Cataract Surgery Recovery: A Day-by-Day Timeline
Most people getting ready for cataract surgery have a long list of questions, and a good number of them are about the recovery rather than the operation. The surgery is quick. The recovery is where you do most of the work, and in my experience patients who know what’s coming do better. So this is what I tell my own patients, and it’s the same information that’s in the instruction book you’ll take home.
Day one: the first few hours and the first night
You’ll spend a short while in the recovery area after the operation, with the nurses keeping an eye on you, and then you go home. A few things about that first day.
- The shield: You’ll leave with a clear plastic shield taped over the eye. Leave it on for two hours, then take it off and start your drops. After that you only need it at night, so you don’t rub the eye in your sleep, and only for the first three nights.
- How the eye feels: Scratchy, irritated and watery is normal on day one. That’s the surface of the eye settling down and it’s nothing to worry about.
- What you can see: Don’t expect sharp vision straight away. It’s usually blurry on day one, partly from the drops we use during surgery. Even so, a lot of people notice within hours that colours are brighter than they’ve been for years.
- Does it hurt? This is the question I get asked most. The operation is done under local anaesthetic, usually with sedation so you’re asleep, and you don’t feel anything during it. Afterwards most people describe discomfort rather than pain, and if you need something, paracetamol is usually all it takes.
- The drops: You’ll go home with three lots of drops: an anti-inflammatory once a day, a steroid four times a day, and a lubricant four times a day, all for 28 days. Leave five minutes between different drops. I say this to every patient: the drops are the most important part of your recovery, and you keep using them even when the eye feels completely fine.
At home on day one: Take it easy. Reading and watching television are fine in moderation. Don’t do anything that puts pressure on the eye, and don’t rub it. The no-rubbing rule runs for four weeks, not just the first day.
The first week and your post-cataract surgery care
This is when you’ll notice the biggest changes. The eye does a lot of healing in the first week, and for most people the vision improves noticeably from one day to the next.
- The next morning: Your lids may be stuck together when you wake up. It looks alarming and it isn’t. Clean them with a tissue moistened with cooled boiled water, then put your drops in as usual.
- Your first review: An optometrist will check the eye on the same day as surgery or the next day. The next planned visit is at one month, with me or one of our clinical optometrists.
- Days two and three: Some blur, a bit of redness and some light sensitivity after cataract surgery are all common. Keep the drops going exactly as written. The shield stays off during the day, and after the third night you can stop wearing it to bed.
- Vision: Most mornings you should wake up and find things a little clearer than the day before.
- Showering and washing your hair: You can do both from day one. Just keep your eyes closed while you’re facing the shower.
- Exercise: After 72 hours you can exercise and get back to normal activity. Contact sports wait four weeks.
- When can I drive after cataract surgery? Usually within one to two days, once your vision is back to normal and the eye is comfortable. The one firm rule is that you never drive the day after surgery, however well you think you can see, so if your review is the next morning, get someone else to take you.
The first month
By the one-month mark the eye has done most of its healing and the vision is usually fairly stable.
- Dry eye: Everyone gets some dry eye after cataract surgery, which surprises people. It peaks at three to six weeks and lasts eight to twelve weeks. It rarely feels dry. What people notice instead is vision that fluctuates and clears for a moment after a blink, lids that feel tired and heavy, and eyes that water. The lubricating drops are the treatment for it.
- The drops: All three drops run for the full 28 days, with no tapering in that time. After 28 days the anti-inflammatory and the steroid stop, and you keep the lubricants going two to three times a day for another two to three months.
- Odd visual things: A flickering light out in your peripheral vision, and floaters that are more noticeable than before, are both common in the first few weeks and both settle.
- Getting back to normal: Eye makeup is fine after one week. Swimming, contact sports and rubbing your eyes all wait for four weeks.
- Your one-month review: This is with me or one of our clinical optometrists. We check how the eye has healed, check the pressure, and talk about glasses.
- Glasses: I’d wait until five weeks before getting a new prescription, because that’s when the eye has settled enough to measure properly. In the meantime a cheap pair of readers from the chemist is fine as a stopgap. A lot of my patients find they don’t need glasses for distance at all afterwards, though reading glasses are often still useful.
- Light sensitivity: Any light sensitivity after cataract surgery should have faded a lot, or gone, by the end of the month. If it’s still bothering you, tell us at the review.
Beyond the first month
The lens I put in during surgery is there for good. It never needs replacing.
- Regular eye checks: Problems this far out are rare, but keep up your normal eye examinations so the rest of the eye gets looked at too.
- Posterior capsule opacification: Sometimes, years after surgery, the clear membrane behind the new lens goes cloudy. You’ll hear it called a secondary cataract, or PCO. If it happens, it’s fixed with a quick, painless laser procedure called a YAG capsulotomy, and the vision comes back straight away.
A few things I tell every patient about post-cataract surgery care
- Follow the instruction book. It’s short, and everything in it is there for a reason. The drops matter more than anything else on the list.
- Sunglasses aren’t required. The eye doesn’t need them. If bright light bothers you in the first few weeks, wear them for comfort, but that’s the only reason.
- Don’t rub the eye for four weeks. That includes once it feels completely normal.
- Eat and drink normally. It’s not specific to the eye, but your body heals better when it’s properly fed and watered.
Most people find recovery from cataract surgery is easier than they expected, as long as they use the drops and know which of the odd sensations are normal. If something feels wrong at any stage, or you’re just not sure, ring the rooms. I’d much rather look at an eye that turns out to be fine than have you sit at home worrying.
For the activity-by-activity rules, with the exact timeframes for driving, showering, exercise, swimming and makeup, see what can and can’t you do after cataract surgery?