Cataract surgery is the most commonly performed surgical procedure in the world. It takes between 15 and 30 minutes, requires no general anaesthetic, and most patients see a dramatic improvement in their vision within 24 to 48 hours. Yet it remains one of the most feared procedures in medicine.

If you or someone you love has been told they have cataracts, this article is written to replace that fear with clarity. It explains what cataracts are, how to recognise the symptoms, what modern cataract surgery actually involves, and what recovery looks like — all from the perspective of a specialist ophthalmologist practising in Kloof and Westville, Durban.

What Is a Cataract?

A cataract is a clouding of the natural lens inside the eye. The lens — which sits behind the iris — is normally crystal clear. Its job is to focus light onto the retina so you can see sharply. Over time, proteins in the lens begin to clump and break down. The lens becomes progressively opaque, scattering light instead of focusing it cleanly. The result is blurred, hazy, and eventually significantly impaired vision.

Cataracts are the leading cause of avoidable blindness in South Africa and globally. The World Health Organisation estimates that cataracts account for roughly 51% of all blindness worldwide — affecting some 20 million people. The encouraging reality is that this blindness is entirely reversible with surgery.

Recognising the Symptoms

Cataracts develop gradually, which is why many patients live with worsening vision for months or even years before seeking help. The symptoms to watch for include:

• Blurred or hazy vision that does not improve with new glasses
• Increased sensitivity to glare — particularly from oncoming headlights at night
• Halos appearing around lights
• Colours that seem faded or yellowed
• Difficulty reading in low light
• Frequent changes to your glasses prescription
• Occasionally, double vision in one eye

If any of these symptoms sound familiar, an eye examination with a specialist ophthalmologist can confirm whether a cataract is responsible — and whether the time has come to consider surgery.

Who Is at Risk?

Age is the primary risk factor. Most cataracts are age-related and become increasingly common after 60. However, cataracts can also develop earlier in life, particularly in:

• People with diabetes
• Those who have used corticosteroid medications for extended periods
• People with a history of eye trauma
• Smokers
• Those with significant UV exposure over many years — something particularly relevant in the South African climate

How Modern Cataract Surgery Works

Cataract surgery has advanced enormously over the past two decades. The gold standard technique today is called phacoemulsification — a microsurgical procedure that removes the cloudy lens and replaces it with a clear, artificial intraocular lens (IOL).

Here is what happens during the procedure:

1. The eye is numbed using anaesthetic drops or a local injection — there is no general anaesthetic required.
2. A tiny incision, just 2 to 3 millimetres wide, is made at the edge of the cornea.
3. Through this incision, the surgeon uses an ultrasound instrument to gently break up and remove the cloudy lens material.
4. A new, folded artificial lens is then inserted through the same incision.
5. Once inside the eye, the lens unfolds into its permanent position.
6. The incision is self-sealing and typically requires no stitches.

The entire procedure takes between 15 and 30 minutes. It is performed as day surgery — patients go home the same day.

Choosing the Right Lens

One of the most important decisions in modern cataract surgery is the type of intraocular lens. Your ophthalmologist will discuss the options with you based on your lifestyle, visual needs, and the health of your eyes. The main lens types include:

• Monofocal lenses, which provide clear vision at one distance (usually far), with reading glasses still needed for close work
• Multifocal lenses, which correct for multiple distances and reduce dependence on glasses
• Toric lenses, which correct astigmatism as well as the cataract
• Extended depth of focus (EDOF) lenses, which offer a continuous range of clear vision

The right lens for you depends on your individual circumstances. This is a conversation best had face to face with your surgeon.

What Recovery Looks Like

Recovery from cataract surgery is remarkably quick. Most patients notice a significant improvement in vision within one to two days. Driving is typically possible within a few days, once your surgeon has confirmed your vision is safe. Full healing takes four to six weeks, during which you will use antibiotic and anti-inflammatory eye drops as prescribed.

There are some things to avoid in the early recovery period: heavy lifting, rubbing the eye, swimming, and dusty environments. Your ophthalmologist will provide clear post-operative instructions and schedule follow-up visits to monitor your healing.

Why Choose a Specialist Ophthalmologist for Cataract Surgery in Durban?

Cataract surgery is one of the safest procedures in modern medicine, but the outcome depends on the skill of the surgeon and the quality of the diagnostic equipment used before, during, and after the procedure. A specialist ophthalmologist — as distinct from an optometrist or general practitioner — is a medical doctor with additional years of surgical training in diseases and surgery of the eye.

About Dr Johann Snyman

Dr Johann Snyman is a specialist ophthalmologist practising in Kloof and Westville, Durban. He holds the Fellowship in Ophthalmology (FCOphth) from the Colleges of Medicine of South Africa and a Master of Medicine in Ophthalmology (MMed) from the University of KwaZulu-Natal. He performs cataract surgery using modern phacoemulsification and offers a full range of intraocular lens options tailored to each patient’s needs.

Dr Snyman is also the founder of Africa20twenty, a non-profit organisation providing free cataract surgery to patients in impoverished rural communities across South Africa who would otherwise have no access to sight-restoring care.