Medical Information
Please find below some information on common ocular conditions:
Cataracts
Cataracts are a relatively common eye condition in adults. They are caused when the lens develops cloudy patches, which leads to blurry and misty vision. Very often they can be left for long periods of time and will cause no ill effects, other than deterioration of sight.
Usually associated with the ageing process, cataracts usually start developing from middle age, although it is possible for children and babies to suffer from them, but this is rare. Trauma to the eye or steroid taking can also kick start the cataract development process.
What are the symptoms of cataracts?
Cataracts are not painful but over time they may start to become visually uncomfortable. They will develop over a number of years and vision will gradually become worse over time.
Help should be sought if one or more of the following symptoms develop:
Blurry or misty vision
Lights become too bright or glaring
Sight in low light becomes challenging
Colours look faded
Difficulties in reading or driving
How are cataracts treated?
In most cases cataracts are harmless and are just monitored at routine eye examinations. However, surgery may be considered when they start to impact daily activities and vision loss is causing problems.
Before treatment is determined, the eyes must be fully assessed. This will involve an eye examination and the administration of eye drops, which will increase the size of the pupil, making the eye easier to examine.
What does the cataract operation involve?
Cataract operations are the most common surgery performed worldwide. Usually carried out under local anaesthetic, the operation only takes between 20 and 45 minutes to perform, depending on the complexity of the case, and the patient is normally allowed home after a few hours.
Although modern cataract surgery is highly effective but, like all medical interventions, there are risks associated with the procedure.
A small incision will be made to the eye and the cloudy lens will be replaced with a clear plastic one. Recovering from the surgery is usually swift with recovery of vision within 48 hours and most people typically start to appreciate the better vision between two and six weeks after the operation.
Once fully recovered vision will be hugely improved, although most people will still need glasses for some tasks after the operation.
What to do following the operation
Although cataract surgery is very common, it is important to take plenty of time to recover from the procedure.
Over the course of the recovery period the following symptoms may be experienced:
Blurred vision
Double vision
Grittiness
Red or bloodshot eye
Watering eyes
Following the surgery, advice will be issued to help further aid recovery and to avoid infection.
Eye drops – these will be issued to help the eye heal and it is important to use the eye drops as instructed, while maintaining good hygiene to reduce the risk of infection.
Night shield – this will also be provided after the operation and can be removed the day after, but should be used for about two weeks after the surgery at night.
Baths and showers – these are fine to continue with, but the eye shield should be worn when washing hair to avoid shampoo getting into the eye.
Active eye use – keep the eye active by reading, working on a computer or watching TV and painkillers should be taken if there is any discomfort.
What NOT to do after the operation
In order to aid recovery and avoid infection it is recommended the following should be avoided during the recuperation period.
Touch – try to avoid touching or rubbing the eye that has been operated on and when administering eye drops ensure hands have been washed.
Avoid driving – getting behind the wheel should be avoided until the doctor has agreed it is safe to start driving again. You can discuss this with the doctor before the operation.
Exercise and housework – should be avoided over the course of the recovery period.
Make up free – do not wear make up for at least four weeks after the surgery.
Click here to download a Cataract information leaflet.
Keratoconus
This condition occurs when the cornea, the clear dome-shaped front surface of the eye, thins and gradually bulges outward into a cone shape. Once the shape of the cornea becomes distorted it can cause blurred vision and sensitivity to light and glare.
Typically, keratoconus starts in puberty and gets progressively worse into the mid-30s. In the early stages the condition causes progressive short sightedness and irregular astigmatism so can be treated with glasses or specialist contact lenses, but further intervention may be required eventually to restore sight.
What are the symptoms of keratoconus?
Keratoconus usually affects both eyes, though it might significantly impact one eye more than the other.
Help should be sought if one or more of the following symptoms develop:
Blurry or misty vision
Lights become too bright or glaring
Inability to improve vision with glasses
Headaches and difficulty focussing
How is keratoconus treated?
Initially, glasses or specialist contact lenses may be prescribed to help correct vision, but as the condition progresses, other procedure options may be explored.
One of the most common approaches is corneal collagen cross-linking (CXL) which is a technique involving vitamin eyedrops and ultraviolet (UV) light to make the tissues in the cornea stronger. If the procedure is successful it could prevent a cornea transplant from being needed in the future.
What does the corneal collagen cross-linking operation involve?
CXL should prevent the eye’s surface from continuing to bulge, the main cause of keratoconus.
There are two types of CXL approaches which are called the epi-off and the experimental epi-on. The epi-off technique involves the doctor removing the epithelium, which covers the front of the cornea, before the drops are administered. The CXL approach with the epi-on, only requires the doctor to loosen the epithelium with eyedrops or a sponge before the eyedrops are put in.
Cross-linking will aim to halt progression, but will not reverse the structural changes already pre-existent in the cornea.
Blepharitis
The most common cause of dry eyes, blepharitis is a condition where the oil glands in the eyelids have become inflamed. It usually affects both eyes along the edges and can clog the eyelashes causing the eyes to become sore, itchy and red.
Dandruff, allergies, mites and certain medications may increase the chance of the condition developing. Although generally uncomfortable, it is not contagious and does not usually cause any long-term damage to the eyes or vision.
What are the symptoms of blepharitis?
People who suffer from dandruff or certain skin conditions, such as eczema, acne or rosacea, which causes redness and bumps on the face, are more likely to develop blepharitis. Oily skin and having allergies can also increase the chance of suffering from the eye condition.
Help should be sought if one or more of the following symptoms develop:
Feeling like there is something in the eye
Crusty eyelids or eyelashes when waking up from a sleep
Burning or stinging eyes
Watery or itchy eyes
Sensitivity to light
Red and swollen eyes or eyelids
Tears that are foamy or have small bubbles in them
Dry eyes
How is blepharitis treated?
The best way to treat blepharitis is to maintain good eyelid hygiene, ensuring they are kept clean as much as possible. Using a soft cloth that has been dipped in warm water and placed over the eyes will help loosen any crusts that have formed, while also helping to prevent the oil glands from further clogging. You will be instructed how to perform good lid hygiene and provided with an information leaflet.
If the problem persists it might be necessary to prescribe steroid and/or antibiotic eye drops to control the redness, swelling, and irritation. Artificial teardrops, which can be purchased without a prescription, might also help ease the symptoms.
If the blepharitis is caused by bacteria it may be necessary to prescribe some antibiotic eye drops, ointments, or pills. Treating the other health conditions, such as eczema, acne, rosacea or dandruff, which might be contributing to the blepharitis, will also help.
Click here to download a Blepharitis information leaflet.
Yag Laser Capsulotomy
Posterior capsule opacification (PCO) is a relatively common occurrence after cataract surgery, affecting about 10% of patients, but is easily treatable using laser technology. A PCO is the development of a thickening of the back (posterior) capsule of the lens which holds your artificial lens in place. Thickening of the capsule means that light is less able to travel through to the light sensitive layer at the back of your eye called the retina. Symptoms include a clouding or blurring of your sight, or you may have problems with bright lights and glare. Patients can experience this problem at any time after surgery
If this happens you may need to have laser treatment to make your vision clear again. This type of laser is safe and has very few complications. The procedure is done by making a gap in the capsule behind your lens using a YAG laser, so that the light can once again pass directly to the retina. For the vast majority of people this can improve vision.
The laser treatment is painless and is carried out while sitting at a machine similar to the one you were examined with in the clinic.
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