Cataract surgery involves replacing the cloudy lens inside your eye with an artificial one.
It's the most common operation performed in the UK, with a high success rate in improving your eyesight.
It can take 4 to 6 weeks to fully recover from cataract surgery.
What are cataracts?
Cataracts are when the lens of your eye, a small transparent disc, develops cloudy patches.
When we're young, our lenses are usually like clear glass, allowing us to see through them.
As we get older they start to become frosted, like bathroom glass, and begin to limit our vision.
Cataracts most commonly affect adults as a result of ageing.
Do you need surgery?
If you have cataracts, it's your decision whether or not to go ahead with cataract surgery.
Cataracts usually get slowly worse over time. Surgery to replace the cloudy lens is the only way to improve your eyesight.
Surgery is usually offered on the NHS if your cataracts are affecting your eyesight and quality of life.
The decision to have surgery should not be based solely on your eye test (visual acuity) results.
You may have other personal reasons for deciding to have surgery, such as your daily activities, hobbies and interests.
You can choose to put off having surgery for a while and have regular check-ups to monitor the situation.
There are no medicines or eye drops that have been proven to improve cataracts or stop them getting worse.
Before the operation
Before surgery, you'll be referred to a specialist eye doctor for an assessment.
During the assessment different measurements will be taken of your eyes and your eyesight.
The assessment is an opportunity to discuss anything to do with your operation, including:
- your lens preference, such as near sight or long sight
- the risks and benefits of surgery
- if you'll need glasses after surgery
- how long you'll take to fully recover
If you're used to using one eye for distance and one for reading, which is called monovision, you can ask to stay that way.
This usually means you'll get a near sight lens fitted in one eye and a long sighted lens fitted in the other eye.
The operation
Cataract surgery is a straightforward procedure that usually takes 30 to 45 minutes.
It's often carried out as day surgery under local anaesthetic and you should be able to go home on the same day.
During the operation, the surgeon will make a tiny cut in your eye to remove the cloudy lens and replace it with a clear plastic one.
With the NHS, you will usually be offered monofocal lenses, which have a single point of focus. This means the lens will be fixed for either near or distance vision, but not both.
If you go private, you may be able to choose either a multifocal or an accommodating lens, which allow the eye to focus on both near and distant objects.
Most people will need to wear glasses for some tasks, like reading, after surgery regardless of the type of lens they have fitted.
If you have cataracts in both eyes, you'll need two separate operations, usually carried out 6 to 12 weeks apart.
This will give the first eye to be treated time to heal and your vision time to return.
Benefits of surgery
After cataract surgery you should be able to:
- see things in focus
- look into bright lights and not see as much glare
- tell the difference between colours
If you have another condition affecting your eyes, such as diabetes or glaucoma, you may still have limited vision, even after successful surgery.
Risks of surgery
The risk of serious complications developing as a result of cataract surgery is very low.
Most common complications can be treated with medicines or further surgery.
There is a very small risk – around 1 in 1,000 – of permanent sight loss in the treated eye as a direct result of the operation.
Recovery-Cataract surgery
ou should be able to go home on the same day as your cataract surgery.
You may have a pad and plastic shield over your eye when you leave hospital, which can usually be removed the day after surgery.
Feeling should start to return to your eye within a few hours of surgery, but it may take a few days for your vision to fully return.
It's normal to have:
- grittiness
- watering
- blurred vision
- double vision
- red or bloodshot eye
These side effects usually improve within a few days but it can take 4 to 6 weeks to recover fully.
If you need new glasses, you won't be able to order them until your eye has completely healed – usually after 6 weeks.
Cataract surgery has a high success rate in improving your eyesight and should allow you to return to your normal activities, like driving.
When to seek help
Contact your eye surgery department as soon as possible if you experience:
- increased pain and/or redness
- increased stickiness
- decreased vision
Dos and don'ts
For the first few weeks after surgery:
Do:
- use your eye drops as instructed
- take it easy for the first 2 to 3 days
- use your eye shield at night for at least a week
- take painkillers if you need to
- bathe or shower yourself as usual
- wear your eye shield when washing your hair
- read, watch TV and use a computer
- use your shield, old glasses or sunglasses outdoors
- avoid swimming for 4 to 6 weeks
Don't:
- rub your eye
- allow soap or shampoo to get into your eye
- drive until you get the all-clear from your doctor
- do any strenuous exercise or housework
- wear eye make-up for at least 4 weeks
- fly without seeking advice from your doctor
You could arrange for someone to help take care of you until your vision returns, particularly if the vision in your other eye is poor.
If you work, how soon you can return will largely depend on your type of job and if you need new glasses.
Using your eye drops
Before you leave hospital, you'll be given some eye drops to help your eye heal and prevent infection.
It's important to use your eye drops as instructed by your doctor. Unless told otherwise, you should:
- start your drops the morning after the operation
- only use them on the operated eye
- wash your hands before using your drops
- don't stop your eye drops without advice from your doctor
- don't let anyone else use your eye drops
You'll be advised further about the use of eye drops at your follow up appointment, usually 1 to 4 weeks after your operation.
At this appointment, you may be given advice on when to stop using your eye drops and when to apply for new glasses.
How to apply eye drops
- wash your hands
- tilt your head back
- look up at the ceiling
- gently pull down the lower lid
- squeeze the bottle until a drop goes into your eye
- close your eye and wipe away any excess liquid
- don’t let the bottle touch the eye
If you run out of the drops, contact your local GP for more. You’ll need to bring your eye drop bottle and discharge letter to your appointment.
How to clean your eye
- boil some water and allow it to cool
- wash your hands
- dip cotton wool or clean gauze in the cool boiled water
- gently wipe from the inside (near your nose) to the outside corner of your eye
- don't wipe inside your eye
- don't wash your eye out with water
- don't press on your eye
During the first 2 weeks, you may need to clean your eye twice a day because the drops and the healing process can cause slight stickiness.