Cataract surgery

Cataract surgery is done to improve your vision if you have cataracts.

This is where the lens in your eye becomes cloudy, which can cause blurry vision and loss of sight. It mainly affects older adults (age-related cataracts) but can also affect children (childhood cataracts).

Surgery is the only way to get rid of cataracts.

For children with cataracts, surgery is usually done as soon as possible to help their vision develop properly. Surgery in adults is not always needed straight away but may be recommended if cataracts are affecting your daily life.

If you have cataracts in both eyes, they'll be treated on separate days.

Before you have cataract surgery, you'll have an appointment with a specialist who will examine and measure your eye.

If you wear contact lenses, you may need to leave them out for a few days before you have cataract surgery.

The operation is usually done under a local anaesthetic, which means you can eat and drink as normal before surgery.

You'll have cataract surgery in a hospital.

It's usually done under a local anaesthetic. This means you'll be awake but you should not feel any pain. The local anaesthetic may be given as eye drops, an injection or both.

During the surgery, you may see movement and changes of light and shade, but you are unlikely to see any detail of what's happening.

The main steps of cataract surgery are:

  1. You'll be given eye drops to widen (dilate) your pupil.
  2. The nurse or surgeon will clean your eye and the area around it.
  3. Your face will be covered with a sterile sheet so that only the eye being operated on is exposed.
  4. When your eye is numb, your surgeon will make a tiny hole through the front of your eye (the cornea) and through the clear layer at the front of the lens (the lens capsule).
  5. Your surgeon may use sound waves (ultrasound) to break up the lens inside the lens capsule.
  6. They'll remove the old lens using suction.
  7. They'll place a clear plastic lens inside the lens capsule, which will hold the new lens in place.

The operation usually takes between 20 minutes and 45 minutes.

After the surgery

Usually, you will not need stitches after cataract surgery and your eye will heal by itself. If you do need stitches, your surgeon will talk to you about what type of stitch has been used and whether they need to be removed.

Your eye may be covered with a dressing to keep it clean.

You should be able to go home on the same day, but do not drive yourself home. You should be able to walk safely but take care on stairs.

Most people recover quickly after cataract surgery.

Your surgeon will talk to you about what to expect and what you should do. They'll check your eye and talk to you about when to remove the dressing. They'll also tell you about pain relief you can take while you recover.

You'll be given eye drops to help your eye to heal and prevent infection. You'll usually need to take these eye drops for about 4 weeks.

After cataract surgery:

  • your vision may be blurry for a few hours – this is because of the eye drops used to widen your pupils
  • your eye may hurt for a few days
  • you may need to use a plastic shield to protect your eye at night while your eye is healing
  • it may take several days for your vision to improve
  • you may feel more tired than usual but you'll start to feel normal again after a few days
  • you may still need to wear glasses for reading or seeing long distances – your prescription may be different to before surgery

Things you can do to help your recovery

There are things you can do until your eye is back to normal or until your doctor says you can return to your normal activities.

Do

  • follow the instructions you've been given about changing your dressing

  • take painkillers such as paracetamol or ibuprofen if you need them

  • wear an eye shield or glasses if you go out in windy weather

  • wear sunglasses if lights seem brighter than normal

Don't

  • do not rub your eye

  • do not drive until your vision is back to normal

  • do not do any heavy lifting or play sports

  • do not wear eye make up

  • do not get water in your eye

  • do not go swimming, even with goggles

As with any operation, complications can happen during or after cataract surgery.

The procedure is usually successful and serious complications are rare.

Your surgeon will explain the possible complications before you have surgery. Some complications may need further surgery.

Possible complications include:

  • problems with your vision, such as cloudiness, blurriness, dark shadows or areas of light
  • problems in your eye such as a detached retina, an eye infection, bleeding or inflammation in the eye, or problems with the position of the new lens

If you have complications, most are likely to happen immediately after surgery. But sometimes your vision can become cloudy months or years after surgery. This may be a condition called posterior capsule opacification (PCO).

Go to an opticians if:

  • your vision gets cloudy or blurry
  • you're finding it hard to focus your vision
  • your eye becomes red or painful
  • you see light or dark areas in your vision
  • it becomes uncomfortable or painful to look at bright light

Get help from NHS 111 if:

  • floaters (dots and lines) suddenly appear in your vision or suddenly increase in number
  • you get flashes of light in your vision
  • you have a dark "curtain" or shadow moving across your vision
  • your vision gets suddenly blurred

These could be signs of a detached retina.

You can call 111 or get help from 111 online.