Patient Information

Understanding your
eyes and your options.

A clear, honest guide to cataracts, how surgery works, what to expect, and the lens choices available to you. There is no pressure here — only information, so that when you meet with Mr Evans, you can have a truly informed conversation.

What is a
cataract?

Inside every eye, behind the coloured part (the iris), sits a clear lens about the size of an M&M. Its job is to focus light onto the retina at the back of the eye, producing the images you see. A cataract is simply the clouding of that lens over time — a natural process that happens to most people as they age.

Cataracts are not a disease, a growth, or anything wrong with the eye itself. They develop slowly, often over years, and are among the most common and most treatable conditions in all of medicine.

A useful way to think about it
"Imagine your eye's natural lens is like the glass in a camera. A cataract is like that glass slowly frosting over — the camera still works, but the image becomes hazier, duller, and harder to focus."

Cataracts develop gradually and symptoms vary. You may notice one or several of the following:

Blurred or hazy vision, as though looking through frosted glass
Colours appearing washed out, faded or yellowed
Increased sensitivity to bright light or glare, particularly when driving at night
Halos around lights, especially at night
Difficulty reading, even with glasses
Needing more light than usual for close work
Frequent changes to your glasses prescription

How surgery works.

Cataract surgery is the most commonly performed operation in the world, with well over 400,000 procedures carried out in the UK each year. It is a day procedure — you come in, have your surgery, and go home the same day. The operation takes around 15 to 20 minutes and is performed under local anaesthetic, meaning you are awake but your eye is completely numb and comfortable.

The procedure involves removing the cloudy natural lens and replacing it with a clear artificial one — an intraocular lens, or IOL. The IOL remains in your eye permanently and requires no maintenance.

1
Preparation
Eye drops are used to dilate your pupil and numb the eye. No injections are needed in most cases. You are awake and can communicate throughout.
2
Removing the cataract
Through a very small incision — less than 3mm — the surgeon uses ultrasound energy to gently break up and remove the cloudy lens. The technique is called phacoemulsification.
3
Inserting the new lens
A folded artificial lens is inserted through the same small incision and unfolds into position inside the eye. The incision is self-sealing and typically requires no stitches.
4
Recovery
Most patients notice an improvement in vision within 24 hours. Full recovery typically takes a few weeks. You will be given eye drops to use after surgery and seen for a follow-up appointment.

See and treat — one visit for everything. Where clinically appropriate, Mr Evans offers assessment and surgery in a single appointment — meaning for suitable patients, there is no need for a separate pre-operative visit. He is the only surgeon in Wales offering this pathway for both cataract and oculoplastic procedures.

Risks and benefits.

Cataract surgery has an excellent safety record and the vast majority of patients experience a significant and lasting improvement in their vision. As with any surgical procedure, there are risks — Mr Evans will discuss these with you personally at your consultation.

Benefits
  • Significant, often dramatic improvement in visual clarity
  • Colours appear brighter, richer and more vivid
  • Reduced glare and improved night vision
  • Reduced dependence on glasses, depending on the lens chosen
  • Improved quality of life, independence and confidence
  • Permanent results — the artificial lens does not cloud again
  • Quick recovery — most patients see improvement within 24 hours
Risks
  • Posterior capsule opacification — a secondary cloudiness that can develop months or years after surgery, easily treated with a quick laser procedure
  • Infection (endophthalmitis) — rare but serious; prevented by antibiotic eye drops used before and after surgery
  • Posterior capsule rupture — a complication during surgery occurring in approximately 1 in 126 cases nationally. Mr Evans' personal rate is 1 in 1,500 — substantially below the national benchmark
  • Retinal detachment — uncommon, more likely in patients with high short-sightedness
  • Residual refractive error — glasses may still be needed for some activities
  • Swelling of the retina (cystoid macular oedema) — usually temporary and treatable

The decision to proceed with surgery is always yours. Mr Evans will explain the likely benefits for your specific situation and help you weigh them honestly against the risks before you make any decision.

Choosing your lens.

When your natural lens is removed, it is replaced with an artificial intraocular lens (IOL). The choice of lens is one of the most important decisions in cataract surgery — different lenses are designed to focus light at different distances, and the right choice depends on your eyes, your lifestyle, and what matters most to you visually.

At Clir Eye, the lens Mr Evans recommends will always be based solely on what is right for you. Our surgical fee is fixed regardless of which lens you choose, so there is no financial incentive behind the recommendation — only clinical judgement.

All three lens types described below are available at Clir Eye. There is no budget option — every patient receives a premium lens as the starting point.

01
Standard choice
Premium Monofocal

A monofocal lens is designed to give you excellent vision at one distance — usually distance, for activities such as driving, walking and watching television. You will typically still need reading glasses for close work such as books, phones and menus.

The lens Mr Evans uses as his standard choice is not a basic monofocal — it is a premium monofocal with enhanced optical quality that provides sharper, higher-contrast vision than a standard lens, particularly in low light conditions. This is the starting point for every patient, not an upgrade.

Best suited to patients who are comfortable wearing reading glasses for close tasks, or who have specific visual demands where the highest possible distance clarity is the priority.

02
Extended range of vision
EDOF — Extended Depth of Focus

An EDOF (Extended Depth of Focus) lens is designed to give you good vision across a wider range of distances — typically excellent distance vision and comfortable intermediate vision (computer screens, dashboards, kitchen worktops), with reduced dependence on glasses for many daily tasks.

Unlike a multifocal lens, an EDOF lens works by elongating the focal point rather than splitting light into separate zones. This typically results in very smooth, natural vision with fewer visual disturbances such as halos or glare at night — making it a good choice for people who drive frequently.

Most patients with an EDOF lens still need reading glasses for small print, though many find they use glasses far less than before surgery.

Best suited to patients who want to reduce their dependence on glasses for everyday tasks, particularly at distance and intermediate range, and who prioritise good quality night vision.

03
Astigmatism correction
Toric

A toric lens is designed for patients who have astigmatism — a common condition where the cornea (the front surface of the eye) is slightly oval rather than perfectly round, like a rugby ball rather than a football. Astigmatism causes blurring and distortion at all distances.

A toric IOL has an additional correction built into it that compensates for the astigmatism of the cornea. Without a toric lens, patients with significant astigmatism would need glasses or contact lenses to correct this even after cataract surgery.

Toric lenses are available in both monofocal and EDOF versions — so the correction of astigmatism can be combined with any of the focal range options above. The additional cost is modest: approximately £80 per eye over the standard package.

Recommended for patients with clinically significant astigmatism, as determined by measurements taken before surgery. Mr Evans will advise whether a toric lens is appropriate for your eyes.

See for yourself
Try the Johnson & Johnson Vision IOL Simulator

Johnson & Johnson have developed an interactive vision simulator that allows you to experience how different lens types affect your vision — across different environments, lighting conditions and distances. It is a genuinely useful way to understand what each lens type might mean for your daily life before you discuss your options with Mr Evans.

Open IOL Simulator →
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