Cataracts rank among the most common eye conditions worldwide and, according to a 2018 study by the Royal College of Ophthalmologists, cataract surgery is the most common elective surgical procedure in the UK. London’s Moorfields Eye Hospital – which was established in 1805 and is the largestcentre for ophthalmic treatment, teaching and research in Europe – is at the forefront of cataract treatment and research.
Cataracts is an eye condition that will affect a large number of us, explains Mr Kamran Saha, consultant ophthalmic surgeon at Moorfields.“Many people will, at some point, develop a cataract, it is quite normal to do so,” he says. “Cataracts are the misting of the human lens and, by and large, they occur completely naturally.
“By the time we are in our seventies, many of us will start seeing some misting of the lens and will notice some changes, such as our vision not being quite as clear as it used to be. It is a natural process, which I always liken to getting grey hair – it doesn't represent anything concerning, it's just a normal protein change in our bodies.”
Another typical symptom of cataracts is increased glare, particularly when driving at night. “We deal with many patients from around the world and they often find that headlights can be troublesome,” says Mr Saha. “One of my patients is an artist and she felt that colours didn’t seem quite as vibrant as they once were, and I've also had patients who were struggling with documents and required more light for reading. This comes down to the fact that the lenses are not allowing as much light through, or dispersing the light a lot more than usual, resulting in reduced clarity of vision.”
There are also instances when cataracts can develop for other reasons – for example, people with diabetes may develop cataracts sooner.“Some children can also develop cataracts at a much earlier age and we have an excellent paediatric team to help them with surgery,” reassures Mr Saha.
Typically, patients visit Moorfields Private for a consultation because they have noticed a deterioration in their vision, or because their optician has recognised that their vision can no longer be improved with glasses or contact lenses, identifying cataracts as the probable cause. “At this stage, we would perform some scans to help us understand more about the patient’s eyes, and then have a discussion about how they would like to proceed,”explains Mr Saha. “Most patients will opt to have their cataracts removed, which is a surgical procedure to remove the natural lens and implant a new, artificial one. By doing so, we can, potentially, help them see better than before they developed cataracts.
“For example, if a patient became rather short-sighted or long-sighted before they had cataracts, we can correct this so that they no longer need glasses, because we are implanting a new lens and can choose the sort of vision that the patient would like. It’s about understanding the patient's needs, what they would like to achieve and seeing whether we can match that with the surgery – not just at the time, but also for their long-term goals.
“The vast majority of patients see an improvement in their vision immediately after surgery. Things will still be rather blurry, but the next day is where things really start to come into their own,” explains Mr Saha. “We don't use any needles or stitches, and all the incisions that are made are self-sealing. In terms of post-operative care, there's actually very little needed, just eye drops and being sensible.”
This swiftness in seeing results after cataract surgery, plus the ease and speed of recovery, are particularly helpful for international patients. “Patients are able fly straight after cataract surgery, even jetting in for surgery and getting back home in time for dinner!” says Mr Saha.
“Our consultants can even see patients from overseas on video to discuss ongoing treatments or, perhaps, even have a discussion prior to their arrival in London,” says Mr Saha. “There are always some things that are best dealt with in person, but we try to stay in tune with our international patients and their needs. Not everyone can fly back and forth to London every few months, so we work with the patient to tailor care around them.”
“We have a dedicated international patient team at Moorfields Private. They are the first port of call for patients and can facilitate all aspects of their visit – from communicating with embassies, arranging finances and securing flights and accommodation, all the way through to organising ongoing treatments and follow-up care back in a patient’s native country.” While the vast majority of cataract patients will not require overnight accommodation, Moorfields Private’s locations in central London mean that patients can easily stay in nearby hotels.
As a long-established and world-renowned specialist ophthalmic hospital, Moorfields is at the leading edge of international research driving eye health advances, including lens technology, as Mr Saha explains: “I am very hopeful that new lenses will be coming through in the foreseeable future that will enable us to help not just patients who would like to get rid of their glasses, but also those whose eyes have been affected by underlying eye diseases, such as diabetes, macular degeneration or, perhaps, dystrophies such as retinitis pigmentosa, which affect the light-sensitive tissue at the back of the eye.
“We also carry out a lot of cataract surgery with ultrasound, as well as with lasers. In the future, I think we are going to be seeing a combination of the two, where we can treat patients with ultrasound and lasers more seamlessly to improve patient outcomes, as well as making treatment a lot easier for them.”