Say goodbye to cloudy vision with cataract surgery in Sydney

Cataract surgery removes the cloudy natural lens inside the eye and replaces it with a clear artificial lens, called an intraocular lens or IOL. Cataracts can cause blurred vision, glare, halos, poor night driving vision, faded colours, reduced contrast and difficulty seeing fine detail.

At Eye & Laser Surgeons in Sydney, Dr Daya Sharma and Dr Shanel Sharma assess cataracts carefully before recommending surgery. The assessment looks at more than the cataract itself. It also considers your glasses prescription, astigmatism, corneal shape, macular health, optic nerve, eye pressure, dry eye, visual goals and lifestyle needs.

Cataract surgery is not simply about removing a cloudy lens. It is also a chance to plan how your eye will focus after surgery. Some patients want clear distance vision. Others want less dependence on glasses for computer work, reading, sport, driving or travel. The best lens strategy depends on the measurements of your eye, your daily visual needs and whether you have other eye conditions.

Learn more about intraocular lens options, lens replacement surgery, astigmatism treatment.

Book your cataract assessment with Dr Sharma at Bondi or Miranda.

A cataract occurs when the natural lens inside the eye becomes cloudy. The lens normally helps focus light onto the retina. When the lens becomes cloudy, light scatters inside the eye and vision may become blurred, dim, yellowed or glare-affected.

Common symptoms of cataracts include:

• blurred or cloudy vision
• glare from headlights or sunlight
• halos around lights
• difficulty driving at night
• faded colours
• reduced contrast
• difficulty reading
• trouble recognising faces
• frequent changes in glasses prescription
• reduced confidence with walking, stairs or uneven ground

Cataracts usually develop slowly. For that reason, many people do not notice how much their vision has changed until reading, night driving, work, hobbies or daily independence become harder.

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Cataract surgery may be considered when cataracts begin to interfere with daily life. This may include reading, driving, working, recognising faces, using screens, playing sport, walking safely or seeing clearly in low light.

The decision should not depend only on the vision chart. Cataracts can reduce glare tolerance, contrast sensitivity, colour perception and confidence with movement even when the measured vision still appears reasonable.

At Eye & Laser Surgeons, Dr Sharma, your ophthalmologist will consider:

• your symptoms
• your visual acuity
• glare and night-driving issues
• your glasses prescription
• cataract density
• retinal and optic nerve health
• corneal shape and astigmatism
• dry eye and tear film stability
• your work, hobbies and lifestyle goals
• whether cataract surgery is likely to improve your real-world function

Cataract surgery may also improve safety and independence in older adults.

Cataracts affect more than clarity on a vision chart. Poor vision can reduce confidence, independence, mobility, reading ability, social interaction and quality of life.

Research has linked cataract-related visual impairment with falls, fractures, reduced activity, anxiety, depression and reduced quality of life. Cataract surgery may improve vision-related quality of life, and some studies report improvements in mood, sleep, independence and cognitive measures after surgery. However, these outcomes vary, and cataract surgery should not be described as a treatment for dementia, depression or falls.

Cataract surgery is usually performed as day surgery. The cloudy natural lens is removed through a small incision and replaced with a clear intraocular lens. The lens implant becomes a permanent part of the eye.

Most cataract procedures are performed with local anaesthetic and sedation. Your eye is numbed, and you are kept relaxed and comfortable. A small device keeps the eyelids open, so you do not need to worry about blinking. You may see colours or lights during the procedure, but you do not see the surgery itself.

At Eye & Laser Surgeons, cataract surgery is performed at Sydney Surgical Centre in Randwick or Southern Sydney Private Hospital in Miranda. You should usually allow several hours at the surgical facility on the day, even though the operation itself is much shorter.

Choosing the lens implant is one of the most important parts of cataract surgery planning. The intraocular lens helps determine how your eye focuses after surgery.

Different lens options suit different eyes and different lifestyles. The aim is not to choose the most expensive or most complex lens. The aim is to choose the lens strategy that best matches your eye health, measurements, visual priorities and tolerance for optical side effects.

Astigmatism means the eye does not focus light evenly in all directions. It can cause blur, ghosting, distortion or reduced sharpness.

Cataract surgery can provide an opportunity to reduce regular astigmatism. This may involve toric intraocular lenses, incision planning or other astigmatism-management strategies. The right approach depends on the amount, direction and regularity of the astigmatism.

Irregular astigmatism requires extra caution. It may occur with keratoconus, previous pterygium surgery, corneal scarring, contact lens warpage, dry eye or previous laser eye surgery. In these cases, your surgeon may need more detailed corneal imaging before choosing the lens.

Cataracts and glaucoma often occur in the same age group. Glaucoma can affect cataract surgery planning because optic nerve damage may limit the final visual result. Eye pressure also needs careful monitoring before and after surgery.

In selected patients, cataract surgery may be combined with a minimally invasive glaucoma procedure, such as iStent. This is not suitable for every glaucoma patient. The decision depends on the type of glaucoma, eye pressure, optic nerve status, visual field results, current medications and surgical goals.

Cataract surgery can improve the view of the optic nerve and retina, which may help future glaucoma monitoring. However, cataract surgery does not remove the need for glaucoma follow-up.

Macular degeneration affects the macula, the central part of the retina used for reading, recognising faces and seeing fine detail. Cataract surgery can improve vision if cataract is contributing to blur, glare or reduced brightness. However, cataract surgery cannot reverse macular damage.

This is why OCT imaging is important before cataract surgery. If AMD is present, the lens choice should usually prioritise contrast, clarity and retinal image quality. Multifocal lenses may be less suitable in patients with significant macular disease because they can reduce contrast or increase unwanted visual symptoms.

The realistic goal in AMD is often better brightness, less glare, improved contrast and clearer retinal monitoring — not necessarily perfect reading vision.

Diabetes can affect the retina and macula. Before cataract surgery, patients with diabetes may need OCT imaging and retinal examination to check for diabetic retinopathy or diabetic macular oedema.

If diabetic eye disease is active, retinal treatment or closer monitoring may be needed before or after cataract surgery. If the retina is stable, cataract surgery may improve clarity and may also improve the view for future retinal monitoring.

Dry eye can affect cataract surgery planning because an unstable tear film can distort measurements. This can affect lens power calculations, astigmatism measurements and toric lens planning.

Symptoms that may suggest dry eye include burning, watering, grittiness, fluctuating vision, light sensitivity and stinging with drops. Treating the ocular surface before final measurements may improve the accuracy of cataract surgery planning.

Dry eye can make cataract surgery measurements less reliable, especially when planning toric lenses, extended depth of focus lenses, multifocal lenses or monovision. One common cause is meibomian gland dysfunction, where the eyelid oil glands do not stabilise the tear film properly.

IPL, or intense pulsed light treatment, may help selected patients with meibomian gland dysfunction by improving eyelid inflammation, gland function and tear film stability. Before cataract surgery, this can be useful when dry eye is affecting biometry, corneal topography, astigmatism measurements or premium lens planning. Recent evidence suggests that pre-operative IPL combined with meibomian gland expression may improve refractive prediction accuracy in patients with MGD-related dry eye undergoing cataract surgery.

IPL is not needed for every cataract patient. However, when dry eye is clinically significant, treating the ocular surface before final lens measurements may improve planning accuracy and post-operative comfort.

Learn more about dry eye treatment and intraocular lens options.

Patients who have previously had LASIK, PRK, SMILE, TransPRK, or other refractive surgery need more detailed cataract planning. Previous corneal surgery can affect lens power calculations and astigmatism measurements.

If you have had previous laser eye surgery, old records can be helpful. Useful information includes your pre-laser prescription, laser treatment details and pre-operative corneal measurements. Even without old records, modern diagnostic testing can guide planning, but the calculations may be less predictable than in an untreated eye.

Cataract surgery and lens replacement surgery are closely related. Both involve removing the natural lens and replacing it with an intraocular lens.

The difference is the reason for surgery. Cataract surgery treats a cloudy natural lens. Lens replacement surgery, also called refractive lens exchange, may be considered when the main goal is reducing dependence on glasses or contact lenses before a visually significant cataract has developed.

For patients over about 45, lens-based options may sometimes be more appropriate than corneal laser vision correction, especially when presbyopia, early lens change, hyperopia, high myopia or narrow angles are present. However, lens replacement is still intraocular surgery, so the risks and benefits need careful discussion.

Your surgery will be performed as a day procedure. You will need someone to drive you home and stay with you overnight.

Before surgery, you may be asked to:

• continue usual medications unless advised otherwise
• bring your glasses
• bring your medication list
• avoid eye makeup and perfume
• follow fasting instructions
• ask specific medication questions in advance, especially if you use GLP-1 medications such as Ozempic or Mounjaro

During surgery, your eye will be numbed and you will receive sedation to help you stay relaxed. You should not feel pain. If you need to cough or move, tell the surgical team so they can guide you safely.

If both eyes need cataract surgery, they are usually treated on separate days, often about two weeks apart. In selected circumstances, both eyes may be treated on the same day, but this requires specific discussion.

After surgery, you will usually go home with a soft pad and hard shield over the eye. The shield is removed at the first post-operative review, usually the next day. You may then be asked to wear the shield at night for one week.

Vision may be blurry and glary at first. It often improves over days to weeks, although final stabilisation can take longer. The eye may feel tender, watery, scratchy or dry. Some redness or bruising can occur, particularly from anaesthetic.

After cataract surgery, you may be asked to:

• avoid rubbing the eye
• wear the shield at night for one week
• avoid swimming for two weeks
• avoid dusty environments for about one week
• avoid heavy lifting for about one week
• use prescribed drops as directed
• wear sunglasses outdoors if glare is bothersome
• attend your post-operative appointments

Most people can return to normal light activities within a few days, although work in dusty environments may need longer.

New glasses are usually arranged once vision has settled, commonly around four to six weeks after surgery.

Cataract surgery is common and often highly successful, but it is still surgery. The decision should be made after understanding the expected benefits, risks, alternatives and limitations.

Possible risks or side effects include:

• temporary blur or irritation
• dry eye symptoms
• glare or halos
• pressure changes
• inflammation
• swelling of the cornea or retina
• infection
• bleeding
• retinal tear or retinal detachment
• lens implant position problems
• need for additional treatment
• posterior capsule opacification

Other eye conditions can limit the final result. These include macular degeneration, or other macular diseases, glaucoma, diabetic eye disease, corneal scarring, keratoconus, irregular astigmatism and dry eye.

A careful pre-operative assessment helps identify these issues before surgery.

Eye & Laser Surgeons provides cataract assessment and surgery planning from clinics in Bondi Junction and Miranda.

Dr Daya Sharma focuses on cataract, corneal and refractive surgery, including premium cataract surgery, lens replacement surgery, astigmatism management and complex corneal conditions. Dr Shanel Sharma provides cataract surgery, glaucoma, medical retina, paediatric ophthalmology and strabismus care.

This matters because cataract surgery planning often overlaps with other areas of ophthalmology. Lens selection may be different if you have astigmatism, glaucoma, AMD, diabetic eye disease, dry eye, previous laser eye surgery or irregular corneal shape.

Book a Cataract assessment & consultation

Eye and Laser Surgeons — Bondi Junction & Miranda

Bondi Junction: (02) 9387 5300
Miranda: (02) 9531 5300
Email: reception@eyeandlaser.com.au

Cataract surgery at Eye & Laser Surgeons in Sydney involves removing the cloudy natural lens and replacing it with a clear intraocular lens. Dr Daya Sharma and Dr Shanel Sharma assess the cataract, cornea, astigmatism, macula, optic nerve, eye pressure and tear film before recommending surgery. Lens options may include monofocal, toric, extended depth of focus, multifocal or monovision strategies. The most suitable option depends on the patient’s eye health, visual goals and lifestyle. Cataract surgery may improve clarity, glare, contrast, colour perception and daily function when cataract is a major cause of symptoms.