Health condition · Clinically reviewed
Cataracts, the most common age-related vision problem — modern day-case surgery.
A clouding of the eye’s natural lens. Modern day-case phacoemulsification with intraocular lens implantation restores vision safely in a 20-minute procedure.
Why trust this guide
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Clinically reviewed
Written by our editorial team and reviewed by a registered UK clinician before publication.
- 02
Sourced, not summarised
Every claim is checked against NICE, the Royal College of Ophthalmologists or a peer-reviewed source you can see at the end.
- 03
Updated for 2026
Reflects current UK practice on phacoemulsification and intraocular lens choice.
Key facts
Cataracts at a glance.
The essentials, in plain English — what a cataract is, how it is diagnosed, and how it is treated in the UK today.
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What it is
Opacification of the crystalline lens inside the eye, most often age-related.
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How common
The most common cause of reversible visual impairment worldwide.
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Subtypes
Nuclear, cortical and posterior subcapsular — each with a slightly different symptom pattern.
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How it is diagnosed
Clinical: history, visual acuity by an optometrist and slit-lamp examination.
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Modern treatment
Day-case phacoemulsification with intraocular lens implantation — typically a 20-minute procedure.
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Lens choice
Toric IOLs correct astigmatism; multifocal and extended depth-of-focus IOLs reduce dependence on glasses.
Why this guide matters
A common problem with a very good fix.
Cataract surgery is the most-performed operation in the UK — and one of the most successful. The three points below shape everything on this page.
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The lens is replaced, not repaired
The cloudy lens is removed and a clear intraocular lens is implanted — a permanent fix.
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The IOL choice shapes your daily vision
Monofocal, toric or multifocal — each has trade-offs worth understanding before your pre-op.
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Timing is a shared decision
There is no visual-acuity threshold — surgery is offered when the cataract affects your daily life.
How the diagnosis is made
From first symptom to a clear plan.
The steps a UK optometrist and ophthalmologist will normally follow, in order — so you know what to expect.
Phase 1 · Recognising
Symptoms, acuity and slit-lamp exam
Phase 2 · Confirming
Biometry and OCT to exclude other pathology
Phase 3 · Managing
Consultation and IOL choice
- 01
Recognising
Symptom and driving impact
Blur, glare and difficulty at night — especially when driving — usually prompt the check.
- 02
Recognising
Visual acuity and refraction
Optometrist measures acuity with your best correction and updates your prescription.
- 03
Recognising
Slit-lamp examination
A magnified view of the lens confirms clouding and grades the type of cataract.
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Confirming
Biometry for IOL power
Precise measurements of the eye calculate the intraocular lens power you will need.
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Confirming
OCT to exclude coexisting pathology
A macular scan checks for AMD, diabetic changes or other retinal disease.
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Managing
Ophthalmology consultation
Consultant reviews findings, discusses risks and confirms suitability for surgery.
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Managing
Discuss IOL choice
Monofocal, toric or multifocal / extended depth-of-focus — chosen to match your lifestyle.
Typical timeline: 4–12 weeks from optometrist referral to surgery.
Symptoms
What a cataract actually feels like.
Gradual, painless and one-sided at first — here is what to look for and when to seek urgent care.
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Blurred vision
A gradual haze or softness to fine detail, often worse in one eye than the other.
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Glare and halos
Oncoming headlights, low winter sun and bright shop lights become uncomfortable.
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Faded colours
Colours look washed out or yellowed — often only noticed after the first eye is treated.
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Driving difficulty
A common trigger for referral, especially struggling to meet the DVLA number-plate standard.
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Poor night vision
Reduced contrast in low light and increased glare from headlights.
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Second-eye planning
Once one eye is done, the difference is stark — the second eye is usually treated within weeks.
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Post-op capsule opacification
Vision can cloud months to years later — a quick Nd:YAG laser in clinic restores it.
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Red flag: sudden vision loss
Not a cataract. Same-day ophthalmology assessment — could be retinal detachment or vascular event.
Treatment
How cataracts are treated in the UK.
Optical correction first where it still helps, then day-case phacoemulsification with the intraocular lens chosen to fit your life.
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Refraction correction (glasses)
An updated prescription often buys useful time in the early stages.
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Better lighting and magnification
Task lamps and reading aids reduce the impact on daily activities before surgery.
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Phacoemulsification + monofocal IOL
Standard NHS operation — clear distance vision, reading glasses still needed.
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Toric IOL for astigmatism
Corrects pre-existing corneal astigmatism at the same time as removing the cataract.
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Multifocal / EDOF IOL
Extended depth-of-focus and multifocal lenses reduce dependence on glasses at multiple distances.
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Post-op steroid + antibiotic drops
A 4-week tapering course settles inflammation and prevents infection.
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Nd:YAG laser for capsule opacification
A 5-minute outpatient laser clears the membrane behind the IOL if it clouds later.
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Address coexisting AMD or glaucoma
Managed alongside cataract to protect the visual outcome.
What this guide is based on
The sources behind every recommendation on this page.
UK and international specialist society guidelines, current at the time of last review.
Key references
Guidelines and standards we relied on.
A quiet reminder
This guide is for information, not medical advice.
Your optometrist and ophthalmologist know your eyes and can tell you which parts apply to you. If in doubt, book a sight test.
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National Institute for Health and Care Excellence (NICE). Cataracts in adults: management (NG77).
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Royal College of Ophthalmologists. Cataract Surgery Guidelines.
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European Society of Cataract and Refractive Surgeons (ESCRS). Clinical guidelines.
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American Academy of Ophthalmology. Cataract in the Adult Eye Preferred Practice Pattern.
Red flags
When to seek urgent eye care.
A cataract itself is slow and painless. These are the situations where something else is happening — and you should act today.
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Sudden vision loss
Not a cataract — same-day ophthalmology assessment. Consider retinal detachment or vascular cause.
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Post-op endophthalmitis
Increasing pain, redness or vision loss in the days after surgery — attend eye casualty immediately.
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Post-op retinal detachment
New flashes, floaters or a curtain over vision after surgery — urgent same-day review.
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Corneal decompensation
Persistent misty vision after surgery from swollen cornea — needs specialist assessment.
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IOL dislocation
Sudden change in vision or a visible lens edge — contact the surgical team.
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Persistent astigmatism after toric IOL
Unexpected refractive result — reviewed by the operating surgeon for correction.
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Diabetic macular oedema
Can flare after cataract surgery in people with diabetes — needs OCT monitoring.
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Coexisting AMD
Cataract surgery helps, but macular disease limits the final result — expectations set beforehand.
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Congenital cataract in children
Any white pupil reflex in a child — urgent paediatric ophthalmology referral.
Living with it
A short recovery, and a lasting result.
Four things that shape the experience — preparation, recovery, second-eye timing and the long view.
A quiet reminder
The lens choice is worth thinking about.
Ask your surgeon about monofocal, toric and multifocal options — and be honest about what you want your vision to do for you.
- 01 Preparing
Choosing your lens is the biggest decision
Monofocal, toric or multifocal — think about driving, screens, reading and hobbies before your pre-op.
- 02 Recovery
Most people see well within days
Drops for 4 weeks, no swimming or eye-rubbing, and clear vision usually returns within a week.
- 03 Second eye
The second eye is usually straightforward
Timed a few weeks after the first — the visual difference between the two eyes is often the trigger.
- 04 Long-term
One eye, one operation — for life
IOLs do not wear out. If vision clouds later, a quick YAG laser in clinic clears the capsule.
Frequently asked
Everything we get asked about cataracts.
Quick answers on surgery, lens choice, recovery and when to seek urgent help.
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What causes cataracts?
The lens proteins clump with age, becoming cloudy. Diabetes, long-term steroid use, previous eye injury and heavy UV exposure all bring it forward.
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How is cataract surgery done?
Under local anaesthetic drops, a small incision is made in the cornea. The cloudy lens is broken up with ultrasound (phacoemulsification) and removed, then an intraocular lens is implanted in its place. It takes around 20 minutes per eye.
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Which IOL should I choose?
Monofocal gives the sharpest single-distance vision (usually distance, with reading glasses). Toric IOLs correct astigmatism. Multifocal and extended depth-of-focus IOLs reduce dependence on glasses but can cause some halos at night.
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When is cataract surgery offered on the NHS?
When the cataract is affecting your daily life — driving, reading, work or hobbies. There is no visual-acuity threshold under NICE NG77; it is a shared decision based on impact.
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What is posterior capsule opacification?
A cloudy membrane that can form behind the new lens months or years after surgery. It is cleared in seconds by an outpatient Nd:YAG laser — no incision needed.
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When should I worry after cataract surgery?
Increasing pain, worsening vision, marked redness, flashes, floaters or a curtain across the vision — attend eye casualty the same day.
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