Ghost Machine

My Cataract Operation
(DRAFT: Liable to change)

Aaron Sloman
School of Computer Science, University of Birmingham.

Installed: 21 Aug 2013
Last updated: 22 Aug 2013

This paper is
A PDF version may be added later.

A partial index of discussion notes is in


This document has not been approved by the University of Birmingham or the School of
Computer Science, and neither can be held responsible for its contents or any
consequences of anyone reading this. I have produced this merely because I found
having personal information about the cataract operation from a colleague who had
already been through the process very useful in reducing my anxiety before the
operation, so I thought I could provide a similar service to others.



After receiving new spectacles in January 2012 I tested them by looking at near and
distant objects with one eye at a time, the other eye being covered. I felt sure
there was something wrong with the right lens and went back to the optician. I was
re-tested, the prescription was adjusted slightly and I had a new right lens. But I
still felt it was not perfect. However the optician said there was nothing more that
could be done.

Several months later I still felt worried about my right eye and went to my doctor.
He could see nothing wrong and suggested I try a different optician, which I
eventually did in December 2012 using the "Which?" report on opticians. I was then
told I had a cataract in my right eye, which would gradually get worse, and I would
eventually need an operation. It was left to me to decide when to take further action.

Conclusion: If you are unusually self aware and believe that in one or both eyes
your new glasses are not working properly: e.g. some things do not seem to be as
clearly in focus as they should be, even though your optician cannot detect anything
wrong with the prescription or the lenses, then you should consider asking to be
tested for a cataract, which requires specialised equipment which may not be
available at all opticians.

By early March 2013, the blurring in my right eye had increased so much that I phoned
the Birmingham eye hospital to arrange a test and was told I would need to go via my
doctor. I saw the doctor on the 18th March, and he agreed to write to the Queen
Elizabeth Hospital requesting an appointment. My eyes were tested on 14th May and I
was told I could have a cataract operation on 12th August, to which I agreed. I was
given quite a lot of information about the operation, and the subsequent precautions

I mentioned this to a colleague in Canada who told me he had had cataracts removed
and enthused so much about the operation that I was much reassured about the

Type of lens

After my test on 14th May I was informed about the operation and told that most
people choose to have a replacement lens set for far sight, so that glasses are
required only for close up work and perhaps reading, since the replacement lens
cannot accommodate like biological lenses.

I agreed to that option, but later reflected that it would be more convenient to have
my previous regime: with glasses needed for driving and distant vision, but no glasses
required for doing things around the house, or reading, except for small print or
close-up work, e.g. repairing a flute. As I spend so much time working at a desk with
a computer screen I thought it best not to have to use glasses for that.

So I phoned the hospital saying I had changed my mind about the lens. I was then
invited back for a short meeting with the surgeon, who agreed with my decision, after
telling me more about about the options for design of the new lens.

The operation: 12th August 2013
Patient age: nearly 77 years

I had been advised to come accompanied, so Alison, my wife, came with me to the
Queen Elizabeth Hospital. On arrival we were told what the procedure would be and
asked to wait in a small corridor where other patients were also waiting. Some were
there for their second cataract operation. I was checked by a doctor soon after
arriving. My identity was checked informally, and they made sure the eye to be
operated on was marked by an arrow drawn above the right eyebrow, pointing to the
right. Drops to produce dilation (I think) were put in the eye. I then went back to
the waiting area. Where a number of people sitting with arrows above one eye, called
at intervals for their operations.

My turn eventually came after we had been there for about two hours. I was given a
"back to front gown" to cover my clothes and taken to the operating area, where I
lay, fully clothed, on my back for the operation. Before it started my face was
gently covered with a dark cloth covering which had a flap that could be lifted by
the surgeon, to access the right eye.

The operation itself is surprisingly painless, with practically no discomfort. It took
only about 20 minutes. Most of that time most of my face including my left eye was
covered. The eye with the cataract had been given pupil-dilating drops in advance
which stung very slightly, as is common in eye examinations.

Just before the operation the area around the eye was wiped, presumably with a
disinfectant, and more drops were administered, which I think included a local
anaesthetic. There was nothing painful. It was much better than having a dental
anaesthetic injection. I mentioned that I had asked for a lens suitable for reading
at a screen an moving around the house without glasses, and was assured that that
was what had been prepared for me.

During the operation itself I was flat on my back, fully conscious, looking up into
bright lights that were blurred and appeared to move around as the eye was dealt
with, while the doctor made soothing comments, and occasionally 'you may feel a
little pressure'. Some apparatus used in the process made a little noise. I was
conscious throughout, but able to relax, wondering what was going on, but not wanting
to ask!

When it was over, I was accompanied back to the waiting area and offered a hot drink:
chocolate proved very welcome. I suspect the whole process had been more traumatic
for Alison sitting waiting there, than for me.

I had a post-operative check about an hour later, and was then allowed home, with two
bottles of eye-drops to administer six times a day from the next morning.

I was also given a transparent plastic eye shield held on by sticking plaster and told
to keep it on till the next morning, and then use it every night for a couple of weeks.

By the next day I found my eyesight in my right eye much better than it had been for
a long time.

I had been told in the hospital that I might feel some pain afterwards, for which I
could take paracetamol, or any other domestic pain reliever, but I did not need any
pain killer at all. I've had to insert drops six times a day, to continue until my
follow up appointment three weeks after the operation.

My vision is now superb -- even better in the right eye than the left eye, which I
have been told may later need a cataract removed, though at present I am not aware of
anything wrong with it. As hoped, I can now see text on a screen very clearly without
glasses, though I need my glasses for distant vision and driving. The old glasses are
not perfect, but I'll go for a new test after my first post-operative check-up.

Cataract replacement with so little trauma is an amazing product of science and

I hope this report will be helpful to others facing the prospect of cataract removal.

NOTE on Queen Elizabeth University of Birmingham Hospital:
Although I had not been impressed by the hospital web site, especially its maps, I
was very impressed with the on-site arrangements for patients, from the time I had my
first appointment. Checking in was done at a computer screen, which told me where to
wait. Another screen in the waiting area told me when to go in to the Ophthalmology
area, where I was soon take for eye tests, done by a nurse and a more detailed
examination done by a doctor. Everything was very efficient.

When I later phoned to say I had changed my mind about wanting a long-sight lens I
was quickly given an appointment to meet the surgeon and again everything went very
smoothly and efficiently.

On the 5th day after the operation my left eye, which had not been operated on, had
become inflamed and sore. I phoned the hospital on the Saturday morning, and within
about two hours was being seen in the hospital, by a doctor who prescribed eye drops
that seemed to solve the problem after a few days. I suspect I had inadvertently
infected the left eye somehow while administering drops in the right eye, or while
manipulating the eye shield at night. After that I was even more careful about what I
touched when inserting drops or attaching the shield. I was impressed with the speed
of response to my call.

On the basis of my experience so far I would happily recommend this hospital, though
of course I know nothing about the other departments. I was treated as a NHS patient
and paid nothing for the operation, or any of the examinations or pre-operative consultation.

Note: alternative lenses
A relative who had had cataracts replaced some time ago told me that she had heard
that by going to a 'private' (i.e. non-NHS) clinic she could get replacement lenses
with power to accommodate, using new technology, though she would have to pay a
considerable sum for the treatment. (I don't know the exact amount). After the first
eye had been done she was not satisfied with the result and had a normal replacement
lens for the second eye.

When I asked my surgeon about the accommodating lens option he replied that he did
not think the technology would be sufficiently reliable for several more years and his
team would not offer that option now. Please draw your own conclusions if considering
an adaptive lens.

Maintained by Aaron Sloman
School of Computer Science
The University of Birmingham