What to Expect Before, During, and After Cataract Surgery
You may be considering having cataract surgery if you've been diagnosed by an ophthalmologist (eye specialist) as having cataracts in your eyes. A cataract is a clouding of the lens in your eye and surgery involves removing your lens and replacing it with an intra-ocular lens. This is done to improve your vision.
Incisions are made in the side of the eye and an ultrasound probe is used to remove the cataract. Most of this type of surgery is successful but you'll need to read and sign a consent form - only if there are complications is there anything to be concerned about.
The good news is that approximately only 1 in 100 cataract operations need further surgery to correct any complications. In approximately 1 in 10 cases the membrane behind the new lens could become cloudy, causing blurred vision again. Laser treatment is needed afterwards to correct this.
Two days after having my second cataract operation (my left eye) I'm busy writing on my laptop able to make a start on this article, without much discomfort. That's saying something for modern medicine and the standard procedure that this type of operation has become.
The optometrist I consulted encouraged me to visit an ophthalmologist about having my eyes tested for cataracts. After deliberating initially I eventually went to have my eyes tested; according to my specialist there was evidence of cataracts starting but surgery was not necessary at the time.
A Doctor/Patient Decision
Your ophthalmologist will more than likely give you the option to decide if your eyesight has deteriorated enough to warrant having cataract surgery. He or she won't force you into having operations but may suggest it when deemed necessary. In my case after having my eyes tested every so often my eye specialist advised me in early 2017 that it was finally necessary for me to have surgery. I decided to let him go ahead with it.
Preparation and Requirements Before the First Operation
Once you know that you need surgery and have agreed with your specialist that your vision has become poor enough to warrant it, you can make an appointment to have your first eye operated on. In my case pre-authorisation was required which involved filling in forms and having some tests such as blood pressure and sugar level done. Both eyes need to be seen to - after the first operation the vision in your eyes will be different and they need to be the same to enable you to see properly.
You can carry on as normal before the first cataract operation, some nervousness may be experienced but it's a good idea at this time to read up on this type of procedure to enable you to help allay your fears. You should have received some information from the specialist concerning this - reading additional literature certainly helps.
Both my operations were done in the afternoon – I had time in the morning to prepare myself mentally and to remain as calm as possible about the prospect of having the first one done. You have the choice of having a general or a local anaesthetic, I opted for the latter as I didn't want to feel too disorientated afterwards. I was allowed to have breakfast but not eat after it. With a general anaesthetic you're not allowed to eat or drink anything except take water six hours beforehand.
You'll need someone to give you a lift there and back and even stay with you beforehand if they wish to. Various eye-drops will be placed in the eye when you are being prepared for the operation. It almost seems like an excessive amount but it's necessary and the pupil of your eye must dilate sufficiently before surgery can be done. Initially I was first in line, but my pupil was taking a long time to dilate with the result that I went in for surgery after most of the other patients.
Having the Operation
When it's time for your surgery you'll be taken to a preparation room where you lie on a bed on wheels; there the anaesthetist will give you a mild sedative intravenously. He or she will then proceed with a local anaesthetic above or below the eye to be operated on. They may need to inject both above and below. Not much discomfort is experienced but of course you can opt for a general anaesthetic beforehand if you feel you need it.
Next you're wheeled into the surgery and your face be will partially covered with an oxygen mask and surgical drapes. You need to lie as still as possible during the operation. At first I could see the doctor but then lights were switched on and all I could see were 3 round dots which were probably part of the equipment. I didn't feel any sensation or pain in my eye while the operation took place. I didn't feel great but I didn't feel terrible either. Quite soon it was all over, it took less than 30 minutes.
A patch is put on your eye and you're taken back to a room where some tests such as blood pressure and sugar level are done. You're then wheeled back to the preparation room in a wheelchair and quite soon you're able to have a sandwich and something hot to drink. I was discharged after about a half an hour after this, some forms first needed to be filled in and then my lift came to fetch me.
After Cataract Surgery
I arrived home finding the anaesthetic had not worn off resulting in there being no pain in my eye until later that night. I took painkillers when some discomfort started. You have to be careful about not getting dirty water in your eye so it's advisable not to wash your hair in the shower the first night, especially as you still have an eye patch on.
More than likely you'll have an appointment with your eye specialist for early the following morning or later, depending on when you had the op done. In my case it was 7am - he removed the eye patch and took some stitches out that he'd put in the day before. He put a temporary patch on which I could remove at home. Once again I wasn't allowed to drive myself there and back for this appointment. As soon as I got home I removed the patch and took it easy for the rest of the day.
After My First Op
- Antibiotic eye-drops will be supplied, these need to be administered as prescribed. They will be reduced over a 4 week time period
- Dark glasses or your own spectacles should be worn until your eye has recovered (4 to 6 weeks)
- You should be given an eye patch with a shield to wear at night for a week. This helps to prevent injury to your eye while sleeping due to it being in contact with your pillow or rubbing it unknowingly
- If any excessive pain is experienced your eye specialist should be contacted immediately
Take pain medication for mild to moderate pain if necessary
Requirements That Need to Be Adhered to After Surgery
- No heavy exercising or lifting of heavy objects
- No jogging
- No motorcycling or horse-riding
- No rough country driving
- Don't rub your eye
- Don't get dirty water in your eye for 3 weeks while showering
- Avoid getting dust in your eye
What Is Allowed?
- Moderate TV viewing and computer usage
Normal activities except those mentioned above
What to Expect During the Healing Phase
- There may be some discomfort - a sensation of “sand” in your eye. Non-prescription eye-drops can be used for this. Any chronic aching in the eye must be reported
- Some specks or floaters in your eye may be experienced – any loss of eyesight should be reported immediately
- Some blurring of your vision can be expected; this should clear up gradually
- Tearing from sunlight may be experienced – this is normal as your eyes may be light-sensitive, remember to wear sunglasses
- There will more than likely be some redness in the white part of your eye – this will gradually disappear
- Some tenderness around the eye, pain medication can be taken for this
Danger Signs Which Require Immediate Attention Are:
- Loss of vision
- Severe unrelenting pain around the eye
- Bursts of bright light followed by reduced vision
After the 6 week recovery time, glasses should be prescribed by an optometrist.
Your eyesight should improve after the recovery period possibly even during that time. Depending on what type of lens has been inserted you should have better vision either for short-sightedness or long-sightedness.
Now it's time to make an appointment for your other eye which shouldn't be left for long. I had my second op done a month and a half after the first one. Since having both my cataracts removed I am happy with the results and my visions has improved greatly.
I will be seeing my optician in the new year to obtain new prescription reading glasses. Having the operations was well worth the slight discomfort experienced for a short while afterwards.