Can you leave a cataract untreated?

What does it mean to have a cataract?

A cataract is a clouding of the natural lens in your eye. Imagine looking through a foggy window: everything seems a little bit blurry or less colourful, often with glare. That’s similar to how vision can appear with a cataract. Over time this cloudiness can make it harder to read, drive, or recognize faces.

Usually, cataract forms slowly as part of the natural aging process. However, other known risk factors include overexposure of the eyes to UV light, eye lens injury and long-term high-dose consumption of certain drugs such as steroids.

What is an early cataract?

The early-stage cataract is associated with subtle changes to vision. You may experience a slight blurriness or increased eye strain and tiredness which can manifest as headaches. If you are presbyopic and use reading glasses, you may notice improvements to your near vision while your distance vision becomes less sharp. You may start noticing glare and halos around light sources which can make driving at night less comfortable. It's a good idea to have regular eye tests which can help spot any changes in your vision and eye health early.

If your optician diagnoses a cataract that's not yet causing major problems with your vision, they might initially suggest monitoring it and updating your glasses prescription as needed. However, with cataract being a progressive condition, there will be a point when its symptoms start to affect everyday activities like reading, cooking, watching TV, or driving safely even while using glasses.

How is cataract treated?

The only effective treatment for cataracts is cataract surgery. It involves removing the cataract-affected cloudy lens and replacing it with a clear artificial implant. The treatment - the most common and successful operation in a human body – is quick, taking between 15-30 minutes per eye, and can greatly improve vision. The procedure is usually done under local anaesthetic, so you’ll be awake but won’t feel any pain. If you’re feeling anxious, you can choose to have a mild sedative to help you relax. You’ll be able to go home the same day after the surgery.

The surgery is especially straightforward in the early to medium stages of cataract when the affected lens is less hardened than in the advanced stages and is easier to remove.

Is going treatment-free an option?

Delaying cataract surgery won’t damage the eye, but there is usually no benefit to the delay either. Because cataracts tend to worsen gradually, you might not notice just how much your vision is declining. This slow change can become risky—especially if your eyesight drops below the legal standard for driving without you realizing it.

Over time, everyday life may start to feel blander without the visual crispness and colours that are important for details and nuances.

When is cataract surgery recommended?

Your eye doctor (ophthalmologist/ophthalmic surgeon) will take into account your lifestyle as well as the results from your eye tests when recommending a suitable time for surgery.

Are there any extra benefits of cataract surgery?

The premium types of intraocular lens implants used in private cataract surgery can help to correct any short-sightedness (myopia) or long-sightedness (hyperopia), and associated astigmatism, meaning you can get refractive vision correction and cataract treatment in the same procedure. That means you could reduce or even stop needing glasses altogether.

Your consultant would recommend the best premium lens options based on your eye health and vision needs.

Cataract surgery and glaucoma treatment

If you suffer from glaucoma, there are some advantages to having your cataracts managed by your glaucoma specialist. That’s because cataract surgery can help lower intraocular eye pressure, and it is used as a glaucoma management procedure for some patients who have both cataract and glaucoma.

This is especially true if you have the closed-angle type of glaucoma, where cataract surgery can help improve fluid drainage in the eye and lower eye pressure. However, even if you have open-angle glaucoma, cataract surgery can still help moderately reduce your eye pressure, supporting better long-term control of the condition.

In some cases, your glaucoma specialist may place a tiny stent (like a Hydrus Microstent or iStent) during the same procedure. This can further reduce eye pressure and may even decrease the need for some of your glaucoma eye drops.

The timing of cataract surgery is especially important if you suffer from glaucoma.

It’s generally best to treat cataracts earlier in the course of glaucoma, in case the glaucoma progresses and requires surgical treatment in the future. This is because if cataract surgery is done too soon after certain glaucoma procedures, such as trabeculectomies, it can affect the healing process and make these treatments less effective.

Conversely, if you’ve already had glaucoma surgery like a trabeculectomy, it’s important not to undergo cataract surgery too soon. Operating on the eye shortly after glaucoma surgery could disrupt the healing process and compromise the long-term success of the glaucoma treatment.

While it may be tempting to put off cataract treatment, it’s important to remember that cataracts don’t improve on their own. Left untreated, they will continue to affect your quality of life, slowly dulling your vision and making everyday activities more difficult, less enjoyable and safe.

Thankfully, cataract surgery can restore and improve your vision and brighten up your everyday life.