Not long ago, I bumped into one of our clients on my way into the practice. She had recently had cataract surgery on both eyes, and she could not stop talking about it. She was a little younger than most people are when cataracts appear, and because she has young children, the decision to go ahead had felt like a big one.

For a few years, her vision had been slowly slipping. She had stopped driving at night, her contact lenses had become uncomfortable, and reading for any length of time left her tired. We had been keeping an eye on her cataracts during her routine appointments and advising her on when treatment might be worth considering.

The thing about cataracts is that they creep up on you. Her sight had faded so gradually that she had lost all sense of what she was missing. Nothing quite prepared her for the difference afterwards. Suddenly, she could recognise faces across the road, read street signs again, and she told me the colours looked vivid in a way she had almost forgotten was possible.

She had wanted to put the surgery off for as long as she could. Looking back, she was glad she had not waited longer.

I share this because cataracts worry people more than almost any other eye condition I talk about, and a lot of that worry comes from not knowing the facts. So let me walk you through what a cataract really is, what the symptoms feel like, and what actually happens if you ever need surgery.

Cataracts at a glance

Question	The short answer
What is a cataract?	A clouding of the natural lens inside your eye, not a film on the surface
What causes them?	Most often, ageing, as the proteins in the lens break down over time
Main symptoms	Misty or blurred vision, glare, faded colours and trouble seeing at night
Can you reverse them?	Not with drops or lifestyle changes. Surgery is the only proven treatment
Is surgery serious?	It is a quick, common day case procedure with a very high success rate
Do you always need surgery?	No. Many cataracts are simply monitored until they affect daily life

What a cataract actually is

Your eye has a natural lens sitting just behind the coloured part, the iris. When you are young, that lens is beautifully clear. It is made mostly of water and protein, arranged so neatly that light passes straight through.

As the years go by, some of that protein begins to break down and clump together. Those tiny clumps form cloudy patches, and that cloudiness is what we call a cataract. The clear lens becomes less clear, and your vision gradually follows.

This is the first myth worth clearing up. A cataract is not a skin or a film growing over the front of your eye. It forms inside the eye, within the lens itself, which is why you cannot see it in the mirror and cannot wipe it away.

A clear lens focuses light cleanly. A cataract scatters it, which is why vision turns misty.

What causes cataracts

By far the most common cause is simply getting older. According to the College of Optometrists, most people who develop a cataract in one eye will eventually develop one in the other, although one eye is often affected before the other.

Age is not the only reason they form, though. You may be more likely to develop cataracts if you:

have diabetes
Take steroid medication over a long period
have had an eye injury or eye surgery in the past
have certain eye conditions such as glaucoma or uveitis
spend a lot of time in strong sunlight without UV protection

A very small number of babies are also born with cataracts, which is one of the many reasons children’s eye examinations matter from an early age.

The symptoms to look out for

Cataracts rarely announce themselves. They tend to build so slowly that you adjust without realising. Still, there are some signs that tend to show up as they progress:

vision that looks misty, cloudy or like looking through a dirty window
colours that seem faded or slightly yellow
glare or dazzle from headlights and bright sunshine
haloes around lights, especially at night
needing more light than you used to for reading
frequent changes to your glasses prescription that never quite fix things

When to seek help straight away

Cataracts come on slowly, so they are not an emergency. But some vision changes are. If you notice a sudden loss or dimming of vision, a new shower of floaters, flashing lights, or a dark shadow or curtain spreading across your sight, these are not cataract symptoms and need urgent attention. Contact us, your GP, or your nearest eye casualty department without delay.

If the gradual symptoms above sound familiar, it is worth booking an eye examination. Often, these symptoms have nothing to do with cataracts at all, but the only way to know is to have your eyes properly checked.

If your vision has started to feel less sharp than it used to, a thorough eye examination is the best place to begin. Our unhurried appointments give us the time to look closely and explain exactly what we find. Book an eye examination in Belsize Park.

Busting the most common cataract myths

In years of practice, I have heard the same handful of myths again and again. Let me put a few of them to rest.

Myth: a laser zaps the cataract away

This is the one I hear most. The popular picture of a laser melting the cataract in seconds is not how the operation works.

To remove a cataract, the cloudy lens has to be gently broken up and removed, then replaced with a clear artificial one. In the standard procedure used across the NHS, this is done with ultrasound rather than a laser. The technique is called phacoemulsification, and the ultrasound softens the lens so it can be drawn out through a tiny opening.

Lasers do play a supporting role in some settings. Some surgeons use them to assist with certain steps, and a quick laser treatment is sometimes needed months or years later if the lens capsule clouds over. But the cataract itself is removed by ultrasound, not vaporised by a beam of light.

Myth: eye drops can dissolve a cataract

I wish this were true, because it would save a lot of people from an operation. There are various drops and remedies that claim to cure or slow cataracts, but there is no scientific evidence that any of them work. The only proven treatment is surgery.

Myth: recovery takes months and months

Most people notice their vision improving within days of surgery. The eye does take a little time to settle fully, usually around four to six weeks, and you will not be able to order new glasses until it has healed. But you are not housebound for weeks on end. Many people are back to most of their everyday routine within a few days.

There are sensible limits in the early weeks. It is best to avoid bending over, lifting heavy things and rubbing your eye while it heals. So perhaps hold off on the bungee jumping and the weepy films for a little while.

Myth: cataracts always need surgery straight away

Not at all. In the early stages, a change in your glasses prescription is often enough to keep you seeing comfortably, and many people do not need surgery for a long time, if at all. Waiting usually does no harm to your eyes. Surgery is something we consider only when a cataract starts to get in the way of the things you want to do.

How cataracts are found and monitored

Cataracts are picked up during a routine eye examination. Using a slit lamp, a special microscope with a bright light, I can look directly at the lens inside your eye and see any cloudiness forming, where it sits and how advanced it is.

If you do have an early cataract, it does not necessarily mean anything needs to happen right away. Often we simply note it, update your glasses if that helps, and keep a close watch at your regular eye examinations. You stay in control of the timing, with our guidance along the way.

What cataract surgery actually involves

If a cataract reaches the point where it affects your daily life, and new glasses no longer do the trick, the next step is a referral to an ophthalmologist, an eye surgeon, for surgery.

Here is the reassuring part. Cataract surgery is one of the most common and successful operations carried out in the UK. It is done as a day case, so you go home the same day. It usually takes around half an hour and is carried out under local anaesthetic, which means you are awake, but your eye is completely numb, and you should feel no pain.

The surgeon removes your cloudy lens and replaces it with a clear artificial one, made of plastic, which stays in your eye permanently. If you have cataracts in both eyes, they are usually treated on separate days.

When we refer you, we do so to ophthalmologists we know and trust. We also see you afterwards for your follow-up checks and to update your glasses once your eye has settled, so you are looked after at every stage rather than handed off and forgotten.

If a cataract is already affecting your sight, you do not have to navigate it alone. We refer you to a trusted eye surgeon and look after your aftercare here in Belsize Park. See why our clients choose us.

The cloudiness that can come back

Here is something many people are never told, and it causes a lot of needless worry. Months, or sometimes years, after surgery, your vision in the treated eye can become misty again. This is not the cataract coming back. The cataract is gone for good.

What has happened is that the thin membrane holding your new lens has clouded over. It is a common and harmless after-effect, and it can be cleared with a painless laser treatment that takes only a few minutes. If your vision starts to mist over again after a successful operation, do come and see us so we can check.

Can you prevent cataracts?

I will be honest with you, because I would rather you trust me than oversell you a promise. There is no proven way to stop cataracts from forming. They are, for most of us, simply part of getting older.

That said, a few sensible habits may help slow things down and are good for your eyes and your health more broadly:

Stop smoking, or avoid starting
Wear sunglasses that block both UVA and UVB rays whenever you are out in bright light
Eat plenty of fruit and vegetables as part of a balanced diet
Keep conditions such as diabetes well-managed

None of these is guaranteed to keep cataracts away, but they tilt the odds gently in your favour, and a good pair of UV-protective sunglasses is never a wasted investment.

Driving with cataracts

A common worry is whether a cataract means giving up your licence. In most cases, not yet. You can keep driving as long as you still meet the vision standards, and you only need to tell the DVLA if your sight no longer reaches the legal standard. This is one of the things we check at your eye examination, and we will always tell you plainly where you stand.

How we help at Perspective

Cataracts are rarely an emergency, but they are a very good reason to keep up with regular eye examinations, especially as you move through your sixties and beyond.

At our Belsize Park practice, looking after clients in Hampstead, Primrose Hill, Camden and across North London, we take the time to do this properly. Our appointments are unhurried, our examinations are thorough, and if you ever do need surgery, we guide you through the referral and stay with you for your aftercare. You will never feel rushed or pressured here, and you will always have your questions answered in plain language.

Cataract questions we are often asked

At what age do cataracts usually start?

Most age-related cataracts begin to develop after the age of sixty, although the early protein changes in the lens can start years earlier. Some people develop them younger, particularly with diabetes or long-term steroid use.

Are cataracts painful?

No. A cataract itself causes no pain. It affects the clarity of your vision rather than causing any discomfort, which is part of why it can go unnoticed for so long.

Can a cataract be treated without surgery?

Not once has it affected your sight. In the early stages, a change of glasses may help, but surgery is the only way to remove a cataract. The good news is that it is a safe, quick and very successful procedure.

How long does cataract surgery take?

The operation itself usually takes around thirty minutes, and it is done as a day case under local anaesthetic, so you go home the same day.

Will I still need glasses after cataract surgery?

Possibly. Surgery usually aims to give you clear distance vision, but many people still need glasses for reading or close work afterwards. We update your prescription once your eye has fully settled.

Can cataracts come back after surgery?

No, a cataract cannot return. Occasionally, the membrane behind your new lens clouds over months or years later, which can feel similar, but this is easily cleared with a brief laser treatment.

Cataracts are part of getting older, and the simplest way to stay ahead of them is a regular eye examination. If you are in your sixties or beyond, we would gently suggest a check at least every two years, or sooner if your vision changes. We will spot any cataract early, tell you plainly where things stand and guide you through treatment if you ever need it. Book your appointment or call us on 020 7586 5508.

Cataracts Explained: Symptoms, Myths and the Truth About Surgery