What’s Cataract Surgery Really Like?

Cataracts are an extremely common eye condition, particularly as we age. By the time we reach our 70s, over half of us will have developed them to some extent. While the word “surgery” might spark a bit of anxiety, cataract surgery is one of the most frequently performed – and safest – procedures in the world. But what is it really like to go through cataract surgery?

Understanding Cataracts
A cataract occurs when the natural lens of the eye becomes cloudy. This clouding can be caused by ageing, but also by injury, certain medications, or health conditions like diabetes. Over time, the cloudiness can interfere with vision, making it blurry, hazy, or giving it a yellowish tint. Night driving can become difficult, and colours may appear duller.

When glasses or contact lenses no longer improve vision, cataract surgery becomes the next step.

The Lead-Up: Diagnosis and Decision

Diagnosis
Cataracts are typically diagnosed during a routine eye examination. Your optometrist or ophthalmologist may notice early changes in your lens before you’ve even noticed any visual symptoms. If your vision begins to decline significantly, you’ll likely be referred to an eye specialist (ophthalmologist) for further evaluation.

Making the Decision
The timing of cataract surgery is a personal choice, but most ophthalmologists recommend waiting until the cataract begins to significantly interfere with daily life – such as reading, driving, or recognising faces. It’s not an emergency surgery, so you can plan it around your lifestyle and schedule.

You’ll be given a pre-operative assessment to ensure you’re fit for surgery. This may include measuring your eye to determine the correct lens implant and reviewing your overall health.

What Happens During Cataract Surgery?
Cataract surgery is typically a day procedure, which means you’ll be in and out of hospital or clinic the same day. The procedure usually takes about 15 to 30 minutes per eye, although you may be at the clinic for a few hours in total.

Anaesthesia
Most cataract surgeries in the UK are performed under local anaesthetic, either as eye drops or a small injection around the eye. This means you’ll be awake, but you won’t feel pain or see much of what’s going on.

For nervous patients or those with other medical conditions, sedation or even general anaesthesia may be offered, but this is less common.

The Procedure 
The most common technique used is called phacoemulsification. Here’s a simplified breakdown of what happens:

1. A tiny incision is made in the eye.

2. A small probe uses ultrasound waves to break up the cloudy lens.

3. The fragments are gently suctioned out.

4. A clear artificial lens, known as an intraocular lens (IOL), is inserted into the same place.

The incision is usually so small that no stitches are needed: it heals naturally.

Can You See What’s Happening?
One of the most common questions asked is: “Will I see what they’re doing to my eye?” The answer is generally no. You might see bright lights or vague movements, but you won’t see the instruments or feel any pain.

Immediately After Surgery
Once the operation is over, you’ll rest for a short while and then be allowed to go home; usually with a protective eye shield and some instructions about eye drops etc.

Vision After Surgery
Many people notice immediate improvement in their vision. Colours appear brighter, and objects are sharper. However, don’t be alarmed if your vision is a bit blurry or hazy at first. This typically clears up within a few days as your eye heals.

Recovery and Aftercare
Recovery from cataract surgery is usually smooth and straightforward. Most people return to normal activities within a few days, although full recovery can take a few weeks.

Do’s and Don’ts

• DO use the prescribed eye drops exactly as instructed. These help prevent infection and reduce inflammation.

• DO wear the protective eye shield at night for the first week or so.

• DO avoid rubbing your eye or getting soap or water directly into it.

• DON’T engage in strenuous activity or heavy lifting for at least a week.

• DON’T drive until your ophthalmologist says it’s safe to do so: this usually once your vision has stabilised.

Follow-up appointments will be scheduled to monitor your healing and assess your new vision.

What Are the Risks?
Cataract surgery has an exceptionally high success rate: over 95% of patients experience significantly improved vision. That said, as with any surgery, there are some risks, including:

• Infection or inflammation

• Swelling

• Retinal detachment (rare)

• Posterior capsule opacification (a common side-effect where the lens capsule becomes cloudy months or years after surgery, easily treated with a laser)

It’s crucial to follow your aftercare instructions and attend all follow-up appointments to catch any complications early.

Choosing the Right Intraocular Lens (IOL)
One part of the process you might not expect is choosing your new artificial lens. There are different types:

• Monofocal lenses (standard NHS option): Correct for either distance or near vision, but not both.

• Multifocal lenses: Provide a range of vision but may cause glare or halos at night.

• Extended depth of focus lenses: Allow vison at all distances with minimal glare and haloes at night. However, reading very small print under low light levels may require a small reading prescription.

• Toric lenses: To correct astigmatism as well as distance or near vision.

Discuss your lifestyle and preferences with your ophthalmologist. They can help you choose the right lens for your needs.

Final Thoughts: What’s Cataract Surgery Really Like?
In truth, cataract surgery is quick, virtually painless, and highly effective. For most people, it’s a life-changing procedure that restores not just vision, but also confidence, safety, and quality of life.

If you or someone you know is considering cataract surgery, don’t hesitate to consult an eye specialist. Restoring your sight could be simpler – and more rewarding – than you ever imagined.