiness that sometimes comes after the operation.
Just because you have a cataract does not mean that you have to have it removed. Cataract surgery only becomes necessary if you are not happy with your vision and want to see better. Talk to us if you have any questions or concerns about your vision.
Every patient is different. Be sure to ask us for specific advice on caring for your eye after the procedure. We may ask you to refrain from rubbing your eye or engaging in any strenuous activity for a few weeks after surgery.
Book a free screening to see if you can be free of glasses and contact lenses
The best way to find out if laser eye treatment is right for you is to have an in-person assessment. You’ll get a clear answer from our experts on your suitability and vision correction options
Emerging evidence is beginning to show that spending time outdoors in the very early years of life protects against developing myopia. What the child does outdoors doesn’t matter; just being outdoors is enough.
Glaucoma is damage to the nerve, which transmits vision signals from the eyeball to the brain. It is commonly associated with high pressures in the eye.
There are many types of glaucoma; open-angle glaucoma otherwise known as chronic glaucoma, and narrow-angle glaucoma which often progresses to angle-closure glaucoma.
Most of the time, when people talk of glaucoma, they are referring to the open-angle type. open-angle glaucoma is described as the silent thief of sight because the loss of vision is painless.
Narrow-angle glaucoma can have no symptoms but can progress to angle-closure. In angle-closure glaucoma, which is much less common, patients complain of seeing halos around lights and a dull eye ache. This may progress to severe eye pain, redness and blurring of vision associated with nausea and vomiting.
Without treatment, glaucoma initially results in loss of peripheral field of vision then tunnel vision and eventually irreversible sight loss.
In its early stages, chronic glaucoma has no symptoms, which is why it is called the silent thief of vision. Early diagnosis is only possible by regular sight tests by your optician or eye specialist. As such everyone over the age of 40 should have a sight test at least once every two years. There is a higher risk of earlier onset and more severe glaucoma if you are:
Of black African origin;
Have a close relative with glaucoma;
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.
If you are at risk of glaucoma and neglect getting tested, you risk damage to your sight. Everyone over the age of 40 or with a family history of glaucoma should have an eye examination at least once every two years. Chronic glaucoma has no symptoms. Without eye tests, glaucoma presentation is late, and the risk of sight loss is high.
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.
When attending an eye test, it is better not to drive yourself, as you may need to have drops that blur your vision. Be prepared to spend at least 90 minutes in the clinic. Please bring your current glasses and a list of your current medication with you.
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.
The treatment options for open-angle glaucoma are:
Laser treatment called trabeculoplasty;
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.
The various drops used to treat glaucoma have different side effects. About 1 in 3 patients experience some redness and stinging in their eyes on commencing eye drops for glaucoma. These symptoms tend to improve within 6-8 weeks. Other side effects include breathlessness if you are asthmatic, sunken eyes, dark rings around the eyes and lengthening of the eyelashes. Please mention any side effects you may be experiencing to your eye specialist as you may benefit from a change to alternative treatment.
Yes, children can have glaucoma, but it is very rare. Congenital glaucoma occurs in infants, and juvenile glaucoma occurs between the ages of 5 and 35. The signs of congenital glaucoma is a large eye with a glazed appearance. This may be accompanied by eye rubbing redness and watering. If your child has a combination of these signs, bring them to your general practitioner or nearest eye specialist. On the other hand, there are no early signs of infantile glaucoma. If you have a family history of early-onset glaucoma or are concerned that your child is having trouble with their sight, get them an appointment at your local optometrist for a sight test.
To be able to see, a healthy eye has to have transparent parts with no blood vessels. Nutrients and oxygen are supplied to these areas by a clear fluid called the aqueous. The exit route for the aqueous is the angle that lies between the coloured iris and the transparent cornea. If the angle becomes too narrow or closes, the fluid is not able to escape, and the pressure builds up.
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.
The treatment of narrow-angle helps prevent painful angle-closure glaucoma, which happens in about 1 in 20 people with narrow angles. If tests confirm that the angle is dangerously narrow, then you would be offered laser treatment or surgery to create a safer fluid drainage route. The laser treatment is YAG Laser iridotomy. The surgery is called clear lens extraction. We will discuss which treatment is more appropriate for you.
No, there is no such thing as an “eye exercise” or routine eye massage for treating glaucoma. If you are concerned you have glaucoma, arrange to see your local optometrist or eye specialist for initial testing and advice.
The target eye pressure is the pressure at which the likelihood of symptomatic loss of vision from glaucoma becomes negligible. This pressure is typically around 30% less than the eye pressure at the time of the first presentation with 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.
Yes. People with a close relative with glaucoma have a slightly increased chance of developing it themselves.
Here’s what Londoners say after eye treatment
We are proud to hear we make a meaningful difference to your life
Mr Bolger suggested having cataract surgery on both eyes on the same day and whilst I had concerns, I decided to go ahead. The day after I was able to remove the eye pads and I had perfect vision. I have told many people that it was the best thing I have ever spent my money on. I have needed spectacles or contact lenses since I was 9 years old and now have 20/20 vision with no assistance from spectacles. I would highly recommend the My-iClinic.
Mrs Penelope Carrozza
Double cataract removal in September 2018. The total experience from initial consultation to operation was most efficient. The result so far has been exactly as described in the brochure, I've never seen so well. I had glasses from just over 1 year old till now, (80+), what a difference!
Just discharged after having monovision cataract surgery in both eyes I am delighted with the outcome. I can see both near and far and have been able to dispense with my contact lenses and glasses. I have been well looked after from my first contact. Mr Bolger was very professional and reassuring and I felt at all times that I was in good hands. I cannot fault the whole experience including the charges, which having researched various alternatives, proved to be very reasonable.
I had high confidence in the team working at My-iClinic due to their attentive and thorough end-to-end service, from the reception desk to the operation theatre. I have recommended the practice already to multiple friends, family members and colleagues. (And my eyesight is better than I even hoped for!)
Absolutely fantastic. I was very nervous having my laser treatment for narrow angle glaucoma. The Consultant was wonderful, caring and very understanding. She talked me through the procedure and was extremely patient. Definitely recommend My-iClinic.
Macular degeneration affects mostly older people and its incidence increases with age. About three people per 1000 over the age of 50 will develop macular degeneration. It’s very rare in young people, and it is usually due to an inherited abnormality.
Yes. There are inherited macular degenerations which affect mostly younger people, but these are very rare. Most macular degeneration is categorised as “age-related” meaning that it occurs mainly in older people.
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.
A group of drugs known as anti-vegF can reverse and improve wet macular degeneration. Currently, there are three different brands of these drugs, two of which are licensed. These are Lucentis and Eylea. Because they have been through the regulatory process, they are far more expensive. Another drug of the same group known as Avastin is equally effective and equally safe. However, it has not been through the regulatory process and therefore is much cheaper.
Macular degeneration damages the central vision only. However, the central vision is very important as it allows us to read and to see fine detail. One way to imagine what it would be like to have macular degeneration is to remember the effect of someone taking your photograph with the flash. In the seconds after the camera flash, you can see a black spot in the centre of your vision that moves around as you try to look about. Imagine a much larger black spot, but instead of wearing off in a few seconds it’s permanent. This is the effect of macular degeneration.
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.
Macular degeneration is more commonly seen among smokers and in people who have a poor diet. Diets rich in dark leafy vegetables such as spinach or kale contain nutrients that are believed to protect against the disease. Some practitioners advocate the use of supplements in the form of tablets, but the evidence for their efficacy is very scant.
Children need glasses to see clearly if their eyes are out of focus.
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.
Myopia is near-sightedness. Myopes have longer eyes and the light rays fall in front of the retina. This results in blurring of the vision for mid and far distance. This means the myopic person is able to see objects held close to their eyes, but distant objects are out of focus and can only be brought into focus with visual aids such as glasses, contact lenses or laser eye surgery.
There is a greater risk of vision, limiting retinal problems later in life with high myopia.
Current theories suggest that short-sightedness, also known as myopia, can be triggered by a lot of indoor living and close work activity. Having natural lighting in the house and spending a lot of time outdoors is protective against the development or progression of myopia. An easy reminder for preventing or reducing the severity of short-sightedness is the 20-20-2 rule:
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.
The easiest way to find out if your child needs glasses is to take them to your local optician for an eye test. If either parent needs glasses or had a squint or lazy eye, then the likelihood of them needing glasses is higher.
Current myopia control treatments are lifestyle changes, use of special contract lens and use of very low-dose Atropine. Atropine eye drops can be preserved so that they last 28 days. Preservatives in eye drops are used to prevent contamination. Preservatives may cause red eyes discomfort and changes to the ocular surface, especially if used for long periods.
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.
Low-dose Atropine (0.01%) is a hundredth of the dilution of Atropine 1% eye drops that have been used in clinical practice for decades. It is such a low concentration that the side effects that typically occur with 1% atropine have not been known to occur at a bothersome level.
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.
Before starting the myopia control treatment, your child will have an assessment of historical changes in glasses prescription, family history of myopia, a detailed examination of the front and back of their eyes, test for glasses after eye drops and various non-invasive scans of the eyes.
Myopia is on the increase in modern society, and there is speculation that the reason for this is that much less time is spent outdoors in normal daylight. Modern living also involves a lot more close-up work on smartphones, tablets and computers. Myopia research is an ongoing and evolving field.
If your child has myopia, you may find that they have trouble seeing things from a distance. You may find that they sit too close to the television, squint or don’t pay attention in school because they can’t see the board from where they are sitting. They may also complain about having headaches or tired eyes when they are trying to focus on something from far away.
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.
Currently, there is no cure for myopia. It’s a refractive error caused by the eyeball growing too long during childhood. When this occurs, light entering the eye fails to form a clear focus on the light-resulting in blurry distance vision.
Yes, there are proven methods that we can prescribe to slow the progression of myopia during childhood. My iClinic will be introducing myopia control methods such as specially designed contact lenses. These are contacts that are worn during the day in order to temporarily reverse myopia by reshaping the cornea.
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.
A study was undertaken to see if low-dose Atropine would influence the progression of myopia in young children. The children who took part in the study showed no side effects. This proves that low-dose Atropine may be a solution to help slow down the progression of myopia in your child’s eye.
If you believe your child may have myopia you will need to schedule a consultation with our specialist. During this consultation, we will examine your child’s eye to discuss the best course of treatment for your child, as recommended by the consultant from the test results.
Having Presbyond surgery in no way affects cataract surgery if you require it at a later time. After we remove your cataracts, your vision should return to normal, and you should remain independent of glasses.
Photorefractive keratectomy, or PRK, is rarely used today but there are occasionally situations where it has advantages. A variant, Photo Therapeutic Keratectomy, is frequently used to treat an uncommon condition called recurrent erosion.
The preoperative assessment usually takes about 2 hours, and your vision will be a little blurry until the drops wear off. This normally takes 6 to 8 hours. Many patients return to work the day after the surgery itself, but many prefer to treat themselves to a little time off.
Laser vision correction does not prevent the eyes from being suitable for transplantation.
Here’s what Londoners say about vision correction at My-iClinic
We are proud to hear we make a meaningful difference in your life
Have been dreaming about laser eye surgery since I was 15. Can't believe that my eyes can actually see right now without contacts, wow! Will recommend My-iClinic to all of my friends. Mr Bolger is the best.
Beautiful setup plus excellent service, reassuring expertise of surgeons, friendly staff and yet very professional. Absolutely phenomenal all round! Very pleased with everything.
Brilliant experience with My-iClinic for laser eye surgery. The team are clearly experts in the area, and I felt well looked after through the entire process. Honest, friendly and professional, I thoroughly recommend My-iClinic for anyone considering laser corrective surgery.
Ms Priti Patel
I had a really satisfactory experience with my-iClinic and am quite happy with the results of the surgery and the aftercare. I would like to recommend it to anyone who wants to have any kind of eye surgery with them. Absolutely brilliant.?
I was struggling with a viral conjunctivitis. After 2 visits to Moorfields and the condition getting worse, I was recommended to My-iClinic. I felt instantly looked after, and was seen almost daily due to the severity of the virus. It has now been 4 weeks and I am well on the mend thanks to the care and patience of Mr Bolger. I also found the pricing of this practice extremely reasonable unlike most of private practice medicine.
I’d highly recommend this clinic because of its nice, friendly and experienced team; they all are very professional in every aspect, you would get the best advise here! Also, the clinic looks very modern from the inside and you will just feel very comfortable and relaxed throughout the whole process in a place like this.
About the experts
Meet the My-iClinic founders, Mr John Bolger and Ms Bola Odufuwa. Two consultant eye surgeons who made it their life goal to make your life better.
Consultant Ophthalmologist Clinic Director MBBS DO FRCS (Ed) FRCOphth MSc
Bola Odufuwa is a consultant ophthalmologist at The Royal Free Hospital and My-iClinic. Her specialities include cataract, glaucoma, paediatric, and laser refractive surgery. Bola has had extensive training at Moorfields Eye Hospital, London, where she gained expertise in the management of various eye conditions.
Bola Odufuwa’s special interests include optimal refractive outcomes following cataract surgery, non-penetrating glaucoma surgery, and assessment eyesight in children with special needs: particularly dyslexia and autism.
Mr John Bolger
Consultant Ophthalmologist Clinic Director FRCS DO FEBOS -CR
John Bolger is a Consultant Ophthalmologist and Clinic Director at My-iClinic. His specialities include ophthalmology, laser refractive surgery (SMILE, Presbyond, LASIK, PRK, PTK), refractive lens exchange (RLE), cataract surgery, glaucoma treatment and macular degeneration.
Over the course of his career, John Bolger has carried out over 35,000 cataract operations, 20 of which were for eye surgeons. He has also taught over 1500 young ophthalmologists worldwide as they begin their surgical careers.
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