Cataracts Explained: What They Are and How We Treat Them in Mbombela

Cataracts are one of the most common reasons people visit us at the Lowveld Eye Institute in Nelspruit and Mbombela, and also one of the most treatable. In this post, I’ll walk you through what a cataract is, why it happens, how it affects your vision, and what actually happens during cataract surgery.

👉 I’ve also created a short explainer video, “Cataracts Explained: What They Are and How They’re Treated,” which you can watch in this blog post.

What exactly is a cataract?

A cataract is not a cancer, growth, or “something on top of the eye.”

Inside every eye is a natural lens that helps focus light onto the retina so you can see clearly. When you’re born, this lens is crystal clear. Over time, for most people, this lens slowly becomes cloudy or opaque – that clouding of the lens is called a cataract.

If you live long enough, it’s very likely you will develop some degree of cataract. It’s a natural age-related change, not a disease you “caught” or something you did wrong.

How does a cataract affect your vision?

In a healthy eye, light passes through a clear lens and is sharply focused on the retina, giving you a crisp image.

With a cataract:

• The lens becomes cloudy (opaque)
•  Less light reaches the retina
• The image becomes blurred, hazy, or washed out

Common symptoms my patients in Nelspruit and Mbombela describe include:

• Glare and halos at night – oncoming headlights feel dazzling or “starburst-like”
• Difficulty reading small print, especially in poor light
• Blurry or foggy vision that worsens over time
• Colours may appear duller or more yellow

If you’re noticing these symptoms and you’re looking for an eye specialist in Mbombela or Nelspruit, it may be time for a cataract assessment.

Can eye drops or tablets cure a cataract?

Short answer: no.

At the moment, there is no proven medication, eye drop, or tablet that can clear a cataract or reverse the clouding of the lens. Marketing online can sometimes be misleading, but from a medical standpoint:

The only effective treatment for visually significant cataracts is surgery.

We don’t rush into surgery based on a “number” or test alone. The decision is based on:

• How much the cataract is affecting your daily life
• Your visual needs (e.g. driving, reading, work)
• Any other eye conditions you may have

When is the right time for cataract surgery?

For most people, cataract surgery becomes appropriate when:

• You’re struggling to do everyday tasks (driving, reading, work, hobbies)
• Your glasses are no longer giving you the clarity you need
• Night driving or bright lights are becoming a problem

Sometimes there are medical reasons to operate sooner (for example, if the cataract is very dense or interfering with other eye conditions), but generally the timing is individual and decided together after a thorough examination.

If you’re unsure, booking an assessment with an eye doctor at the Lowveld Eye Institute is the best starting point.

What happens during cataract surgery?

Modern cataract surgery is a safe, highly refined procedure that usually takes about 15–20 minutes per eye.

Here’s what typically happens:

• Anaesthetic & sedation

1. 1. 1. We use a local anaesthetic (eye block) to numb the eye and surrounding area.
   2. 2. You remain awake but relaxed, with light sedation. Patients are often surprised by how comfortable it is.

• Accessing the lens

1. 1. 1. Eye drops are used to dilate your pupil.
   2. 2. Through tiny incisions in the front of the eye, we open the thin capsule on the front surface of your natural lens.

• Removing the cloudy lens

1. 1. 1. We use a technique called phacoemulsification, in which a specialised ultrasound device breaks the hard, cloudy lens into tiny fragments.
   2. 2. These fragments are then gently suctioned out through very small incisions.

• Implanting a new lens (IOL)

1. 1. We do not leave the eye without a lens; that would be extremely blurry.
   2. A soft, foldable intraocular lens (IOL) is injected into the remaining lens “bag” (capsule).
   3. Once inside the eye, the lens unfolds and sits securely in place using two delicate “legs” called haptics.

The incisions are so small that stitches are often not required, and recovery is usually quick.

Customising your vision: choosing the lens power

One of the major advantages of modern cataract surgery is that we can choose the strength (power) of the new lens to match your visual goals as closely as possible.

Before surgery, we perform detailed measurements of your eye to calculate the most suitable IOL power. This allows us to:

• Reduce your dependence on glasses for distance vision
• Aim for specific visual outcomes based on your lifestyle and preferences
• Discuss options like slightly more focus for near vs distance, depending on your needs

During your consultation, we’ll talk through what’s realistic and help you choose what will work best for your day-to-day life in Nelspruit, Mbombela, and beyond.

Watch the explainer video

To make this easier to understand, I’ve recorded a short video:

“Cataracts Explained: What They Are and How They’re Treated”