What if I blink or move during surgery?

A small, spring-loaded speculum holds your eyelids open throughout the procedure, so blinking is not possible. You do not need to hold your eye still — normal involuntary eye movements are expected and the surgeon works with them. If you are very anxious about moving, sedation is available to help you relax. Your surgical team will explain what is happening throughout the procedure and guide you through any steps where keeping still briefly is helpful.

Is the injection painful if a peribulbar or sub-Tenon’s block is used?

If an injection block is used (rather than topical drops alone), the injection itself is usually performed after sedation and after topical anaesthetic drops have been applied. Most patients describe a brief sensation of pressure rather than sharp pain. The discomfort is very short-lived, and the profound numbness achieved by the block means the surgery itself is entirely painless. Surgeons who routinely use injection blocks are experienced in making the process as comfortable as possible.

How long does discomfort last after cataract surgery?

For most patients, mild discomfort — a gritty, sandy, or mildly scratchy sensation — is most noticeable in the first 24 to 48 hours. This typically resolves over a few days as the eye settles. Light sensitivity can persist for up to a week. If you experience significant pain — beyond mild grittiness — at any point, contact your surgeon, as this is not typical and should be assessed.

Can I take paracetamol for eye discomfort after cataract surgery?

Yes. Paracetamol (acetaminophen) is safe and appropriate for mild post-operative discomfort. Standard adult doses are effective for the mild, dull discomfort that occasionally follows the procedure. Avoid ibuprofen and other NSAIDs unless your surgeon specifically approves them, as some surgeons prefer patients to avoid systemic NSAIDs during the initial healing period. If pain is severe enough to require regular analgesia, this is unusual and warrants a call to your surgical team.

Is Cataract Surgery Painful? | Clarity Eye Surgeons

Quick Answer

Cataract surgery is one of the least painful operations in all of medicine. During the procedure, patients feel pressure but not pain— anaesthetic eye drops numb the eye completely. Afterwards, a mild gritty sensation for 24–48 hours is common. Significant pain at any stage is unusual and warrants a call to your surgeon.

What You Feel During Cataract Surgery

Fear of eye surgery is understandable — but the reality for the vast majority of patients is far more comfortable than they anticipate. Here is what actually happens during a routine cataract procedure:

Anaesthetic eye drops are instilled into the eye before surgery, numbing the surface of the eye completely. The drops take effect quickly and are highly effective. You will not feel cutting, stitching, or any sharp sensation.

What patients do commonly report feeling:

• Pressure — a gentle pushing or pressing sensation as the surgeon works, particularly during phacoemulsification (the ultrasound step)
• Bright light — the surgical microscope is very bright; patients often see swirling colours and bright light but do not see the surgical instruments
• Movement — the sensation that something is happening, without pain
• Water — irrigation solution used during surgery may feel cool or wet around the eye

Patients consistently describe the experience as far more comfortable than they expected. Common feedback includes: “I just felt some pressure,” “It was over before I knew it,” and “I was surprised by how little I felt.”

The procedure typically lasts 10 to 15 minutes. The duration varies slightly with the density of the cataract and complexity of the case, but routine surgery is remarkably quick.

10–15 min

Typical duration of each eye’s procedure

Topical

Anaesthetic type used for most patients (eye drops only)

24–48 hrs

Duration of typical mild post-operative discomfort

Anaesthetic Options

The type of anaesthetic used for cataract surgery varies by patient and surgeon preference, but most procedures in Australia use one of three approaches:

1. Topical Anaesthetic (Most Common)

Anaesthetic drops (such as oxybuprocaine or tetracaine) are applied to the surface of the eye. They work within seconds, cause no injection, and leave no lasting numbness of the face. This is the standard approach for the vast majority of cataract operations. It may be combined with an intracameral (inside the eye) injection of lidocaine for added comfort.

2. Sub-Tenon’s or Peribulbar Block

An injection of local anaesthetic is placed behind or around the eye using a small, blunt cannula. This achieves deeper numbness and also immobilises the eye. Used in more complex cases, for patients with difficulty co-operating, or surgeon preference. The injection itself is performed with sedation and is typically described as a brief pressure sensation.

3. Sedation

Intravenous sedation (such as midazolam or low-dose propofol) is offered to anxious patients. It does not put you fully to sleep but causes relaxation and mild amnesia. You remain able to co-operate but feel far less anxious about the procedure. Sedation is combined with topical or injection anaesthetic — not used alone.

Tell your surgeon about anxiety

If you feel anxious about surgery, mention it at your pre-operative assessment. There are genuine options to make you more comfortable — including oral medication the morning of surgery, sedation during the procedure, and reassurance from staff who understand eye surgery anxiety.

After Surgery: What Is Normal?

Once the anaesthetic wears off — typically within an hour or two of surgery — some mild discomfort is normal and expected. This is not pain in the traditional sense, but rather:

• A gritty or sandy feeling, as if something is in the eye — caused by the incision site healing
• Mild light sensitivity that makes bright environments uncomfortable
• Occasional mild aching around the eye socket
• Watering of the eye

These sensations typically peak on the first night and improve significantly over the following 24 to 48 hours. Lubricating eye drops help with the gritty sensation. Paracetamol is adequate for mild aching if needed.

Normal Sensations vs Concerning Symptoms

Contact your surgeon immediately if you experience:

• Severe pain that is not controlled with paracetamol
• Sudden or worsening vision loss in the operated eye
• Increasing redness getting worse rather than improving
• New floaters, flashing lights, or a dark curtain in your vision
• Coloured or sticky discharge from the eye
• Nausea and vomiting with eye pain (can indicate acute pressure rise)

These symptoms are not typical and, in rare cases, can indicate a serious complication such as elevated intraocular pressure or infection (endophthalmitis) that requires immediate assessment. Most patients will never experience these, but it is important to know what to look for.

Frequently Asked Questions

General anaesthetic is rarely required for cataract surgery. The vast majority of cataract procedures in Australia are performed under topical anaesthetic (eye drops) with or without light intravenous sedation. You will be awake but relaxed. If you have severe anxiety, significant physical limitations, or a very complex eye condition, your surgeon may discuss local injection or general anaesthetic as alternatives, but these are uncommon. General anaesthetic carries additional risks and is generally reserved for patients who genuinely cannot co-operate with the procedure.

Written by

Dr Parth Shah

Dr Parth Shah is a subspecialty-trained Canberra ophthalmologist with expertise in cataract surgery, paediatric eye care and strabismus surgery.

Anxious about cataract surgery?

Understanding what to expect is the first step to feeling confident. Book a consultation with Dr Parth Shah to talk through every aspect of the procedure.

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