LOOK! NO GLASSES!
The cataract operation
The eye has to be cut making a very small incision. The cataract clouded natural lens is broken up using ultrasound and then sucked out through a narrow tube. Then a new “plastic” (silicon or acrylic) lens is inserted. It may be soft enough to be folded to be inserted through an especially small opening. Tissue grows round the new lens to hold it in place!
For me – success
I don’t often use the expression “I am overjoyed” but having worn glasses since the age of 18 and in recent years with increasing problems seeing, even with glasses, and now finding I can see brilliantly without glasses, well, it’s truly amazing. It seems like a miracle.
The new lens is folded with tweezers and is being put in place
There appeared to be little chance of an operation on my cataracts
About a year ago the optician at Boots Opticians told me that the NHS waiting list for a cataract operation was at least two years. The alternative was a private operation which would cost about £4000 per eye. Waiting list time about eight weeks.
This last October (2023) they said I could now have the operations on the NHS and waiting time was about 8 weeks. It would be done by a private company, SpaMedica which had a clinic on a factory estate in a nearby village, Sayers Common.
On 30th November I went for a very thorough initial assessment by an optometrist and was given eyedrops to use 4 times a day until the operation, to relieve a slight inflammation. Also a date in December for my operation.
When I turned up for the operation in mid December I was shocked to be told that it had been cancelled and the reason was that I had not completed fourteen days of using the eye-drops. The receptionist said the office had left a message on my answerphone. In fact there was no message. And no text, no email, no direct contact.
After a couple of days I had had no communication from SpaMedica. When would I get a new appointment? There was only one phone number on the literature and that took me to an office in Bolton. They didn’t know when my operation would be and told me that the local clinic would contact me. I would have liked a phone number for the local clinic. I think this is a gap in SpaMedica’s otherwise excellent service.
After another few days I was phoned with a date for the operation.
My operation was on Saturday 6th January 2024.
I arrived at 9am. I had a series of eye-drops to dilate the pupil of the right eye, to numb the area and maybe to make the eye as sterile as possible.
At 10.50 I was called into the operating theatre, asked to lie back on the operating bed, and from then on things seemed to happen very quickly with hardly a word spoken.
A small sheet was placed over my face, then I felt scissors cutting round my eye to allow access for the surgeon. I’m not a hundred per cent sure what was going on, but I think at this point my eyelid was clipped back so that I couldn’t blink. I didn’t feel this at all.
I think the next thing was that some iodine was flooded into my eye. I then felt a sensation of wiping across my eye and it seemed to be with quite a strong pressure which was uncomfortable.
A very bright light was swung over my eye and shone into it. What I could see from then on was an intense glare.
I was asked to look down, look up, look left, look right. Was this a test to see if I was still alive?
A number of people have told me that the whole operation is so pain-free that you feel nothing. That wasn’t my experience. There was quite a tickling sensation in the corner of my eye and for a short while my eye felt as if it was being pressed and bruised. There was a feeling of a downward pressure on the eye.
All this took only a few minutes. I was told it was all over and I could get off the operating table. I sat up feeling a bit dazed.
A nurse led me to her tiny office and put a transparent eye-patch over my eye, fixing it with two pieces of tape. The eye shield was to stay in place till the next morning. I was given a bottle of steroidal eye-drops to sooth the eye and ward off infections. I was to put a drop in four times a day.
I had a nice cup of complimentary hot chocolate in the waiting area and waited for Julie to collect me. I tried to see through the transparent eye-shield, but there was no vision, just a dense white fog. I had read that that not all cataract operations are successful and that in two percent of operations vision ended up being worse and that in 0.2 per cent of cases there was severe loss of sight or even blindness.
At home, after about an hour, my eye began to ache. Then it felt as if I had been punched in the eye by a very big fist and really hurt. I had a paracetamol and after a while a second one. After two to three hours the pain went away and didn’t return.
Vision in the eye didn’t return that day.
When I woke up, as instructed I removed the eye-shield. I blinked and looked around. I could see things clearly, though not in the near distance. I knew I would need glasses for reading.
I began to notice that some colours and effects were different and not always for the better. Grass isn’t so green, buttercup growth is much more visible in the lawn, white’s are whiter which is good in a bathroom, but people in the street look paler and not so well.
I had to clean my eye and eyelid with sterilised cotton wool and start the four times a day steroidal eye-drops.
The rule is no driving for at least 48 hours. Julie drove me to a Sunday morning jazz concert in Shoreham, about fifteen miles away. I had had difficulty reading road signs before my operation and was disappointed to find that I still had problems. The letters seemed to dissolve round the edges and blur so I couldn’t read the signs as I would have hoped.
The following days
However, over the next few days my vision became better and better. Whereas it was doubtful if I could have read a number plate at the required twenty metres before the operation even with glasses I can now read a number plate without glasses at thirty metres or more.
When I started driving at night car headlights seemed much brighter. I have read that in the early days after the operation the eye that has been operated on is more sensitive to light.
There were a few restrictions after the operation. Very limited bending down, avoiding dusty places and work, no hoovering for a fortnight (such a disappointment), no heavy lifting or gardening and a few other things. The restrictions on heavy lifting and bending are because these activities can cause increased pressure in the eye and put a strain on the wound.
A follow up appointment is scheduled for a month after the operation with my usual optician.
The NHS and cataract operations
A year ago there were long waits for cataract operations. It seems clear that the NHS has realised that with operations taking only ten minutes actual theatre time they can clear large numbers from their waiting list and deliver a first class service. Taking advantage of this need for eye surgery eye surgeons have organised themselves into specialist companies and set up clinics all over the country to specialise and streamline the whole process. The NHS has contracted out to these companies which has been a great benefit to the thousands of people who need cataract surgery.
I feel very grateful to the NHS, the surgeons, the nurses, ancillary and admin staff and all the people who have made this cataract service possible. They are doing a great job.
SpaMedica is the largest provider of cataract surgery to the NHS.
SpaMedica is a private company founded in 2008. It was acquired in March 2020 by Nordic Capital for £300 M.