What it is
A cataract is a cloudy area in the lens, the clear part inside the eye. Cataract surgery takes out the cloudy lens and almost always puts in a clear artificial lens (an , or IOL). It is the only way to remove a cataract. In the usual method, phacoemulsification, sound waves break the lens up through a very small cut and the pieces are sucked out.
Why it is done
Cataracts make vision blurry, hazy or dull. Surgery is usually advised when this gets in the way of reading, driving or other daily activities, and there is usually no need to rush. It may also be advised when a cataract hides the back of the eye from the doctor, for example in diabetic retinopathy. Children born with cataracts usually need early surgery so that their vision can develop.
What it helps with
How to prepare
The eye doctor examines and measures your eye to choose the right artificial lens. Hospitals differ on eating and drinking, so follow your instructions.
Do
- Use any prescribed eye drops exactly as told
- Ask which medicines to take or stop, as some that raise the risk of bleeding may need a break
- Ask when to stop wearing contact lenses
- Bring a list of your medicines and earlier eye reports
Do not
- Do not stop any medicine on your own
- Do not plan to drive yourself home
What happens
This is usually a day-care operation, one eye at a time. Adults are usually awake, with the eye numbed by drops, an injection or both. It goes like this:
- Drops widen the pupil, and the eye is cleaned and numbed.
- You may see light and movement but not the details. You should feel no pain.
- The surgeon makes a tiny opening, breaks up the cloudy lens, usually with , and sucks it out.
- A clear artificial lens is placed in the eye. Stitches are often not needed.
- A dressing or shield may cover the eye.
It takes under an hour. If both eyes need surgery, each is done separately. Children usually have a general anaesthetic.
Afterwards
Most people go home the same day. Vision is blurry at first and improves over several days. The eye may feel itchy or sensitive to light for a day or two. You use eye drops for a few weeks and may wear a shield at night. Do not rub the eye, and keep soap and water out of it at first. Avoid swimming, eye make-up and heavy lifting until the surgeon agrees. Your glasses prescription may change, and new glasses are fitted once the eye has healed.
Get urgent help for sudden new floaters, flashes of light, a dark curtain over your vision, severe pain or loss of vision.
Risks and side effects
Cataract surgery is one of the most common operations and is generally safe. Serious problems are rare. They include swelling, bleeding or infection in the eye, a change in eye pressure, a detached retina (the light-sensing layer at the back of the eye pulling away), double vision and vision loss. Part of the lens may be left behind and need another small procedure. Weeks to years later the membrane behind the new lens can turn cloudy and blur vision again, and a quick laser treatment clears it. Other eye diseases, such as glaucoma, can limit the result.
Results and what comes next
Most people see better afterwards, and colours often look brighter. Vision may be blurry at first. How well you see depends on the rest of the eye, and many people still need glasses for some tasks. Some lenses give both distance and near vision, but they do not suit everyone, so ask. Check-ups follow to watch healing, often the next day.
Questions to ask your doctor
Tick the ones you want answered and take them with you.
Common questions
Does cataract surgery hurt?
No pain is expected. The eye is numbed and you stay awake. You may see lights and movement but not the details of the operation. Afterwards the eye may feel itchy, gritty or sensitive to light for a day or two.
When will I see clearly after cataract surgery?
Vision is often blurry for the first few hours and then improves over several days. Healing continues for some weeks. You may need new glasses once the eye has healed, and your surgeon will tell you when to have them fitted.
Can my vision become cloudy again after surgery?
Yes, sometimes. The thin membrane behind the new lens can turn cloudy weeks, months or years later, which blurs vision again. This is called a secondary cataract or posterior capsule opacification, and a short laser procedure can treat it.
When can I drive and get back to normal activities?
You cannot drive yourself home. Do not drive until the surgeon says your vision is good enough. Keep activities light, and avoid heavy lifting, swimming and eye make-up until you are told it is safe. Recovery takes some weeks, so ask your surgeon.
