Cataract surgery eye drops schedule day by day: a UK patient guide

The eye drops after cataract surgery are what actually deliver the good outcome. The operation places the lens; the drops prevent infection and control inflammation while the eye heals. Most UK protocols use two drops — an antibiotic and an anti-inflammatory steroid — on a four-week tapering schedule. Here is what that looks like day by day, and the mistakes patients most commonly make.

For the wider recovery picture see my cataract surgery recovery day by day guide.

The two drops you will be given

Standard UK post-cataract regimens use:

- An **antibiotic drop** (commonly chloramphenicol or a fluoroquinolone such as levofloxacin) for the first 1–2 weeks, to prevent bacterial infection while the tiny corneal wound seals.

- A **steroid anti-inflammatory drop** (commonly dexamethasone or prednisolone) for 4 weeks, tapered down, to control the natural post-surgical inflammation that would otherwise cloud vision.

Some patients also receive a **non-steroidal (NSAID) drop** (e.g. ketorolac or bromfenac) for 4 weeks if they are at higher risk of macular swelling — for example diabetics, or patients with retinal disease.

The exact drug names and bottle colours vary between hospitals. What matters is the schedule.

Day 0 — evening of surgery

Start both drops on the evening of surgery, once you are home and settled. Typically:

- Antibiotic: 1 drop, 4 times a day

- Steroid: 1 drop, 4 times a day

Leave at least 5 minutes between different drops so the second one is not washed out by the first.

Days 1–7 — week one, both drops four times a day

For the first full week you continue both drops four times a day. A practical UK schedule that patients find easy to remember:

- On waking (around 8am)

- Lunchtime (around 12–1pm)

- Late afternoon (around 5–6pm)

- Bedtime (around 10pm)

Wash your hands, tilt your head back, pull the lower lid down, look up, and let one drop fall into the pocket. Close the eye gently for 30 seconds and press lightly on the inner corner (near the nose) — this stops the drop draining into the tear duct and gives it time to absorb.

Day 8–14 — antibiotic stops, steroid reduces

At the one- to two-week review the antibiotic is usually stopped. The steroid drop typically reduces from 4 times a day to **3 times a day**. Some protocols use a slower taper (e.g. 4/day for 2 weeks then 3/day for 1 week) — always follow the schedule your surgeon gives you.

Day 15–21 — steroid twice a day

The steroid drop reduces to **twice a day** for the third week. Vision should now be clear and stable; the drop is doing background inflammation control rather than treating obvious symptoms.

Day 22–28 — steroid once a day, then stop

In the fourth week the steroid drops to **once a day**, then stops at the end of the week. By this point the eye should be white, comfortable and refractively stable.

The most common drop mistakes

In clinic I see the same errors repeatedly. Avoid these:

- **Stopping the steroid early** because the eye 'feels fine'. This is the most common cause of rebound inflammation and blurred vision in week 3.

- **Missing the tapering step** and dropping straight from 4/day to 0/day. Always step down through the schedule.

- **Two drops back-to-back** so the second washes the first out. Leave 5 minutes between different drops.

- **Squeezing multiple drops in at once** — the eye only holds one; extra drops just run down the cheek and waste the bottle.

- **Touching the bottle tip to the eye or eyelashes** — this contaminates the bottle and risks introducing infection.

- **Using drops in the wrong eye** — label bottles clearly if only one eye has been operated on.

What to do if you miss a dose

If you remember within 2 hours of the scheduled time, take the missed drop and continue as normal. If it is closer to the next dose, skip the missed one — do not double up.

Drops and daily life

- Contact lens wear is not permitted while on antibiotic drops. Restart contacts in the un-operated eye once cleared at your review.

- Eye make-up should be avoided for 2 weeks; from week 3 you can use fresh mascara and eyeliner, avoiding the water line.

- Store both drops at room temperature unless the label specifies fridge storage (some steroid suspensions).

- Shake steroid suspension bottles before use — they separate.

Red flags — call the same day

Speak to the clinic the same day if any of the following develop while on drops:

- Increasing redness, pain, or discharge

- Sudden drop in vision

- A severe stinging or allergic reaction to a specific bottle

- Fresh floaters or flashing lights

Next steps

Every patient in our fast-track cataract pathway gets a printed drop schedule with tick-boxes for each dose, plus a phone number if any step is unclear. Book online or call **020 3137 3237**.