Cataract Surgery: What to expect

Treatment of Cataracts

On the day of your cataract surgery it is normal to feel a little apprehensive, however, you will be well looked after by an experienced team of health care professionals, including your surgeon, anaesthetist and nurses at the hospital.

You will be asked to fast over night before the surgery, so you may feel a little hungry. This is necessary for your safety. Normal medications can be taken as usual on the morning of surgery with a small amount of water.

It is best if you have someone to drive you to the hospital and essential to have someone pick you up to take you home afterwards.  After arriving at the hospital on the morning of your operation, you will need to fill in some paperwork with a nurse and then see the anaesthetist.

Nurse caring for elderly patient

The anaesthetist will give you sedation and administer your local anaesthetic prior to surgery. Your sedation medication is given via a cannula inserted into your arm to make you drowsy and feel calm. Local anaesthetic is administered after the sedation around the eye area so you will not feel any discomfort during the surgery.

Although you will be technically “awake” during the operation, many people do not remember being in the operating theatre at all. It is normal to be ‘aware’ of the surgery, and to hear machinery and theatre staff.  You should not feel any pain and instead feel calm and sleepy.  If you suffer from claustrophobia, it is best to tell the anaesthetist before surgery.

It is rarely necessary to perform cataract surgery with a general anaesthetic. 

Once the anaesthetist has given you sedation and local anaesthetic your surgeon will perform the cataract operation. A small incision is made in your eye and your cloudy lens (cataract) is removed and an intra ocular lens (IOL) inserted.  The cataract is actually dissembled into tiny pieces and removed from the eye.  Usually you do not have any stitches and the eye wound will heal itself after a few weeks.

This operation usually takes less than 30 minutes. An eye pad and a protective clear plastic shield will be placed on your operated eye at the conclusion of the procedure.  You will then be taken to the postoperative recovery ward area where nursing staff will look after you. Nurses will check your blood pressure and heart rate and once you are feeling well enough you can have something to eat and drink.  You will need to stay in the recovery ward area for a short period, usually less than 2 hours. Once you are ready to leave nursing staff will phone the person picking you up to let them know you are ready to leave the hospital.

Cataract Surgery

The last step in this eventful day is to have a check by your surgeon about 4 hours after the surgery. This is to check the eye pressure is not elevated. Your surgeon will remove the eye pad and measure the pressure, check your eye and explain the postoperative drops.  The eye shield will be put back on to protect your eye overnight. Sometimes the postoperative check may be done the following day. Postoperative instructions on how to care for your eye will be given to you. This will include instilling drops 3 or 4 times a day for approximately a month. You will need to wear the eye shields overnight for about a week to protect your eye while you sleep.  A follow up appointment will be made for you for 2-3 weeks after surgery, or sooner if required.

You will need someone to drive you home following the surgery and preferably stay with you overnight just to check you are ok. Remember you will have one eye covered so may feel a little unbalanced for the first evening.

It is normal for your eye to feel gritty, uncomfortable and even a little painful for the first night after surgery.  Mild analgesics such as paracetamol can be taken if necessary.  It is also normal for you to have double vision for up to 12 hours after surgery.  This is due to the local anaesthetic given, and will improve spontaneously.  Your eye may feel gritty for several weeks after surgery.  Your postoperative drops may help alleviate this.

If you feel severe pain you need to contact the hospital to speak to your surgeon. This happens very rarely and could indicate a complication.  Any change such as loss of vision or increasing redness should be reported to the practice, and may require urgent attention.

You can shower and wash your hair when you wish, however you do not want to get water in your operated eye for about 2 weeks, so wash your hair carefully!  You should avoid bending or heavy lifting, prolonged coughing or vigorous exercise for one month after surgery and do not swim for 2 months.  You may drive a car 3 days after surgery as long as your vision is not blurry.

One month after surgery is the time you will be able to perform all your usual activities, and is the time glasses may need adjusting by your Optometrist.  By then you should be seeing much clearer!