What to expect when you have treatment for cataracts - Your questions answered

Cataract treatment is one of the most common and most successful procedures performed today. If you have been told you have cataracts, it is natural to have questions about what will happen. This guide explains the journey from first assessment through surgery and recovery, so you know what to expect at each stage.

Before your assessment

Before you are seen, you may be asked to stop wearing contact lenses for a few days or weeks so your cornea returns to its natural shape. Bring your current glasses, a list of any medications and eye drops, and details of your general health. It is helpful to think about what you want from surgery, such as less dependence on glasses for distance, reading or computer work.

The assessment appointment

During the assessment, your vision and prescription are checked, and the cataract is examined. Measurements are taken of the length and shape of your eye to help choose the right lens. Drops may be used to dilate your pupils, which can blur your vision for a few hours, so you should not drive yourself home. You will also have a chance to discuss the risks and benefits, the lens options and the expected recovery.

Choosing your lens

One of the most important parts of modern cataract treatment is selecting the lens that replaces your cloudy natural lens. Options include monofocal lenses, which provide clear distance vision but usually require reading glasses, and premium lenses such as toric, multifocal, trifocal or extended-depth-of-focus lenses, which can reduce dependence on glasses at more distances. The right choice depends on your prescription, lifestyle, eye health and personal preferences.

On the day of surgery

Cataract treatment is usually performed as a day-case procedure. You will be awake, but drops and a small anaesthetic injection or gel are used to make the eye comfortable. You should not eat or drink for a few hours beforehand if you are having sedation, and you will need someone to take you home afterwards. Most people are at the hospital or clinic for two to three hours in total, though the procedure itself usually takes only 10 to 20 minutes.

The procedure itself

The cloudy lens is removed through a tiny opening and replaced with a clear artificial lens. The technique most commonly used is phacoemulsification, where ultrasound gently breaks the lens into small pieces. Stitches are rarely needed because the opening is so small. You may see bright lights and feel some pressure, but the procedure should not be painful. A clear shield is usually placed over the eye for protection.

Immediately after surgery

After the procedure, you will rest in a recovery area for a short time. Your eye may feel slightly gritty or watery, but significant pain is uncommon. You will be given eye drops to use at home to reduce inflammation and prevent infection. Most people are able to go home within an hour or two of the surgery.

The first week at home

In the first few days, it is important not to rub the eye and to keep it clean and dry. You should avoid heavy lifting, bending double, and getting water or soap into the eye. Light activities, reading, watching television and gentle walking are fine. Many people notice that colours look brighter and vision is clearer within a day or two, although the eye will continue to settle over the following weeks.

Driving and returning to normal

You can usually return to light daily activities within a day or two. Office work is often possible within two to three days, but you should avoid dusty environments or tasks that could strain the eye. Driving should only resume once your vision meets the legal standard and your surgeon has confirmed it is safe. This is usually checked at your first post-operative appointment.

Follow-up appointments

Most patients are seen the day after surgery, then again at one week and around four to six weeks. These checks are important to ensure the eye is healing well, the pressure is normal, the lens is in the right position and the vision is improving. If you have surgery on both eyes, the second eye is usually treated once the first has settled.

When to seek help

Contact your clinic urgently if you have severe pain, a sudden drop in vision, increasing redness, discharge, flashes, floaters or a curtain over your vision. These symptoms are uncommon, but early assessment is important. Do not wait for your next scheduled appointment if you are worried.

Next steps

If you have been told you have cataracts and would like to understand your options, the first step is a consultant-led assessment. Write down your questions beforehand, bring your glasses, and be ready to discuss what you want from your vision. Cataract treatment is highly effective, and most patients are delighted with the improvement in clarity and colour.