What you need to know about cataract surgery

Ophthalmologist Dr Patrick Versace explains what to expect during your surgery and recovery.

Understanding your procedure: What is cataract surgery?

A cataract occurs when the lens of the eye, which is naturally clear, becomes cloudy. During cataract procedures, a surgeon removes the cloudy lens and replaces it with an artificial one. 


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What are the signs and symptoms of cataract?

Cataracts are very common in older people, particularly those over 65 years of age.

Ophthalmologist Dr Patrick Versace says the signs and symptoms vary from person to person, but they are often picked up by optometrists and ophthalmologists in the early stages.

“It can be as simple as difficulty getting the right glasses. Patients go to an optometrist and their vision is just not quite right and they find it very hard to choose the right glasses. 

Sometimes it can be increased sensitivity to glare. For example, when you are driving at night and you start to become aware that it’s just not as comfortable,” says Dr Versace. 

“Then you have people who come in and say, I covered my left eye for whatever reason and suddenly realised I couldn’t see properly out of my right eye. But when you have both eyes open you might not notice.”

Do I need cataract surgery?

If you have a cataract, it’s important to consult your treating doctor before making a decision about surgery. 

Typically, the decision to have cataract surgery is based on the effect it has on your vision, says Dr Versace.  There may also be many other factors to consider, including your health and suitability to undergo the procedure. 

“Some patients may have significant cataract but they say I’m really happy with my vision and I don’t believe I’ve got a problem, in which case I’ll say you haven’t got to do surgery. Other patients will have the earliest sign of cataract and they are noticing glare, or poor vision at night so we’ll advise they go ahead with surgery.”

In rare cases, surgery is needed to reduce pressure in the eye with some types of glaucoma. 

What happens during cataract surgery?

Cataract surgery typically takes 10-15 minutes, and is usually done as a day procedure. 

Patients are usually sedated, and given eye drops to numb and dilate their eyes. Surgery is then performed through a microscope or sometimes using a laser. 

“For patients, it’s painless. They may see some lights and feel a bit of pressure but there should not be any pain. The sedation we provide is to keep them calm and relaxed because it can be scary lying there,” says Dr Versace.  

As with any surgical procedure, there are some risks with having cataract surgery.  You should discuss these risks with your treating doctor. 

Will I still need glasses after cataract surgery?

As with any surgery, outcomes differ and will depend on a number of factors.  However, generally, your vision following cataract surgery will depend on the artificial lens implant you have. 

A standard monofocal lens will give vision for one focus – typically distance vision for television viewing and driving a car. Meaning reading glasses are usually still needed for close distances.  

A multifocal lens will provide short and long distance vision without having to wear glasses, reducing the need for glasses. 

Talk to your treating doctor about the type of lens they think is most suitable for you. In the private system, patients generally have a choice about the type of lens implant they would like.  

Recovering from cataract surgery 

If there are no complications, recovery from cataract surgery is generally relatively quick. 

Generally, after surgery a clear plastic shield is taped onto the skin to protect the eye. You should be able to see through this, though the vision may not be clear until the next day.  

“It’s normal to feel mild irritation, some scratchiness and a mild burning sensation with a little wateriness.  Any discomfort should be able to be managed with over-the-counter pain medication,” says Dr Versace. If you're concerned, you should contact your treating doctor as soon as possible.    

Until the sedation wears off and your vision is tested, you won’t be able to drive, so you’ll need someone to drive you home. 

Preventing infection and damage 

While your treating doctor will speak to you in more detail about your recovery, there are a few things to keep in mind as you recover to ensure things go smoothly. Most patients are prescribed eye drops to help prevent infection and inflammation. 

Swimming and contact sports should be avoided for a week or so following surgery. It’s also a good idea to avoid getting water in your eye when showering, or using eye makeup. 

“The incisions we make during a cataract procedure are very small. Whilst the eye is strong after surgery rubbing it or accidental bumps could cause damage,” says Dr Versace.  

Warning signs to look out for after cataract surgery

Dr Versace tells patients to look out for three key thing following surgery:

  • Pain: Generally, cataract surgery should not be painful. If you can’t manage the pain or discomfort with paracetamol, or your pain is increasing, it is a sign of a problem.  Speak to your doctor immediately. 
  • Redness: The eye is often a bit blood shot after surgery but this should improve. If there is increasing redness or the eye suddenly becomes red where it was previously clear this can be a sign of inflammation or infection and needs urgent attention.  
  • Loss of vision: if the vision is getting worse rather than improving there is something wrong.  Deteriorating vision with pain and redness is an emergency and needs immediate attention.

“These three symptoms can be signs of an infection of the eye – endophthalmitis. While this is not common, it can have an impact on your vision if not treated quickly. If you notice these warning signs, you should speak to your specialist or go to the hospital straight away.” 

Dr Patrick Versace has been an ophthalmologist for more than 25 years with an interest  in cataract surgery and laser vision correction. He is a founding member of East Sydney Private Hospital.

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