How to care for your eye after cataract surgery.
Let me first start with a disclaimer. Anything YOUR surgeon told you to do after surgery should supersede what is in this post.
There are many variations of what each surgeon asks their patients to do after cataract surgery so please just use this as a general guideline. These are my instructions to patients, but it may not match every surgeon’s preferences.
What to expect immediately after the surgerySome redness, light sensitivity, tearing, tenderness and foreign body sensation is normal following cataract surgery. Any discomfort is usually relieved with two Tylenol tablets every four hours.
Mucus and crusting on the eye and eyelids following surgery is not unusual. The eyelids and lashes may be gently cleaned using a clean washcloth & warm tap water. This may be done as often as needed.
You may watch TV, use the computer or read.
Showering is permitted, as well as washing your hair, but try not to get soap into the operated eye.
It is not unusual for the vision to be blurred, foggy, hazy or for you to see black spots and colors after surgery. The vision may be clear immediately after surgery and then get somewhat hazy, cloudy or foggy a few hours later. This comes from mild swelling that occurs a few hours after surgery and usually clears significantly by the next day. If you notice a sudden decrease in vision, new flashes of light out of the operated eye, or significant pain (not just a feeling like there is an eyelash in your eye) you should call your doctor at once.
EyedropsThe majority of people having cataract surgery are asked to put eye drops in their eyes after surgery. The number of individual types of drops is usually either 2 or 3. The drop schedule is different for every surgeon, so you should definitely follow the frequency instructions you were given. Whenever two different drops need to go in at around the same time it is wise to try and separate the two drops by about 5 minutes or so. This allows each drop to fully absorb without being washed out by the following drop. Most patients will take less and less drops over time. For my patients their drop schedule gets down to one drop a day about 4 weeks after surgery and stops around the 5thweek. Again every surgeon’s instructions may be different and you need to follow your surgeon’s instructions on the drops.
SunglassesMost facilities that do cataract surgery (either a hospital or ambulatory surgery center) send you home from surgery with a pair of sunglasses to wear. The sunglasses are used to try and protect your eye while your eyes are dilated after surgery. For some people their dilation may last for a few days, so it is a good idea to wear the glasses anytime you are out in the sunlight. In the first day or two after surgery many people wear their sunglasses inside because the normal indoor lighting even seems too bright.
After the first few days after surgery the sunglasses are mostly there for your comfort. You should wear them whenever you feel the lights are too bright. Often after cataract surgery it takes a while to get used to how bright the world looks. When the cataract was in your eye it blocked some of the light from getting through to your retina. Once the cataract is gone the world is a much brighter place and you may need the sunglasses for an extended period of time to help deal with the brightness. Many people after cataract surgery immediately notice how much brighter colors look. This is especially true for things that are white or blue. The cataract that was removed was yellow in color and when you put a yellow filter in front of something it makes whites look yellow and really dims things that are blue. Therefore wear the sunglasses for the first few days and then whenever you feel you need them.
ActivitiesEvery surgeon has slightly different instructions and limitations after surgery, but these are mine.
For the first week after surgery there are 4 things I don’t want you to do:
1. Don’t rub your eye
2. Don’t wear eye makeup
3. Don’t swim
4. Don’t lift anything heavy enough to make you hold your breath to lift it
Notice there is no limitation to bending over. Almost every cataract surgery done today is done with a very small incision that is not going to open by simply bending down. What you are trying to do is avoid any direct pressure on your eyeball (rubbing or lifting heavy objects) and trying not to get any foreign/toxic chemicals or bacteria in your eye (no swimming or eye makeup).
After the first week you can return to normal activities except I still don’t want you to rub your eye hard. Your eye is a delicate sensory organ and it is really not wise to ever rub it hard.
The one other thing I like everyone to do for the first week after surgery is to wear a protective shield (usually given to you by the facility you had your surgery in) over the eye when you are sleeping. The shield helps protect the eye in that first week from getting rubbed or smashed into the pillow or your arm while you are sleeping.
DrivingYou should not drive the day of surgery. For most surgeries you are given some degree of sedation and it is not a wise idea to drive after the surgery on the first day. You likely have an appointment to see your surgeon on the day after surgery. The question often arises, “Can I drive to the office the next day?” I’m ok with people driving the next day as long as they do not still feel groggy from the anesthesia and if the vision in the eye that was not operated on is good. Although many people see well out of the eye that was operated on in the first 24 hours it is hard to count on the vision being good that quickly. You need to be sure you are comfortable driving the next day and it is hard to predict that in advance.
If it is relatively easy to arrange a ride for the day after surgery, I would do that. If that is hard for you to do, you are probably going to be able to drive yourself the next day if the vision out of the other eye is good. If the vision in your other eye is not good I would not count on being able to drive the first day. Once you are examined your surgeon can tell you if visually you are passing the legal requirement to drive in your state or not.
EyeglassesWhat happens with your eyeglasses varies a great deal depending on what type of implant you had inserted during cataract surgery and what your pre-surgery eyeglass prescription was. Usually we prescribe new glasses after cataract surgery about 3 weeks after the surgery. This allows enough time for the eye to heal and for the glasses prescription to stabilize. Giving a prescription earlier than that may result in having to re-do the prescription because the eye wasn’t quite stable enough before the three-week mark.
Immediately after surgery your old prescription in your glasses is likely not to be right for the new state of your eye. Wearing your old glasses will not do any harm to the post-surgery eye you just might not see very clearly out of them. What I usually tell patients after their surgery is to compare how they see with their old glasses on versus what you see with the glasses off and just go with whichever way looks better. Which works best may change over the early post-operative course. In the first couple of days you may see better with the glasses on and as the eye heals you may be better with them off. You just need to go with whatever makes you see best each day until the glasses script gets changed at about 3 weeks.
If the script in the old glasses is very far off from where the “new” eye is after surgery, we sometimes have our patients take the lens out of their old glasses for the post-operative eye to see if they see better that way. No matter which way works best for you just remember you are not doing any harm to the post-op eye by looking through your old glasses even if the script isn’t right any more.
If you had what we call a mono-focal or fixed focus implant set for distance (this is currently the most frequently implant lens type in the US) you may have good distance vision without glasses but won’t be able to read anything unless you have glasses to help. I usually recommend patients get an over the counter reading glass (usually around a +2.50) to use temporarily to read until they get a real prescription at about 3 weeks after surgery.
SummaryMost people can easily take care of themselves and do fairly normal activities right after their cataract surgery. There is really not a lot of “down time”. As long as you can get the eyedrops in your eye by yourself there is rarely any need to have anyone else stay with you right after surgery.
For more on cataracts and cataract surgery please read some of our other blogs below:
Why would I have to pay out of pocket for Cataract Surgery?
Should I pay out of pocket for Cataract Surgery?
How much should I pay out of pocket for Cataract Surgery?
Is it wise to have Cataract Surgery if you have Macular Degeneration?
Do I really need Cataract Surgery?