Everything about Cataracts & Surgery: A detailed guide

Cataracts are a common worry, especially as we get older. Imagine your eye’s natural lens gradually getting cloudy—that’s what happens when cataracts form. As expected, when diagnosed with cataracts, patients often have lots of questions about cataracts and cataract surgery. 

This blog is here to give you straightforward answers from a reliable source, clearing up the common questions people have about cataracts and the options for fixing them. We’ll break down the details in simple terms, aiming to make cataracts and cataract surgery easy to understand. Our main goal is to share knowledge, ease worries, and help you make informed choices when it comes to cataracts and cataract surgery. 

Recognition-Phase Questions

1) What is a cataract?

A cataract is the name given to the condition where the natural lens of the eye is not crystal clear. This occurs when proteins in the lens clump together, obstructing light and affecting vision.

2) What are the symptoms of cataracts?

Cataracts are usually not painful. If your vision is not as clear as it used to be, either for distance focus, near focus, or both, you should see a doctor. You may also have some of the following symptoms:

  • Difficulty seeing at night.
  • Sensitivity to light.
  • Seeing a “halo” around bright lights, such as street lights or car headlights.
  • Seeing double vision or ghosting of images.
  • Colours do not seem as bright or vivid as they used to.

3) How are cataracts diagnosed?

Diagnosis involves a comprehensive eye exam, including a visual acuity test, dilated eye exam, and other specialised tests.

4) What are the types of cataracts?

Cataracts can be classified into subcapsular, nuclear, and cortical types, each affecting different parts of the lens.

5) Can cataracts be prevented?

While cataracts cannot always be prevented, a healthy lifestyle, UV protection, and regular eye check-ups can reduce the risk.

6) Who usually gets cataracts?

Cataracts are a common eye condition that primarily affects older adults, although they can occur in people of all ages. Other common risk factors include family history, UV exposure, smoking, diabetes, certain medications, eye trauma, previous eye surgery, and excessive alcohol consumption. Regular eye check-ups are essential for diagnosis and management.

7) Can cataracts be treated with medication or eye drops?

Cataracts cannot be treated with medication or eye drops. Surgery is the only effective option to remove the cloudy lens and restore vision.

8) Can cataracts be a sign of other health issues?

In some cases, cataracts may be associated with diabetes, obesity, or prolonged use of certain medications.

Pre-Surgery Questions

1) Do I really need surgery?

Here are some reasons why you need to undergo cataract surgery:

  • You have reduced quality of vision or blurred vision affecting daily activities or driving.
  • You have difficulty seeing well at night.
  • You cannot see clearly even with glasses.
  • Colours appearing faded.
  • You experience sensitivity to glare and bright lights.

2) Is cataract surgery safe?

Yes, cataract surgery is considered a safe and routine procedure.

3) How do I find the right surgeon for cataract surgery?

To find the right surgeon for cataract surgery:

  • Ask for referrals from your primary care doctor, friends, or family.
  • Check the surgeon’s credentials, experience, and patient reviews.
  • Ensure the surgeon is board-certified and affiliated with a reputable hospital.
  • Inquire about technology and techniques used.
  • Consider accessibility, communication, and trust your instincts.

4) What are the types of Intraocular lenses (IOLs)?

  • Monofocal Lens – Monofocal IOLs are the traditional choice for cataract surgery. These lenses have a single focus point, providing clear vision at a specific distance. They work similarly to natural lenses before the development of cataracts.

  • Multifocal Lens – Multifocal IOLs, as the name suggests, have multiple focal points. These lenses are designed to provide clear vision at various distances, reducing dependency on glasses for daily activities.

  • Toric Lens – Toric lenses provide correction for astigmatism, making vision clearer for those patients who have pre-existing astigmatism.

  • Extended depth-of-focus lens – Extended depth-of-focus (EDoF) lenses are specially designed to provide good distance and intermediate focus. This is helpful for using the computer, watching TV and seeing the car dashboard,etc.

    Discover the perfect lens for your vision. Explore our comprehensive guide to choose the right IOL for Cataract Surgery .

     

5) Will I still need glasses after surgery?

The need for glasses after surgery depends on the type of IOL and your vision goals.

6) Will the surgery be painful?

Cataract surgery is not painful due to local anaesthesia. Some post-surgery discomfort is normal but can be managed with medications and eye drops.

7) What are the potential side effects?

Cataract surgery is generally safe, but potential side effects include:

  • Infection: the risk is low. However, if you do have an infection, it can be treated with antibiotics.
  • Bleeding: this is rare, and precautions are taken by surgeons to help avoid this.
  • Swelling and inflammation: this is normal and managed with medication.
  • Increased intraocular pressure: is often temporary and can be controlled with medication.
  • Posterior capsule opacity (PCO): Cloudiness of the lens capsule, removed with YAG laser.
  • Retinal detachment: although rare, it is important seek prompt attention for symptoms.
  • Corneal oedema: this is swelling of the cornea, which is often temporary and resolves with time or medication.
  • Droopy eyelid (ptosis): this is rare, however, is correctable with additional surgery.
  • Vision changes: Glare, haloes, or low-light difficulty may occur temporarily.

8) How successful is cataract surgery?

Cataract surgery has a high success rate, with most patients experiencing improved vision.

9) Will insurance cover the cost of surgery?

Cataract surgery is often covered by private health insurance as a medically necessary procedure. However, coverage varies, so it’s important to check with your ophthalmologist & insurance provider to understand specific details and potential out-of-pocket costs.

10) What pre-operative preparations are necessary?

An initial assessment:

  • A comprehensive eye examination: to assess the cataract and overall eye health. This may include pupil dilation for better visibility of the eye structures.
  • Medical Review: Share medical history and medications.
  • Tests for calculating the correct intraocular lens (IOL): Measurements of the cornea and , assessment of the IOL power.
  • IOL Discussion: You and your surgeon will choose lens based on preferences.

On the day before and day of surgery:

  • Fasting: No food/drink the night before.
  • Transportation: Arrange a ride home from surgery.
  • Comfortable Clothing: Wear loose attire.
  • No Makeup or Jewellery: Avoid wearing these on surgery day.
  • Illness Alert: Notify the hospital or surgeon if you are unwell before surgery.
  • Follow Guidelines: Adhere to surgeon’s pre-op instructions.

During Surgery Questions

1) What happens during cataract surgery?

Patients usually have to fast for a few hours before surgery, as light sedation is usually given. They may also need to stop taking certain medications, such as blood thinners.

Cataract surgery is a very safe and straightforward procedure in most cases, and patients usually go home shortly after. It is important to have someone bring you to the surgery centre or hospital, and take you home.

Here are a few things to know about surgery:

  • Anaesthesia: For surgery on your eyes, the anaesthetist will numb the eye with drops, or an injection around the eye. You will also be given medication to help you relax. You’ll stay awake during the procedure, but the eye will be asleep. You may be able to see movement and some light. You will also hear the eye surgeon and the phacoemulsification machine. The procedure will not hurt, but you may feel some pressure while the surgeon is operating.
  • Positioning: You will be lying down flat, or at a slight angle, for the cataract surgery.
  • Cataract removal: The ophthalmologist uses an operating microscope to perform the surgery. Tiny incisions are made to reach the lens, which is then broken up by ultrasound waves and surgically removed. Finally, the new artificial lens is placed and antibiotic injected to reduce the risk of post-operative infection.

2) How long does the Cataract surgery take?

The process of cataract surgery usually takes 10-15 minutes. In some cases, it can take longer. The admission process, anaesthesia and discharge mean that you can be in the surgery centre or hospital for 2 or more hours.  

3) Will I be awake or asleep during the surgery?

Patients are usually awake, but relaxed, during the surgery.

Post Surgery Questions

1) What happens after cataract surgery?

  • The first night: A pad and shield may be placed over the eye for the first night following surgery.

  • Eye drops: After your one day review, you will need to use prescription eye drops for about four weeks after the surgery. These are anti-inflammatory drops to help the eye heal.

Most people need a few days for vision to improve after surgery. It is common for the eye to be red, gritty and irritated, and watery.

2) What happens one week after cataract surgery?

After a week, it’s generally safe to discontinue the use of an eye shield, especially during sleep. However, it’s crucial to seek advice from an eye doctor before making any decisions.

You should now find it comfortable to engage in activities such as watching TV, using a computer or laptop, using your mobile phone, and reading newspapers without experiencing strain in your eyes.

While your vision may not be flawless at this point, it should be gradually improving over time.

3) What happens one month after cataract surgery?

Approximately one month post-cataract surgery, significant improvement in vision is expected. The eye is likely to have undergone nearly full healing. Colours may appear more vibrant, and objects will exhibit enhanced clarity. It is advisable to refrain from swimming for a minimum of four weeks following the cataract surgery.

4) What precautions should I take during the initial days after surgery?

Follow post-operative care instructions, including avoiding eye rubbing, strenuous activities and protecting the eyes from bright lights.

5) How long does it take to recover from cataract surgery?

Recovery time after cataract surgery varies, but most people experience improved vision within a few days to weeks. Initial discomfort and blurry vision are common in the first days, with significant improvement by the end of the first month. Full healing may take several months, and follow-up appointments with your eye surgeon are crucial for monitoring progress and addressing any concerns.

6) Will my vision be completely restored, and if so, how long will it take?

Vision improvement varies, but most patients achieve significant restoration, often within a few weeks.

7) Will I need to take any medications after cataract surgery?

Medications, including eye drops, may be prescribed to aid healing and prevent infection.

8) Are there any potential side effects of the medications?

Side effects are generally mild and temporary, such as mild burning or stinging.

9) Why does my eye feel like something is in it after cataract surgery?

A common post-cataract surgery experience is a sensation akin to having sand in the eyes, which many individuals report. While most patients do not have a suture (stitch) in their eye, the surgical procedure and the antiseptic used for eye cleaning can contribute to dryness and irritation on the eye’s surface. Fortunately, these symptoms typically subside rapidly for the majority of patients.

FAQs

No, after cataract surgery, your vision might experience immediate improvement, but it may not be consistently stable. Moreover, you might have undergone twilight anaesthesia (sedation) before the procedure, and its effects may not have fully dissipated. Operating a vehicle independently under these circumstances can pose risks.

After undergoing cataract surgery, it is advisable to arrange for someone to accompany you home. Even if you plan to use public transportation or a taxi, having a companion is essential to ensure your safe return and allow you to rest comfortably.

Most individuals can typically resume driving either 24 or 48 hours after undergoing cataract surgery. However, this timeline is contingent upon the unique circumstances of each patient. Following the surgery, you are advised to attend a follow-up appointment at your ophthalmologist’s clinic the day after. At this visit, your vision will be assessed, and your doctor will determine when it is safe for you to resume driving and engage in regular activities.

It is crucial to adhere to your doctor’s guidance, as healing rates can vary among patients. Your doctor may recommend waiting a bit longer before getting behind the wheel to ensure a safe recovery. Consequently, it is advisable to arrange for someone to drive you to and from the follow-up appointment. Additionally, you might need to wear an eye shield for a few days post-surgery to support the healing process. It’s important to note that it may take approximately a week for your vision to fully stabilise. Your eye surgeon will discuss these considerations and their potential impact on your ability to drive during the post-operative consultation.

While not mandatory, having someone to assist with transportation and daily tasks is advisable.

After surgery, your eyes will require a period of healing during which they may exhibit heightened sensitivity. We recommend that all our patients refrain from exposure to heat, steam, and moisture in the initial days post cataract surgery.

The majority of patients can resume their regular activities, such as watching television, using a computer, and using a mobile phone, within the first one to two days after undergoing cataract surgery.

After cataract surgery, you might have considerations regarding your sleeping routine and position. It is crucial to use an eye shield during sleep to minimise the risk of infection and inadvertent eye rubbing.

In addition to wearing the eye shield, it is advisable to avoid sleeping on the side with the healing eye. Opt for the opposite side to reduce the chances of infection and irritation from the surgery.

Given that every patient is unique, it is essential to discover a sleeping position that provides comfort for your individual needs.

You may safely take showers or baths 24 hours after your cataract surgery. Exercise caution to prevent water or soap from coming into contact with your eye for the first week.

To clear any debris or mucus from your eyes, use a damp cloth soaked in cooled boiled water. Ensure the use of a mild eye cleanser and refrain from using harsh soaps.

Wait a minimum of two days post-surgery before initiating the washing of your hair using mild, baby shampoo, or soap. Exercise caution to avoid any contact of water or soap with your eye.

After cataract surgery, it is common to experience fatigue and a desire for additional rest on the same day. Adequate rest after your cataract surgery will enhance the pace of your recovery.

It’s crucial to avoid touching or rubbing the eyes to prevent infection or injury.

In general, stairs are considered safe after cataract surgery. However, individual experiences may vary. If you have any concerns, it’s important to discuss them with your eye doctor.

Getting better after cataract surgery might feel difficult, but it usually doesn’t stop you from doing normal daily activities. You can do light housework, but avoid heavy lifting and bending over for about a week after the surgery. Avoid any strenuous physical activities until your eye has recovered.

Conclusion

Empowering patients with knowledge is crucial for a successful cataract surgery journey. At Clarity Eye Surgeons, we are committed to providing clarity in understanding and addressing your concerns about cataract surgery.

Author Bio

Dr. Parth Shah is a leading ophthalmologist in Canberra, specialising in cataract surgery. With extensive training and experience, he’s renowned for his expertise in the field. Dr. Shah is dedicated not only to performing successful surgeries but also to patient education. His compassionate approach, combined with technical proficiency, has earned him the trust and gratitude of countless patients. He’s a true advocate for eye health and a trusted name in the Canberra ophthalmology community.