Overview

Cataract surgery is one of the most commonly performed operations in the world. It is also one of the most poorly explained to patients in terms of what the weeks before and after actually look like. The procedure itself takes 15 to 25 minutes. It is the preparation and the recovery that most people have questions about, and where things go wrong when expectations do not match reality.

Before the Operation

Several weeks before surgery you will have biometry, a set of precise measurements used to calculate the power of the artificial lens that will replace your clouded natural one. The measurements take about 20 minutes and are painless. Their accuracy directly determines how close your post-operative vision will be to the target your surgeon is aiming for.

Tell the surgical team about every medication you take, particularly alpha-blockers prescribed for prostate conditions or blood pressure (tamsulosin, alfuzosin, and similar drugs). These cause a condition called intraoperative floppy iris syndrome that complicates surgery if the surgeon is not prepared. Do not stop taking these medications, but the team needs to know about them before the day.

Pre-operative drops are usually prescribed one to three days before surgery. Follow the schedule exactly. Starting drops on the morning of the operation rather than the day before because you forgot is a real problem. The eye needs to be prepared.

The Day of Surgery

You will be awake throughout. Anaesthetic drops numb the surface of the eye completely. You will not feel pain. You may see shifting coloured light and sense gentle pressure, both of which are normal and expected. The surgeon removes the cloudy lens through an incision usually less than 3mm wide and inserts the folded artificial lens, which unfolds in place. No sutures are typically needed.

Arrange transport home in advance. Do not drive, and navigating alone on public transport immediately after is not advisable.

The First Week

Vision on the day of surgery is often blurry or hazy. The pupil was dilated during the operation and the eye is still settling. Most patients notice significant improvement by the next morning. Full visual stabilisation takes four to six weeks.

The post-operative drops are not optional. Antibiotic and anti-inflammatory drops typically run for three to four weeks, tapering at the end. Stopping them early because the eye feels fine is a common mistake. The drops are preventing problems that have not occurred yet, and that is the point. Learning correct drop technique before your procedure will make this easier.

Do not rub the eye. Avoid swimming pools and open water for at least four weeks. The incision, while small, takes time to seal completely. Some redness, light sensitivity, and grittiness in the first few days is expected.

Weeks Two to Six

Most daily activities resume quickly. Reading, watching television, and computer use are fine. Driving is not permitted until your vision has been formally assessed at your post-operative review and confirmed to meet the legal standard for your country.

Do not update your glasses prescription until both eyes are fully stable, which for most people means waiting four to six weeks after the second eye if both are done. A prescription dispensed three weeks after the first operation will be out of date within another few weeks.

The dilated examination at your post-operative follow-up appointment is particularly important, your surgeon needs to check the artificial lens, the retina, and the optic nerve before discharging you from care.

When to Call Your Eye Doctor

• Severe eye pain that worsens after the first 24 hours
• Increasing redness with any discharge
• Vision that was improving and then suddenly gets worse
• New floaters or flashing lights at any point after surgery
• The protective shield comes off and you are not sure what to do

Questions People Ask

• Will I still need glasses afterward?
  With a standard monofocal implant, almost certainly yes for reading. The artificial lens does not adjust focus the way the natural lens did in youth. Premium lenses reduce spectacle dependence but come with trade-offs including reduced contrast and nighttime glare, a discussion to have before the operation, not after.
• Can the cataract come back?
  No. The natural lens is completely removed. Some patients develop posterior capsule opacification months to years later, which blurs vision in a similar way to a cataract. It is treated with a quick laser procedure in the clinic, not repeat surgery.
• I see halos around lights at night. Is that normal?
  Halos, starbursts, and glare around lights are common in the first weeks and usually settle. If they persist beyond two months or significantly affect night driving, mention this at your next appointment.
• How long before I can exercise?
  Light activity within days. Avoid contact sports, heavy lifting, and anything that significantly raises intraocular pressure for at least two weeks. Your surgeon will give specific guidance.
• When will the second eye be done?
  Both eyes are done in separate procedures, usually a few weeks apart. This allows assessment of the first result before proceeding, and allows any adjustment to the lens power calculation for the second eye if needed.

This page is for general patient education and does not replace advice from your surgical team. Further reading: Cataract and Lens subspecialty overview, American Academy of Ophthalmology cataract surgery overview and how to use your post-operative drops correctly.