Cataract surgery

I have a cataract growing, apparently you have to wait until they are ripe!

I’ve been told I need the surgery. I was told in September, but I have put it off because I could manage, and I had other health problems so it all seemed too much. The optician called them ‘significant cataracts’, and said they made it difficult for him to examine my eyes properly.

I can’t read small print or small titles on TV, and I have great difficulty reading the temperature on my oven dial. I rarely read books or newspapers now except online/on Kindle where I can enlarge the texts. I can’t read notices everybody else can read. I’m a lot better in daylight than artificial light, though. I don’t drive, so I don’t think I’m a danger to anyone.

I shall go back to the optician soon, probably in the next few weeks. I am pretty scared at the thought of an operation on my eyes, but it would be nice to see a bit better.

Googling the subject it seems that the concept of a cataract being "ripe" is old hat now, and that they should be dealt with when they start to interfere with daily life. I was wondering about how much interference with daily life constituted a reason for surgery for others who have had the surgery.

I’ve tried to describe how mine are interfering with my life, and the optician thinks I need surgery. I’m the one who has delayed it a bit.

My optician echoes the experience of a friend who has had cataract surgery on both eyes. She was told, as was I, that referral usually happens when the patient’s sight is such that delay would interfere with the ability to drive. It seems it matters not if the patient actually drives. My friend was worried because she lives alone, she expressed her considerable anxiety to her optician who referred her earlier than usual, no objections from the hospital, the operations went ahead. She also said the actual operations were only mildly unpleasant, she was out and about the day after.

My OH had his cataract surgery about 7 years ago, on both eyes. All has been well until 2 weeks ago when he went for an eye test and was told that a film was starting to cover both eyes. He is having laser treatment tomorrow to remove the film.

Nowadays you do not need to wait until they are ripe. Modern methods and surgery make this concept irrelevant.

I was told that the time to have mine done was as soon as they impacted on my life. So the moment I felt it was affecting my driving I saw the optician and had it removed within a few months. The same, 5 years later, with my other eye, same problem - affecting my driving.

I had the same problem as Sar's DH and had 10 minutes laser surgery and haven't had any problems since.

Nowadays if you are short sighted or long sighted the replacement lens can be tailored to your prescription. My surgeon said he couldn't make my sight perfect, I was very short sighted, but I could choose to use to have my lens adjusted so that I only needed glasses for reading or driving. I chose to have driving glasses. After 50 years of wearing specs or contact lens. The joy of walking around without glasses and being able to see properly is still such a pleasure.

People I've known that have had it done have had excellent results.

Sounds as though it went well M0nica - that is encouraging.

I saw the optician today and explained how hard night driving has become; and also that I am having trouble reading, especially reading music - she said there was nothing to be done - no change in prescription would help and it is due to the cataracts. But she also said they were not bad enough to operate. That is why I am wondering how bad it has to be before it is considered to need surgery.

I do not want to have the surgery unnecessarily, but I do want some improvement!

Monica your experience was exactly the same as mine!
No specs after 50 years! What freedom!
It's 8 years since mine were done and even then the 'ripening' idea was old hat.
My first was done just weeks after diagnosis and the second a couple of months later. Although the second was not significant, the surgeon said that with the clear lens exchange (as Monica described) there would be an uncomfortable discrepancy between the eyes.
The op's were far easier than I'd expected and a year or two later, the laser removal of the film that developed was no more fuss than the optician's peripheral vision test (the one where you track the green dots as you spot them).
Push to have them done before you suffer any real deterioration and dismiss the old idea of ripening!
Good luck with this and don't worry at all .

Lucky girl - try a different optician. My optician told me a few years ago that the 'ripe' concept had been superseded as other posters have said.
OP - I was very scared but had minimal discomfort, no pain, and marked SATs papers in the evening.

I am looking through a bit of a fog while writing this - and reading music is hopeless. I may seek a second opinion, or ask my GP to refer to an ophthalmologist.

I had to have a vitrectomy and macular repair. I won't go into complicated detail so you can google it if you are interested. This involved a 3 month recovery period with no driving. I still had some distortion of vision though much improved but it triggered the growth of the already existing cataract. This was a quick, painless operation with no real after effects except sharper vision and I was then discharged from the eye hospital.

I know I also have a cataract in the other eye but it has not changed. Apparently most people get them as they age. The operations have amazing results and I know some people who no longer have to wear glasses subsequently. Of course there are risks with any operation but as others have said, with this one there is little to worry about.

I went to the opticians with my FiL last month and he was told he's got the start of a cataract in one eye, but it didn't require surgery. The three of us had a discussion about cataracts because my FiL is hoping to get back to driving again. The optician said that hospitals have just recently been told to treat cataracts earlier because delaying can affect the person's quality of life. By treating them at an earlier stage patients get the benefit much longer and overall it helps people stay independent and active for longer.

Many trusts were waiting until there was serious deterioration in the person's sight and quite often would only do one eye at a time.

I looked online and everything he said was correct. In October the National Institute for Health and Care Excellence (Nice) warned trusts that restricting cataract surgery until people are virtually blind cannot be justified. It's guidance is the NHS should offer immediate surgery.

I would definitely have the surgery.

It sounds as if it’s time for a change of optician lucky or as you say seek GP referral. Your optician may simply not know about recent advice about quality of life. You could perhaps look up the NICE guidelines and have a copy to hand. Wishing you well with it all, it does seem unnecessary hassle for you.

Lucky some NHS trusts are starting to limit cataract operations by setting standards about how bad your eyes have to be before they will operate. Perhaps you are caught up in this. If so your optician should have explained.

When my eyes were done, 10 years ago, cataract ops were freely available, with mobile medical units coming to the local town and parking up in a public car park. A bit like breast scanning and blood donating untis.

I suggest you go with your plan and have a GP referral to the eye department at your hospital. When we had the lead retinal surgeon at our group meeting. He said that, as you have said, when the cataracts affect your quality of life they can be removed. And added that this point is different for each patient. So go for it and good luck.

M0nica its that rationing of treatment I was referring to and NICE revised its guidelines in October telling NHS Trusts they should not be doing this.

This is the link for anyone who wants to read the revised guidance

NICE Guidelines for managing cataracts in adults

I had the same operation last month as Grandma 2213. As I had a cataract in the eye as well the surgeon did that at the same time. I felt absolutely nothing when he did the cataract and he'd done it in 10 minutes so don't worry, your eye will be anaesthetised.

Several friends have had this done with no problem. Even one who makes everything a problem was fine!

She must have been quite disappointed then?

Spoken to my BIL (an optician) and he says it is all about money. There used to be freer access to surgery, but now they are saying that you have to be having problems with day driving rather than just night, as you can choose not to drive at night!!! And what about the winter??

luck mum in her 90s decided she couldn’t wait for the NHS so had it done privately.

£1k plus for one eye. But you can phone and find out from the consultants secretary she’ll have details of charges.

I’m interested in this as DH was told at a routine eye yesterday that he has the start of both cataracts and macular degeneration. He has an appointment next week with another optician that he has been referred to, so we might find out more then.