Vision Changes and Associated Conditions

Do you or your loved ones notice changes in vision over time? They can be harmless or indicate the onset of an eye condition. In this article Moorfields Private and Moorfields Eye Hospital NHS Foundation Trust consultants address some of the most common symptoms and associated conditions, answering your questions.


Dr Hari Jayaram, Consultant Ophthalmic Surgeon
Cataract causes a gradual blurring of vision and often glare at night, generally whilst driving, which usually worsens over time. Surgery to replace the cloudy lens is the only effective treatment for this. While cataract surgery is the most common operation performed in the UK, it can still be a source of uncertainty for patients.

When should I have my cataract treated?
When the cataract starts to interfere with your day-to-day activities, then it is time to start thinking about the surgery. The timing will vary from person to person, however if you drive a lot or have a job that requires very clear vision, then an operation will probably be recommended at an early stage, even when you may still be able to read well on the vision chart at your local optometrist. Your consultant will be able to advise you on the best timing for the cataract surgery based on your preferences, lifestyle and your eye test results.

What happens during cataract surgery?
During cataract surgery, ultrasound is used to remove the cloudy lens within the eye, and a new artificial lens is implanted to replace this via a small incision that does not even require the use of stitches in the majority of cases. A benefit of the surgery is that the power of the implanted lens can be matched to your visual requirements. Surgery in the private sector allows you to choose from premium lens implants (multifocal and extended depth of focus lens implants) that can offer good vision for both distance and near, therefore reducing the need for glasses altogether after surgery.

How effective is cataract surgery?
Cataract surgery is usually very successful in improving eyesight for the majority of patients, but, as with all surgery, there are risks which your consultant will discuss with you.

Is cataract surgery painful?
Modern cataract surgery is usually quick and can be performed under local anaesthetic making surgery as painless as possible.

How long will I take to recover?
Cataract surgery is performed on a day-case basis meaning you are admitted to hospital, have your operation and are discharged home all in the same day. The recovery times are different for every person, usually approximately 3-4 days. It is normal for your vision to take a few days to improve. Your eyes may additionally be sore, scratchy and light sensitive during this period. You will have both antibiotic and anti-inflammatory drops to help with your recovery after cataract surgery, typically starting the day after surgery. You should be able to return to work a within a week of your operation, depending on your occupation.

Learn about cataract treatment at Moorfields Private.

Age-related Macular Degeneration (AMD)

Mr Bishwanath Pal, Consultant Ophthalmic Surgeon
AMD is a condition that occurs when the macula becomes damaged over time. It mainly affects people over the age of 50 and is in fact, one of the most common causes of vision loss in this age group.

How does AMD affect vision?
Macular degeneration can occur in one or both eyes and lead to a gradual loss or blurring of central vision. People suffering from AMD do not go completely blind; however, their ability to see objects clearly – both close-up and at a distance – is significantly reduced. While the side and peripheral vision usually remain unaffected, patients may find they are unable to drive, read, use a computer or recognise faces.

Are there different types of AMD?
There are two types of AMD – ‘dry’ AMD which is the most common form, and the less common ‘wet’ AMD. In dry AMD, there is slow build-up of waste material which leads to the thinning of the retina in the macula. Initially this may not affect the vision but can slowly progress over the years and impair the central vision. In the wet AMD, abnormal blood vessels grow and leak blood and fluid beneath the macula, which will stop it from working correctly. Eventually, if not treated urgently, this results in scarring and irreversible loss of central vision.

How is AMD diagnosed and treated?
Both dry and wet AMD are diagnosed by detailed OCT scans of the retina at the consultation with an eye specialist. Some forms of dry AMD are helped by specific vitamin supplements, which can slow the progression to advanced macular degeneration. 15-20% of dry AMD can progress to wet AMD.

In wet AMD, if diagnosed early and treated promptly, vision can be stabilised or improved in 95% cases. The treatment usually involves regular intravitreal injections which can stop abnormal blood vessels growing, bleeding and leaking beneath the retina.

What are the latest treatment options of wet and dry AMD?
Vabysmo intravitreal injections is the new line of treatment for wet macular degeneration. For some patients, it can offer better symptomatic control and less frequent injections. Also, there are newer treatments on the horizon for dry macular degeneration which have shown in clinical trials to slow down the progression of geographic atrophy.

Learn about age-related macular degeneration (AMD) treatment at Moorfields Private.

Eye floaters

Mr Jaheed Khan Consultant Ophthalmic Surgeon
Eye floaters are shapes or shadows that people can see drifting across their vision. These can take the form of spots, shadows, clouds or longer strips, all of which could be of various size. Generally harmless, eye floaters can become less noticeable over time. However, in some cases, they can indicate serious eye conditions, especially when they are associated with flashes of light.

Do people get eye floaters as they age?
Generally, yes, with the exception of very short-sighted people with long eyeball lengths who will have marked floaters not related to their ageing process.

As we age, the central part of the vitreous humour becomes more liquid and less firm, and strands of collagen become visible within it, swirling gently when the eye moves.

How can I reduce the impact of eye floaters in my day-to-day life?
The power of focus is strong. The more you focus on your eye floaters the more you notice them. Whereas if you ignore them, your brain usually learns to make them ‘disappear’.

In addition, taking regular breaks and avoiding working in bright white backgrounds where eye floaters can be more noticeable, could also be helpful.

What are the red flags to watch out for when you have eye floaters?
Generally, people should not be concerned about seeing a few floaters in their vision if they’ve been there for some time.

However, things like a new onset or a sudden rush of eye floaters, red blob-like floaters, new floaters in diabetic patients, floaters associated with a curtain-like defect falling in the visual field, new floaters due to a trauma or injury to the eyeball, floaters accompanied with a red eye or pain – all need to be investigated further by an optometrist or GP. They will be able to advise if further treatment or tests are needed.

Learn more about eye floaters.

For over 200 years Moorfields has pioneered research, employed the brightest minds, and delivered visionary eye care. We offer the full range of ophthalmic care including vision correction, cataract, glaucoma and complex eye conditions.

To find out more or book your consultation:
Or call us 0800 328 3421 (Monday – Friday, 8am – 6pm)

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