If you are skimming, here is a quick summary.
A cataract is clouding of the natural lens inside your eye. It scatters light, so symptoms are often glare, halos, washed-out contrast and a “smudge you can’t clean off”, not just blur.
- Cataracts are usually age-related. You cannot reverse them with drops, but UV protection, not smoking, and good diabetes control can reduce risk and slow progression.
- We confirm cataracts by looking at the lens directly in an eye examination and checking the rest of the eye too because dry eye, prescription shifts, and retinal changes can mimic cataract symptoms.
- Surgery is common and usually very successful. The cloudy lens is replaced with a clear intraocular lens (IOL), an “internal contact lens”.
- NHS and private pathways both exist. Private may offer faster timelines and more lens options, but the “best” choice depends on your eyes and your priorities.
- If night driving is getting stressful, glare is worsening, or your vision feels hazy even with the right glasses, book an eye examination at Eyediology or Blackheath Eyecare.
The full details
People usually don’t come in saying “I think I’ve got cataracts“. They come in saying things like: “I’m finding night driving really challenging“, “Everything looks a bit washed out”, “My glasses are clean but it’s still not crisp“, or “One eye feels like it’s got a smudge I can’t wipe off.” And because cataracts tend to creep up slowly, it can be hard to tell what’s normal ageing, what’s just a prescription shift, and what needs proper checking.
I’m Amiee. I’m a Dispensing Optician and over the years I’ve spent a lot of time talking people through common ocular conditions, what happens i an eye examination and what results mean in real life. For this blog I sat down with Ravi (our optometrist) and basically said: “Right, here are all the cataract questions people ask us. Can we answer them properly in one place?” So this is that. No fluff, no scare tactics, just the full picture.
First, what is a cataract, exactly?
A cataract is clouding of the natural lens inside your eye.
The lens sits behind the coloured part of your eye (the iris) and behind the pupil. When you’re younger, it’s clear. Light passes through cleanly and focuses onto the retina at the back of the eye.
Over time, the lens proteins can change and clump together. Instead of being transparent, the lens becomes hazy. That haze scatters light as it enters the eye. That’s why cataracts often cause glare and “milky” vision rather than a neat, simple blur.
Ravi put it like this when I asked him to explain it without jargon:
“A cataract isn’t a film on the surface of the eye. It’s a change inside the eye. The lens itself becomes less clear, and that scattered light is what creates the glare and halos, and washed-out contrast people describe.”
Are there different types of cataract?
Yes, and it matters because it affects symptoms.
- Nuclear cataract – the centre of the lens changes. Often causes a slow general haze and sometimes a surprising short-term shift where reading feels easier for a bit (people call it “second sight”).
- Cortical cataract – changes around the edges of the lens. Can cause glare and streaks, especially at night.
- Posterior subcapsular cataract (PSC) – a change at the back of the lens, close to where light passes through. This one often causes disproportionate glare and trouble in bright light, and it can feel more sudden.
You don’t need to memorise these. The point is that cataracts aren’t one single “thing”. The pattern helps explain why your symptoms feel the way they do.
What do cataracts feel like day to day?
Here’s what we hear most often in practice:
- Glare and halos around headlights and streetlights. Night driving becomes stressful.
- Washed-out colours or a yellowish tint.
- Reduced contrast. Everything looks a bit flat, especially in dim light.
- Blur that doesn’t clean up even with the right glasses.
- More light needed to read.
- Frequent prescription changes or “My new glasses are better, but not better enough.”
- One eye worse than the other (very common).
One important detail. Cataracts can be present and mild without causing much trouble. A lot of people have early lens changes we can see on examination, but they’re not yet the reason vision feels off. That’s why the eye examination matters. We’re not just labelling, we’re working out what’s actually driving your symptoms.
Are cataracts inevitable? Preventable? Or both?
Most cataracts are age-related. If you live long enough, the lens will change. That’s normal biology. But “age-related” doesn’t mean “nothing you can do”.
Things that are linked with cataracts developing earlier or progressing faster include:
- UV exposure (especially without sunglasses over years).
- Smoking.
- Diabetes (particularly if blood sugar control is poor).
- Long-term steroid use (tablets, inhalers, sometimes eye drops. It depends on dose and duration).
- Eye injury or surgery.
- Short-sightedness (myopia) can be associated with earlier changes.
- Family tendency. Some people just get them earlier.
Ravi’s take:
“You can’t ‘detox’ a cataract away, and you can’t reverse it with drops. But you can absolutely influence risk. UV protection, not smoking, and good diabetes control genuinely matter over the long term.”
So cataracts aren’t fully preventable, but you can reduce risk and slow progression.
How do we know it’s cataracts and not something else?
People assume blur equals cataract, but we also see:
- Dry eye causing smeary vision and glare (especially on screens).
- A prescription shift (sometimes big enough to feel dramatic).
- Astigmatism changes.
- Posterior capsule opacity (PCO) (a haze that can happen after cataract surgery. Different issue, different treatment).
- Macular changes (the retina) that affect sharpness and distortion.
- Optic nerve issues that affect contrast and clarity.
What we check in an eye examination when cataract is suspected
In a proper eye examination, we’re not guessing. We’re looking at the lens directly and checking the whole system.
Typically, that includes:
1. Your symptoms and timeline
When did it start? One eye or both? Glare, driving, reading, headaches, contact lenses, general health, medications.
2. Vision and refraction (prescription check)
Cataracts can cause prescription changes, but the pattern matters.
3. Slit lamp examination of the lens
This is the key part. We look at the lens under magnification and illumination and assess the type and density of any cataract changes.
4. Eye pressure and front-of-eye health
Because not every painful or light-sensitive eye is cataract-related.
5. Retinal health checks
We need to know the “screen” at the back of the eye is healthy too because cataract surgery can clear the lens, but it can’t fix a retinal problem.
At Blackheath, we currently offer a more in-depth advanced eye examination option, and the same level of imaging and detail is coming to Eyediology very soon (summer 2026). The important bit is this: between Eyediology and Blackheath Eyecare, you’re choosing between two practices that take eye health seriously, with experienced clinicians and the right equipment to properly assess what’s going on.
How do you know if you’re likely to need cataract surgery?
Cataract surgery is usually considered when the cataract is affecting function, not just because it exists.
Ravi explained it like this:
“We don’t operate on a cataract because it exists. We operate when it’s affecting function. Driving, reading, work, safety, and when the expected benefit outweighs the risk.”
Things that make surgery more likely sooner:
- Night driving becoming unsafe or avoided.
- Glare that stops you functioning normally.
- Vision that can’t be improved enough with glasses.
- Cataract affecting the view of the retina when we need to monitor other eye health issues.
Things that often mean “not yet”:
- Mild changes we can see, but you’re coping well.
- Vision still corrects nicely with an updated prescription.
- Symptoms are more consistent with dry eye or screen strain.
What actually happens during cataract surgery?
Cataract surgery removes the cloudy natural lens and replaces it with a clear artificial lens called an intraocular lens (IOL), basically an “internal contact lens”. It is usually a day procedure. Recovery varies, but many people notice meaningful improvement within days, with vision settling over the following weeks.
Vision after cataract surgery. Will you still need glasses?
The intraocular lens (IOL) can be chosen to target different outcomes.
Monofocal IOLs (most common)
Designed for clear vision at one main distance, usually distance. Many people still need reading glasses afterwards.
Monovision
One eye set for distance and the other for near. Works brilliantly for some, not for others.
Multifocal lenses or extended depth of focus (EDOF) lenses
Designed to reduce dependence on glasses across distances. They can be great for the right person, but may come with trade-offs like halos or reduced contrast.
Ravi’s honest version:
“The lens choice is about priorities. If night driving is important, we’re careful about anything that could increase halos. If being glasses-free is the priority, we talk through the trade-offs properly. There isn’t one ‘best’ lens. There’s the best lens for that person.”
Eyes still change over time, so you may still need glasses at some point. But cataract surgery can remove the “fog” and glare that glasses cannot fix.
NHS vs private cataract surgery. What’s the difference?
NHS cataract surgery
Eligibility is usually based on how much the cataract affects daily life and vision. Waiting times and thresholds vary by area. NHS surgery is common and can be excellent.
Private cataract surgery
Private surgery may offer faster timelines and more lens options, including multifocal lenses and extended depth of focus (EDOF) lenses. Private is not automatically “better”. It depends on your eyes and your priorities.
Can cataracts come back?
The cataract itself does not grow back. Some people develop posterior capsule opacity (PCO) months or years later, which can feel similar. It is usually treated with a quick YAG capsulotomy laser procedure.
When should you book an eye examination?
Book in if:
- You’ve noticed new glare, especially during night driving.
- Your vision feels hazy or washed out.
- You’re getting more frequent prescription changes.
- One eye feels noticeably worse.
- You’re worried, even if you can’t explain why.
You can book an eye examination at either practice:
Eyediology Styling Opticians (Commercial Street, London)
Blackheath Eyecare (Blackheath, London)
(Advanced eye examination option currently available, with the same level of detail coming to Eyediology very soon, summer 2026.)
If you’re unsure, message us first and we’ll guide you to the right next step.
Cataracts are incredibly common, but that doesn’t mean you should simply put up with changes in your vision.
Many people assume worsening eyesight is “just getting older”, when in reality it could be something that can be diagnosed, monitored, or treated. Equally, not every blurry or glare-filled day is caused by a cataract, which is why a thorough eye examination is so important.
Whether the cause is dry eye, a change in your prescription, a cataract, or another eye health condition, understanding what’s happening is the first step towards finding the right solution.
At Eyediology and Blackheath Eyecare, we take the time to understand not just what we can see during your examination, but how your vision is affecting your everyday life. That allows us to give advice that’s tailored to you, whether that’s simply updating your glasses, monitoring early cataracts, or discussing when cataract surgery may become the right option.
If you’ve noticed changes in your vision, don’t wait until it becomes a problem. Book an eye examination and let us help you see clearly again.
Written by Amiee FBDO (your trusted Dispensing Optician and Boujie Buddha)
