The benefits of cataract surgery are clear to Valerie
For Dr Valerie Stewart, a semi-retired industrial psychologist from Wincanton, becoming aware that she had cataracts was a gradual process.
“For about six months I was constantly taking off my glasses and cleaning them, because I thought the blurred vision was caused by smears. I found I was unable to read subtitles on the television and I had to fight double vision at the computer screen,”
Valerie visited her optician who told her that she had cataracts. Her optician contacted her GP who confirmed the diagnosis and explained to her that she could choose where she had her treatment.
“Shepton Mallet NHS Treatment Centre was on the list and the waiting time was only three weeks, so I asked my doctor to refer me there,” said Valerie.
She had cataracts replaced in both eyes, with a month’s break between each operation. Valerie was so happy with the level of care she received and the results of her treatment that she wrote an article about her experiences, so that others in a similar predicament would feel reassured about receiving treatment from Shepton Mallet NHS Treatment Centre. A full version of her article follows.
She also designed an information and progress sheet to help other patients undergoing cataract replacement.
“I now have remarkably good vision without glasses and when I wake up I can actually see – despite having a heavy prescription before the procedures. It’s made an incredible difference – the world appears much sharper and brighter.”
“Treatment at Shepton Mallet NHS Treatment Centre was pleasantly surprising – thorough information, efficient treatment, thoughtful good-humoured nurses and other professionals, a comfortable environment and a great result.”
Chester Barnes, Hospital Director at Shepton Mallet NHS Treatment Centre, commented:
“We were delighted when we received Valerie’s article – as an account of her experiences here it is a great asset for patients considering having cataract removal with us. We were very pleased to hear that she was so happy with the care she received.”
It is estimated that around 2.5 million people aged 65 and over in England and Wales have some form of vision impairment caused by cataracts. While cataracts can interfere with everyday life if left untreated, cataract surgery is a successful procedure with good results for almost all patients – and treatment is available on the NHS, there is no need to pay.
A typical cataract story *
Dr Valerie Stewart
My cataract story began when I noticed that I was constantly cleaning my glasses, with no result – the world still looked blurred, I couldn’t read subtitles on the television, and at the computer screen I had to fight double vision. That’s the way it happens for most people, with the addition of poor night vision making driving difficult. In our society you don’t often see the milky-white opaque lenses that signal cataracts in countries that don’t have our level of health care, but the name cataract reminds us that the lens looks as if a waterfall of cloud has grown to obscure the vision. It’s something that comes with age, and there’s not much you can do about it.
It’s a bit of a dog-leg, the process for getting them operated on. The optician tests your eyes and tells you that she can see cataracts; she writes to your doctor, who shows you the ‘choose and book’ system that allows you to look at the waiting times of different local hospitals to find one that suits. At Shepton Mallet Treatment Centre the waiting time was only three weeks, so I booked in there.
Shepton Mallet is a friendly, welcoming, efficient place; Him Indoors (my driver – you shouldn’t drive yourself, you have to have drops in your eyes) was very impressed, wouldn’t mind getting his done there. I saw two different nurses, each with their own test to do, and then the surgeon, who confirmed that I did indeed have cataracts, talked about what the operation involved – replacing my own cloudy lenses with clear, manufactured ones – and booked me in for a month’s time. It wasn’t at all painful; the eyedrops felt for a couple of seconds like squeezing orange juice into the eye, and one of the machines delivers a small puff (that’s to test for glaucoma – increased pressure inside the eye). The private sector couldn’t have been quicker, and I don’t think it could have done better. I’ll say why later. I left with some drops to put in just before leaving home for the operation, a contact phone number, and instructions to wash my hair before the operation because I wouldn’t be able to for several days afterwards.
The one piece of information I didn’t have (and, to be fair, probably couldn’t have with any certainty) was how long it would be before my sight would be dependably normal again. That’s why I’ve written this account, because my experience is pretty typical.
My left eye was much more short-sighted, so they did it first. A few days before the first operation, they telephoned to ask some routine questions: did I have a cold, did I get claustrophobia, could I lie still on my back for twenty minutes. I said that the last question was something that Him Indoors complained about on a regular basis, but you know nurses – they’ve heard it all before.
I put the eyedrops in just before leaving the house, as directed; on arrival I was directed towards a comfortable chair in a pleasant, quiet room with four or five patients in various stages of preparation or recovery. After the usual checklists and tests, the nurse put anaesthetic drops in at intervals, no discomfort at all. The atmosphere was comfortable and competent, with that sense of unhurried calm that nurses project so well. They do about twenty operations a day (the NHS does over 350,000 cataracts per year) so they’ve got a pretty smooth procedure going.
After about 40 minutes it was time to go into the theatre, which had some very impressive high-tech equipment. More checklists, which was reassuring, and onto the table; they put a heavy flexible cover over my face leaving only the eye exposed and immobilised. One of the nurses offered to hold my hand – an offer I accepted, I did feel slightly vulnerable. Once I was comfortable, the surgeon began work, saying what he was doing at each stage, starting by wiping clean the surface of the eye. I couldn’t ‘see’ in any detail what was happening: the field of vision was white-ish, going dark once or twice when the surgeon cleaned the surface, and occasionally I got that effect where you get a quick view of the blood vessels at the back of your eye. There wasn’t much noise apart from the surgeon (and sometimes the machinery) saying what was happening; in fact the most unexpected feeling was that my hair got wet because of course the eye was irrigated several times.
And after twenty very interesting minutes it was thanks all round and back to the comfortable chair, where my eye was covered by a translucent aerated plastic dome for protection. Finally for a chat and cup of tea with the last nurse of the day, who gave instructions on aftercare and made a follow-up appointment for three weeks ahead. Total time taken: less than three hours.
Aftercare was pretty simple. They like to know that you’ve got someone within calling distance for your first night’s sleep, just in case. Keep the cover on for the first day and night, and then put the cover back every night for a week. Don’t do anything likely to challenge the new lens as it settles into its new environment – so don’t rub your eyes, wash half your face only, don’t pick up sacks of coal or put turkeys into the oven, no violent nose-blowing. And there’s a regime of drops to be put in: an antibiotic, which just feels cool and refreshing, followed by an anti-inflammatory, which is pretty uncomfortable for about as long as it takes to draw three or four deep breaths.
As for getting about and leading a normal life: I wouldn’t be passed fit to drive until I’d had the three-week follow-up. I could take the left lens out of my glasses, so that I’d still have something to help my right eye; or I could abandon my glasses completely (they suggested buying a cheap pair of sunglasses if my face felt strange without any covering). And there was a pretty satisfactory third way, given that I’d been wearing varifocals: get a pair of half-eye reading glasses. Without much need for distance vision, the readers suited very well indeed. There was no post-operative pain or discomfort at all, and within a couple of days I had really good vision in my left eye, which was amazing.
The check-up was fine, so we booked the second appointment a month ahead. And the right eye went as smoothly as the left – the only difference was that for a few days it sometimes felt as if I’d got a speck of dust in it and had to stop myself scratching, but that went away eventually. Just as with the left eye, my vision in that eye felt really good after only a couple of days.
There was, however, a bit of a catch. The operation gives you a new lens for old, but the new lens has to bed down in the existing eye-muscles (if you look into a cat’s eyes, you’ll see some of those muscles at work as its pupil goes from a small slit to a big black circle). And like most people my age, my muscles need a spot of help transiting from distance vision to reading, so I really needed those half-eye readers. And like many other people, my eyes weren’t in perfect alignment with each other, and I was getting pretty unpleasant double vision. Of course, these deficiencies had always been there, I’d simply never been aware of them because my spectacles corrected them as well as my short-sightedness. (Opticians correct for the misalignment by prescribing a ‘prism’ – you might look for it in your own prescription if you’ve got a copy).
So the interval between the second operation and actually having perfect all-round vision was about seven weeks: three weeks to wait for the check-up, two weeks before I could get to see the optician, and two weeks waiting for my glasses. I could read, and use my laptop, with the help of reading glasses, but because of the double vision I couldn’t read titles on television programmes and I wasn’t OK to drive. However, I do need an unusually strong prism, so it might not be like that for everyone. And when my new, clear lenses were looking through my brand new spectacles – Yippee!!!! The world looks rinsed clean and bright, as it does in summer after a rain shower. My vision is now clearer than it’s been for years; in fact I can’t remember it ever being so good. I’m now wearing varifocals with prisms; I can see when I wake up, and I don’t lose the soap in the bath. It’s wonderful.
(I said that the private sector couldn’t do better. When I was waiting for the first appointment I asked a few private hospitals what they did, and why they were preferable to the NHS. Several left me with the impression that they would deliver perfect vision, which they can’t; as my experience shows, you can have perfect vision in each lens but they still need help with working together and with reading.
Perfect vision guaranteed? I don’t think so. I was also urged to have both eyes done inside 24 hours, which would have required someone to be with me for the first week – with both eyes covered at night I’d need guiding to bed and bathroom. Some of the eye surgeons at Shepton Mallet go abroad from time to time to work for charities; my advice to anyone contemplating going private is to give them the money and let the NHS do the work).
To sum up: time between the optician saying I had cataracts and having perfect vision: about four months. Pain: hardly any – the eyedrops can sting, that’s all. Adequate vision (for most things except driving): nearly all the time. Unexpected difficulties: just the one, after both lenses had been done but I was waiting for glasses to correct the naughty muscles. Pleasant surprises: many – thorough information, efficient treatment, thoughtful good-humoured nurses and other professionals, comfortable environment, and a great result.
* Views expressed are Dr Valerie Stewart’s and do not reflect those of Shepton Mallet NHS Treatment Centre or Care UK