Patient education: Cataract removal (The Basics)

What is a cataract? — A cataract is clouding of the lens in the eye. The lens is the part of the eye that focuses light (figure 1). Cataracts can:

●Cause vision loss

●Make your vision blurry or dull

●Make things look slightly gray, yellow, or brown

●Cause a glare when you look at light

What is cataract removal? — During cataract removal surgery, the doctor takes out the cloudy lens and replaces it with an artificial one.

In some cases, the doctor will do surgery on 1 eye and then do the other eye another day. In other cases, they will do surgery on both eyes on the same day.

How do I prepare for cataract removal? — The doctor or nurse will tell you if you need to do anything special to prepare.

Before your procedure, your doctor will do a "comprehensive eye exam." This is a detailed check of your eyes and vision. Most people do not need any other tests before surgery.

Your doctor will also ask you about your "health history." This involves asking you questions about any health problems you have or had in the past, past surgeries, and any medicines you take. Tell them about:

●Any medicines you are taking – This includes any prescription or "over-the-counter" medicines you use, plus any herbal supplements you take. It helps to write down and bring a list of any medicines you take, or bring a bag with all of your medicines with you.

●Any allergies you have

●Any bleeding problems you have – Certain medicines, including some herbs and supplements, can increase the risk of bleeding. Some health conditions also increase this risk.

You will also get information about:

●Eating and drinking before your procedure – In some cases, you might need to "fast" before surgery. This means not eating or drinking anything for a period of time. In other cases, you might be allowed to have liquids until a short time before the procedure. Whether you need to fast, and for how long, depends on the procedure you are having.

●Whether you need to use eye drops before surgery

●What help you will need when you go home – For example, you will need to have someone else bring you home.

Ask the doctor or nurse if you have questions or if there is anything you do not understand.

What happens during cataract removal? — You might be able to sense movement or light during surgery. But you won't be able to see what the doctor is doing.

When it is time for the procedure:

●You might get an "IV," which is a thin tube that goes into a vein. This can be used to give you fluids and medicines.

●You will get anesthesia medicines. This is to make sure that you do not feel pain during the procedure. Most cataract removal surgeries are done with local anesthesia to numb the eye. This can be eye drops, a shot given near the eye, or both. Most people get "sedatives," which are medicines to help you relax and feel sleepy.

Cataract removal surgery can also be done with general anesthesia. This means getting medicines to put you to sleep for the procedure.

●The doctors and nurses will monitor your breathing, blood pressure, and heart rate during the procedure.

●The doctor will use a special microscope to see the eye. To remove the cloudy lens, they can:

•Make a small cut (incision) in the eye and use ultrasound or sound waves to break up the cloudy lens. They remove the small pieces of the lens with suction.

•Make a larger incision in the eye, and remove the lens in 1 piece.

•Use a laser to make a small incision and break up the old lens. Then, they remove the small pieces of the lens with suction.

●After the lens is removed, the doctor will put an artificial lens in place through the same incision. In some cases, the lens can be chosen to reduce the need for glasses after surgery.

●You might need stitches to close the incision. The doctor will place a patch or protective shield on your eye after surgery.

●Cataract surgery often takes less than an hour.

What happens after cataract removal? — After your procedure, you will be taken to a recovery area. The staff will watch you closely as your anesthesia wears off.

Most people are able to read, walk, eat, and do things like watch TV the night of surgery. The doctor will also tell you when it is safe to drive again.

What are the risks of cataract removal? — Your doctor will talk to you about all of the possible risks, and answer your questions. Possible risks include:

●Infection

●Bleeding

●Swelling

●Problems removing all of the old lens

●Eyesight getting worse after surgery

●Problems with the new lens

How do I care for myself at home? — Ask the doctor or nurse what you should do when you go home. Make sure that you understand exactly what you need to do to care for yourself. Ask questions if there is anything you do not understand.

You should also:

●Take all of your eye drops as instructed. Always wash your hands before using eye drops or touching your eye or face.

●Take non-prescription medicines as needed to relieve pain, such as acetaminophen (sample brand name: Tylenol).

●Wear the patch or shield on your eye until your doctor says that you can remove it. Usually, you only need to wear the patch for the first night. You might need to wear the shield for a few days or weeks. Wearing it at night will help protect your eye while sleeping.

●Avoid rubbing or pressing on your eye. Avoid things that could irritate your eye, like dust or wind. Sunglasses can protect your eye from bright lights if they bother you.

Based on the size of your incision, your doctor might recommend that you limit heavy lifting or strenuous activity for a few days or weeks. With a larger incision, you might need to limit your activities for few weeks or months.

What follow-up care do I need? — The doctor will want to see you again after surgery to check on your progress. It's important to go to all of your appointments.

The doctor will also check for problems that might not affect your vision. They might change your medicines. In some cases, they will need to remove stitches. You might also need a new prescription for your glasses.

When should I call the doctor? — Call for advice if:

●You have a fever of 100.4°F (38°C) or higher, or chills.

●You have more pain in the eye.

●You have more eye drainage, or the eye drainage changes color.

●You have trouble seeing. Examples include:

•Eyesight getting worse

•Double vision

•Flashes of light

•Floaters

•Seeing a shadow or curtain across all or part of your vision

•Not being able to see up, down, or to the sides when looking straight ahead

More on this topic

Patient education: Cataracts (The Basics)
Patient education: Capsulotomy after cataract surgery (The Basics)
Patient education: Anesthesia for elective eye surgery (The Basics)