What to Expect Before and After Cataract Surgery
Human Eye With and Without Cataracts
Recently, I had cataracts removed from my left eye and a week later, the same surgery was performed on my right eye. Amazingly, this is done as an outpatient procedure, and two hours after I walked into the hospital, I walked out again!
Like many people, I never realized that I had cataracts until my night vision worsened. When I went to get new glasses, I was shocked to learn that I had cataracts—and that new glasses would not help my vision.
What Are the Signs?
It's easy to overlook the signs of cataracts because vision changes are usually very gradual. Symptoms of cataracts are:
- Dimming of vision. Increasingly bright light is needed to see well.
- Dulled vision. Colors don't seem to have the same intensity. I didn't realize that it was my impaired vision until after my surgery.
- Blurred vision. You may blame this on dirty glasses or needing a new prescription. I was constantly cleaning my glasses because I thought that my blurred vision was caused by smeared lenses.
- Difficulty with night vision. Driving at night becomes difficult. I was frustrated trying to read in lamp light or see to drive at night.
What Are Cataracts?
Cataracts are a clouding of the naturally clear lens in your eye. As the lens becomes more cloudy, the opacity increases and prevents light from passing through the eye and focusing on the retina. This causes increased vision loss and will cause blindness if left untreated. During surgery, this cloudy lens is removed and a new, permanent, intraocular lens is inserted through a tiny incision in the eye.
Age related cataracts are the most common, but some other causes of cataracts are:
- Exposure to Ultraviolet Light
- Drug use
What Are Your Options?
There are several choices of the kind of lens you can have implanted. Insurance generally covers the cost of the surgery to remove the cataract, but not the cost of the lens or the implant. Be sure you understand your insurance coverage and financial responsibility before choosing your lens and scheduling surgery.
My doctor gave me the option of standard micro surgery or laser surgery. Because the laser surgery was much more expensive, and my doctor was an expert in the standard surgery, I decided to go with the standard surgery.
There are also several choices of the kind of intraocular lenses to have inserted ranging from the standard lens, which costs the least, to a multi-focal lens, which costs the most.
I chose to have a multifocal lens implanted, even though it would be a substantial out-of-pocket expense. With a multifocal lens, I was told that my vision would be restored to near 20/20, and I should not need to wear glasses. I reasoned that the money saved in the long run would make up for the up-front costs now.
Preparing for Surgery
- Prior to the day of surgery, the surgeon orders a series of tests and eye scans. Specialized equipment is used to measure every aspect of the eye so that the surgeon knows my eye inside and out and can determine exactly how and where to make the incisions. These measurements are also needed for ordering the new intraocular lenses to my precise fit.
- After all measurement and tests are complete, I met with the surgeon to discuss the procedure and follow-up. He was so reassuring and answered my questions and my husband’s questions clearly.
- A couple of days before surgery, I signed consent forms and had a final eye scan. At home, I began using two different eye drops to help prevent infection and prepare the eye for surgery.
- The day before surgery I was told not to eat or drink anything after midnight. No Coffee? NO! Not even water. I scheduled my appointment as early as possible!
- We arrived at the hospital at 8am. My husband was there, too, and went with me as I checked in, showed my insurance cards and ID and gave pertinent information. At this time, I also had to pay for the special multifocal lens that would be inserted in my eye which were not covered by my insurance.
- We were shown to a pre-op room where I put on a gown, but could stay dressed from the waist down. All jewelry had to be removed – next time I’ll leave it home!
- Nurses came in to take vital signs and start an IV for the sedation. I would not be put under, but would be given medication to relax me in the OR.
- A nurse started giving me a series of eye drops to dilate my eye. As my eye became dilated, it was more sensitive to light, and the nurse laid a light piece of gauze over my eye to shield it from the light.
Cataract Surgery Video
What Happens in the Operating Room and Post Op
Although I knew I was supposed to be sedated, I believed that I would be awake during surgery. Nurses put drops in my eye to numb them, and my head was put in restraints to prevent any movement. I was unaware of everything that happened in the OR after the surgeon came in to mark the astigmatism in my eye. During my second surgery, I was aware of something being taped over my eye lids to keep them from moving, and could hear some murmuring in the background. I did not feel any pain whatsoever. When the surgery was done, I could feel tape being removed and a nurse cleaned around my eye and eye lids with an antiseptic. Before I knew it, I was back in my room where my husband waited. A few more drops were put in my eye, probably antibacterial agents, then I was told to get dressed, get something to eat and go over to the doctor's office for a post op visit. From check-in to check-out, it took about 2 hours.
While I was in surgery, the hospital staff provided my husband with a post-op kit containing protective sunglasses and a protective plastic eye cover with tape to use at night so that my eye was not accidentally bumped. I also had prescriptions for 4 different drops that I would take 4 times a day for a week, then gradually cutting down on the number and frequency of medications. These drops are to help the healing process and to prevent infection. There were also artificial tears to sooth the eyes if they became dry.
A post op visit is needed very soon after the surgery to make sure the new lens is in exactly the right place and that the incision looks good. Some doctors require the patient to return the next day for an office visit. In my case, I was told to go directly to the surgeon's office after my release from the hospital. There his associate examined me and made sure I was clear on the post-op instructions. Although my eye was watery and a little blurry, I could already see with my new lens. In fact, we had to remove the corrective lens from my eye glasses because it was no longer needed. The day after my second surgery, I put away my glasses for good.
Things to do following surgery
- Keep soap and water out of eye. The first week after surgery, care must be taken not to get water or soap in your eye when bathing or washing your hair.
- Wear a protective eye cover to keep anything from pressing or bumping into your eye. The plastic eye cover I was given was taped on each night before bed. It sounds uncomfortable, but it really wasn't bad. I slept fine!
- Wear protective glasses outdoors. Anytime you go outdoors, you will wear the special protective sun glasses that fit snugly against your face. This will keep dust and grit out of your eyes as well as offer sun protection.
- Light sensitivity. Because my eye was so fully dilated for the surgery, it took a couple of days for it to get back to normal. When light bothered me, I either wore sunglasses or pulled curtains to filter strong light.
- Take eye drops as prescribed. In the first week after surgery, I took four prescription eye drops four times a day. Although they can be self-administered, it was so much easier to have someone do it for me. I was lucky that my husband was such a good nurse!
- See the surgeon for Week 1 Post Op visit.
- The second week after surgery, the number of medications was reduced to two, and the frequency was reduced to two. By week four, I will only take one eye drop once a day.
- By week two, the protective eye cover is no longer required at night and you can shower and wash your hair normally.
- You will still want to wear good sunglasses or the post-surgery sunglasses when you go out as you'll be more sensitive to light with your new intraocular lenses.
Noticeable Improvement in Vision
I was amazed at the improvement in my vision even the first week after surgery. The most dramatic change was that everything looked brighter and whiter. My living room no longer looked dull! When I just had one eye done and while waiting for the second surgery, I could cover my "good" eye and I would see that everything had a yellowish cast that I never noticed before because I had nothing to compare it to. Now I could cover my right eye (still with cataracts) and look through my repaired eye and the yellow cast was gone! Two days after surgery, I woke up and could read the time on my bedside clock without my glasses! And the day I could read the fine print on the tube of toothpaste without glasses was so exciting.
At my one week post op visit for my second eye, my eyes tested 20/20 for reading and 20/25 for distance. I can now have the restrictions removed from my driver's license; I no longer need glasses to drive!
Six months later...
My vision remains good, though I am somewhat sensitive to bright sunlight and wear my sunglasses whenever I go out. I can read close-up print without glasses, but do have to wear low power reading glasses for computer work. I developed a slight fuzziness in my right eye due to minor scaring from the surgery. A quick, painless laser procedure in my eye doctor's office removed the scar tissue and took care of the problem.
Overall, I am very pleased with the outcome of my cataract surgery.