Key takeaways:
Cataracts are a common cause of decreased vision, especially in older people.
An eye specialist, called an ophthalmologist, can remove a cataract using surgery. This will improve your vision.
You’ll need to limit certain activities for a while after cataract surgery to ensure a safe recovery.
If you notice some trouble driving at night because you see a “halo,” or things appear hazy when you are trying to read — you may have a cataract. A quick trip to the eye doctor can confirm if you have a cataract.
The lens of our eye is normally clear and lets us focus on objects. As we get older, proteins break down in the lens of the eye and can form clumps. These clumps cause cloudiness in the lens, and this cloudiness is called a cataract. When you have a cataract, things may look hazy, like looking through a dirty windshield. You might also have trouble seeing at night, and colors may seem faded.
If a cataract is keeping you from doing your normal activities, your ophthalmologist probably will recommend surgery to remove your cataract and replace your lens. Cataract surgery is quick, painless, and low risk. Let’s take a look at what you can expect before and after your cataract surgery.
Before the big day, your ophthalmologist will have you come into the office to measure your eye using an ultrasound. You’ll put artificial tears (lubricating eye drops) in your eyes several times a day for about a week before the appointment to make sure they get a proper measurement. Once the measurements are done, you and your doctor will decide what type of artificial lens is best for you.
You will then schedule your surgery. If both of your eyes need a new lens, your eye surgeon will replace one lens at a time, about a month apart — so you’ll need to schedule two separate surgeries.
Your ophthalmologist might ask you to see your primary healthcare provider before your surgery to make sure it’s safe for you to have surgery. But you shouldn’t need any blood tests before surgery.
On the day of your surgery you’ll be asked to arrive at the center or office a few hours before your surgery time. You won't be able to have anything to eat or drink for a few hours before your surgery starts because you’ll be getting sedation, a type of anesthesia. You’ll also need to find someone to give you a ride home.
You’ll meet with a lot of people, including your preoperative nurse, anesthesiologist, and ophthalmologist. Be prepared for everyone to ask you many times which eye is getting the replacement lens. Your ophthalmologist will even put a mark over your eye to make sure they are operating on the correct side.
Your nurse will put in a set of 3 drops before you go into the operating room:
1) Numbing drops: so you don’t feel pain during surgery
2) Antibiotic drops: so you don’t get an infection after surgery
3) Dilating drops: to make your pupil bigger, which makes the surgery easier to do
You’ll get this set of drops several times before you even go into surgery.
The anesthesiologist will then give you medication through your vein. This medication helps you relax right before and during the surgery, but it doesn’t put you to sleep. You’ll be awake for surgery, but don’t worry — you’ll be comfortable and free of pain.
During surgery, the ophthalmologist will remove your cloudy lens and replace it with the artificial one. You’ll only see a very bright light the entire time because the surgeon uses a microscope to perform the surgery. The entire surgery will be over in about 10 minutes.
Once you are in the recovery room, you’ll notice that you can see and colors will look brighter! You’ll realize just how cloudy your eyesight was before. Your vision will now be like looking through a clean window.
The nurse will make sure that you feel well enough to go home. Before you go, the team will tape a plastic guard over your eye for protection and will give you instructions about how to care for your eye.
Cataract surgery is quick, but you’ll need to make a few adjustments to your lifestyle so your eye heals properly over the first month after your surgery. Here’s what to expect:
For the first night and day after your surgery, you can expect:
Blurry vision: While your vision will be clear, you might see some blurring for a day or so. This is normal and will go away.
Foreign body sensation: It might feel like something is stuck in your eye — resist the urge to rub your eye.
Mild discomfort: As the numbing medication wears off, you may have some mild discomfort in your eye. You can use an over-the-counter pain medication to help with the pain.
You’ll also need to see your ophthalmologist 1 to 2 days after your surgery for an eye check.
For the first week after your surgery, you’ll need to focus on several “do's and don’ts” so your eye heals properly:
Don’t get water or soap in your eye. Wash your hair in the shower with your back facing away from the water, and avoid splashing water in your eye.
Don’t do strenuous exercise. This can dislodge the new lens. It’s OK to walk.
Don’t lift anything heavy. Don’t lift anything that weighs more than 15 pounds.
Don’t scratch or rub your eye. Your eye needs time to heal from the surgery — even minor trauma from rubbing can cause damage.
Do wear your eye guard while sleeping. When you’re sleeping, you’ll need to wear the eye guard you got. This way if you roll over you won’t put pressure on your eye.
Do keep the area around your eye clean. Avoid using makeup, and gently clean around your eye. This will help prevent infection.
Once you get past the first week, there are only a few more things left to do:
Use drops, drops, drops: You’ll need different eye drops to prevent inflammation and infection. You’ll use drops several times a day for the first week after surgery. But don’t worry, you’ll gradually reduce that frequency over the month.
Don’t go swimming: You won’t be able to swim for a month after surgery because it can put your eye at risk for damage or infection. But after the first week, other kinds of exercise are safe.
Stay close to home: If you have a complication from your surgery, it’ll likely happen in the first month. Your ophthalmologist will want you to be within an hour's drive from the hospital where you had your procedure — in case you need emergency care.
Follow up with your ophthalmologist: You’ll need a few visits during the month following your surgery to make sure everything is healing well. Be prepared for at least two to three visits.
While cataract surgery is quite safe, there are still things you’ll want to look out for. Call your ophthalmologist right away if you have:
Moderate or severe eye pain
Vision loss
Discharge from your eye
Swelling of your eyelids
Flecks or floaters in your vision
Light sensitivity
These symptoms could mean you have bleeding in your eye, an infection, or a detached retina. These complications are rare — but you need to call your ophthalmologist right away, as these things can permanently affect your vision.
Cataracts are common and decrease your vision. Fortunately, cataracts can be removed, and an ophthalmologist can replace your lens with a quick and painless surgery. You’ll need to change your daily routine for a few weeks after surgery, but cataract surgery can bring long-term clear vision.
American Academy of Ophthalmology. (2016). Cataract in the adult eye preferred practice pattern.
Boyd, K. (2021). Detached retina. American Academy of Ophthalmology.
National Eye Institute. (2020). Cataract surgery.