CATARACT

If you’ve developed cataracts, you don’t have to simply put up with it. Our cataract surgery, available privately or through the NHS, involves removing your cataract and replacing it with a synthetic intraocular lens (IOL) to help restore your vision. Alternatively, our cataract refractive surgery involves replacing your natural lens with a multi-focal lens, which means that your dependence on glasses can be greatly reduced or eradicated entirely.

What is a cataract?

A cataract is a painless clouding of the lens of the eye. The lens is the crystalline structure that sits behind the pupil and is that part of your eye that helps to focus an image on the retina. The retina is the light-sensitive tissue at the back of your eye. A cataract generally develops over a long period of time, causing your eyesight to get progressively worse. Your vision becomes blurred because the cataract acts as if you are looking through frosted glasses and affects vision. Over time, cataracts become worse and eventually surgery is needed to remove and replace the affected lens.

Can a cataract spread from one eye to another?

Cataracts cannot spread from one eye to another; however they do tend to develop in both eyes around the same time asymmetrically. It is possible to suffer from cataracts in just one eye.

Can I get both eyes treated at once?

Typically, your expert consultant will not perform cataract removal on both eyes at the same time, with each eye requiring a separate procedure. If you need cataract surgery on both eyes then the procedures can generally be done within a few weeks of each other.

Can my cataract come back after it has been removed?

No, once a cataract has been removed it cannot return to the same eye. The artificial lens which replaces your eye’s natural lens in surgery does not allow cataracts to build up, leaving you with clear vision after the treatment.

Do I have to stay overnight after the cataract surgery?

No, the surgery itself only takes a few minutes and the majority of your recovery can be done in the comfort of your own home. It is advisable to arrange for transportation or bring a family member or friend along.

How quickly will my vision be restored?

After your cataract operation, your vision will be blurry at first and you may be asked to wear a protective patch. Your sight should return a few hours after the operation and your vision should improve quickly over the next week or two, reaching its optimum at 4-6 weeks.

What are the treatment options?

At present, the only corrective treatment for a cataract is surgery. Patients contemplating cataract surgery can choose between a standard cataract surgery or cataract refractive surgery. Patients may wish to consider cataract refractive surgery if they want to reduce their dependence on glasses. If the cataract is not removed, vision will gradually get worse and can, if severe, lead to blindness if left untreated.

Will I need glasses, contact lenses or reading glasses after cataract surgery?

Cataract surgery replaces the natural lens with a clear permanent artificial lens. Any existing or future long or short-sightedness problems may still exist. This surgery could help you eliminate or reduce dependence on glasses at the same time as removing your cataract.

Will there be any pain?

The operation itself is pain free. During the procedure a local anesthetic is used to numb the eye and the area surrounding it. After the procedure, mild discomfort or itching is normal. This should disappear in just one or two days.

GLAUCOMA

Glaucoma is a group of eye conditions in which the optic nerve becomes damaged, usually due to a rise in intra-ocular pressure, (IOP). If left untreated this damage, (neuropathy), can cause loss of field of vision and ultimately blindness.

What is Glaucoma?

Glaucoma falls into two categories. The most common form, open angle glaucoma, occurs when the eye’s drainage canals become clogged over time. This prevents the correct amount of fluid from draining away and causes the internal pressure to rise. A much rarer condition, closed angle glaucoma (also known as acute or narrow-angle glaucoma), occurs when the space between the iris and cornea through which fluid passes is unusually narrow and becomes blocked. When this occurs, the inner eye pressure can rise sharply and cause pain, nausea, blurred vision and redness in the eye.

FLOATERS

Floaters appear as spots or strands which drift across the vision as the eye moves. Floaters themselves are harmless and don’t usually interfere with your vision – you may even have them without noticing. This is because your brain constantly adapts to changes in your vision and learns to ignore them. However, in a significant minority, floaters can cause disturbances that affect the quality of vision. If this persists, treatment can be offered. However, the first step is establishing the underlying cause.

ated entirely.

What are the different kinds of floaters?

Long term floaters: usually a symptom of vitreous degeneration and can be very annoying if you suffer with them. They are caused by break-up of the vitreous jelly which fills the inside of the eye. Vitreous gel is 99% water and 1% clear solids that are present from birth. The solids start to become opaque as the gel degenerates.

Acute floaters: A sudden occurrence of floaters, sometimes associated with flashing lights, may indicate that a posterior vitreous detachment (P.V.D) is occurring which could cause a retinal tear. This in turn could lead to a retinal detachment. Acute floaters should be treated as a medical emergency and professional medical advice should be sought within 24 hours.

EYELID CONDITIONS

The primary function of the eyelids is to protect the eye and vision. Eyelid problems are relatively common and can usually be corrected surgically under local anaesthetic.

Eyelid conditions that we treat at Optegra

At Optegra, we offer a range of specialist eyelid treatments for both medical and cosmetic reasons.

Ectropion (outward turning eyelids): Ectropion describes the “rolling out” of the lower eyelid, from its normal position in contact with the eye.

Ectropion: Ectropion  is usually a result of age-related stretching of the lower eyelid, but can also follow a facial nerve palsy or stroke, or result from excessive tightening of the lower lid skin following eczema or a facial trauma. It typically results in a tear overflow and watering due to disturbance of normal tear drainage. This may result in inflammation and soreness of the lower lid and a tightening of the lower lid skin which can further increase the degree of ectropion.

Ectropion: Ectropion can usually be corrected by tightening of the lower lid; insertion of a skin graft may be required in cases of skin ‘shortage’ of the lower lid.

Entropion (inward turning eyelids): Entropion describes the “rolling in” of the lower eyelid (and occasionally upper eyelid), causing the eyelashes to rub against the cornea, that usually results in a feeling of irritation or ‘foreign-body sensation’, and occasionally results in a corneal abrasion and a red painful eye.

Entropion: Entropion usually occurs as a result of age-related stretching and subsequent instability of the eyelid, and can be readily corrected surgically.

Ptosis (drooping eyelid): The upper eyelid can gradually drop with age and gravity, eventually obscuring vision, in one or both upper lids. This may require the patient to continually raise their eyebrows or lift their chin in order to see clearly, which may result in headache and neck pain.

Eyelid ptosis: Eyelid ptosis is usually due to age-related stretching of the tendon of the muscle that elevates the upper eyelid, and can be corrected by surgical tightening of the muscle and tendon.

Eyelid lumps, bumps and benign cysts: The eyelids, a specialised area of skin, can develop skin tags, moles, cysts and other benign lesions as elsewhere on the body. Styes and meibomian cysts (chalazion) are common inflammations of the sebaceous glands of the eyelids, the majority of which will resolve spontaneously in time. Cysts that are particularly symptomatic or which do not resolve sufficiently quickly can be easily incised and drained by an oculoplastic surgeon.

Eyelid tumours: The most common type of skin cancer of the eyelids (and elsewhere) is a basal cell carcinoma (BCC or “rodent ulcer”). This usually grows very slowly, over months and years, often without symptoms, and may be mistaken for a simple cyst or mole. This type of tumour does not spread elsewhere, but can gradually enlarge to distort and destroy the normal eyelid structure, affecting its protective function. Development of BCCs and other eyelid skin cancers is associated with a history of long-term exposure to sunlight and a pale skin type. Excision of an eyelid tumour, and any necessary eyelid reconstruction, may result in disturbance to eyelid structure and function. It is therefore ideally undertaken by a specialist oculoplastic surgeon who has the training and expertise in both ophthalmology and eyelid plastic surgery.

Baggy eyelids (medical issue): The loss of skin elasticity and a forward movement of eyelid fat normally present behind the eye that occurs with age may result in excess upper eyelid skin, known as “dermatochalasis”, which may lead to a ‘tired’ appearance, a feeling of ‘heaviness’, and can sometimes obstruct vision. It can occur in association with a ptosis of the upper eyelid. If sufficiently symptomatic, the excess skin and fat may be removed in a ‘blepharoplasty’ procedure.

Acute floaters: A sudden occurrence of floaters, sometimes associated with flashing lights, may indicate that a posterior vitreous detachment (P.V.D) is occurring which could cause a retinal tear. This in turn could lead to a retinal detachment. Acute floaters should be treated as a medical emergency and professional medical advice should be sought within 24 hours.