Why would I need cataract surgery?
Cataracts make the lens of your eye cloudy. They usually develop slowly over many years. You may not notice any problems with your vision at first. In fact, many cataracts are diagnosed at a routine eye check. But your vision will become affected as your cataract gets worse. If your vision is severely affected, this can interfere with your daily activities, including reading, watching television and driving. Cataract surgery will help you see more clearly again.
You can have your cataracts removed at any stage. You don’t necessarily need to wait until your eyesight is badly affected. The timing of the surgery will depend on your personal circumstances, such as your age and how much your cataract affects your daily life. If you drive, you may wish to have surgery sooner than someone who doesn’t drive at all. If your optometrist thinks you may need cataract surgery, you’ll be referred to an ophthalmologist (a doctor who specialises in eye health, including eye surgery).
If you have cataracts in both eyes, you’ll usually be advised to have them removed one at a time. You’ll probably have the first operation on your eye that's most severely affected by a cataract. You’ll then have the second operation once your surgeon is sure that the first operation was successful.Back to top
Preparing for cataract surgery
The ophthalmologist will discuss the pros and cons of having cataract surgery with you. They’ll measure your eye and check your vision with several tests so they can decide which artificial lens will be best for you. They may ask about your general health and if you have any other problems with your eyes or vision. This will help them assess your risk of complications after surgery (see our section: Risks of cataract surgery).
Cataract surgery is usually done as a day-case procedure. This means you can have the operation and go home on the same day.
You’ll usually have cataract surgery under local anaesthesia. This means you’ll be awake during the procedure but won’t feel any pain. Your surgeon will use anaesthetic eye drops or an injection to completely block pain from your eye and the area around it.
You can have cataract surgery under general anaesthesia, but this is less common. If you have a general anaesthetic, you’ll be asleep during the operation.
Your surgeon will discuss with you what will happen before, during and after your surgery. If you’re unsure about anything, don’t be afraid to ask. No question is too small. It’s important that you feel fully informed so you feel happy to give your consent for the operation to go ahead. You may be asked to do this by signing a consent form.Back to top
What are the alternatives to cataract surgery?
If you have a cataract, replacing your cloudy lens with a new one is the only way to restore your vision. But you may not need to have surgery straight away.
If your vision is only slightly affected, or not affected at all, your surgeon may suggest you have an eye examination once a year. This will monitor both how your cataract develops and any changes in your vision. Wearing glasses may help you see better for a short while, but they can’t stop the clouding of your lens from getting worse. Eventually, you’ll need to have surgery to help you see clearly again.Back to top
What happens during cataract surgery?
Your surgeon will remove your cloudy lens and then replace it with a new one. You’ll need to be able to lie reasonably flat and still.
Your surgeon will put some drops in your eye to widen your pupil and relax your eye muscles. This will make it easier for them to examine your eye and remove the lens. They’ll also put local anaesthetic eye drops into your eye or inject your eye with a local anaesthetic. Your eye may burn or sting for a few seconds after the anaesthetic, but many people don’t feel anything at all. Your surgeon will place a clean drape (sterile sheet of fabric) over your face. The drape will make a small tent over your face so you can still breathe and speak. Your surgeon will use a small clip to hold your eyelid open so you don't need to worry about blinking at the wrong moment.
Once the anaesthetic is working, your surgeon will make tiny cuts on the surface of your eye. You’ll be awake and see some movement, but you won’t be able to see any details. You won’t feel any pain either, but may feel some touch and pressure.
Most surgeons remove a cataract with an operation called phacoemulsification. They’ll use a special instrument that uses ultrasound (sound waves) to break up your cloudy lens. They’ll remove the broken lens from your eye leaving behind the capsule it sat in. Then they’ll put the new artificial lens into the empty capsule, where it will stay permanently.
Your surgeon will usually leave your eye to heal naturally without stitches.Back to top
What to expect afterwards
Your surgeon will check on your eye shortly after your surgery. You’ll usually be able to go home within a few hours, as soon as you feel ready. After you’ve had a local anaesthetic, it may take several hours before the feeling comes back into your eye. Make you have someone who can take you home.
If you have a dressing, keep it in place for 24 hours to protect your eye. You may be able to remove any dressing yourself the following day, but check with your surgeon. Your eye will probably also be protected with a plastic shield, which you’ll need to wear at night.
Your eye may feel a bit sore at first as the anaesthetic wears off, but you'll be offered pain relief as you need it. You may be given a course of antibiotic eye drops to use at home to help prevent an infection. It’s important to complete the whole antibiotic course. You may also be given steroid eye drops to help control any swelling in your eye. It's important to follow your surgeon's advice about how often to use the drops. You may need to use them four times a day for up to four weeks.Back to top
Recovering from cataract surgery
Your eye may look red and bruised at first. This should disappear after a few days. Your vision should start to get better within a day or two, but your eye may take a few weeks to heal completely.
If you need pain relief, you should be able to take over-the-counter painkillers, such as paracetamol or ibuprofen. But always check this with your surgeon. If over-the-counter painkillers aren’t working, your surgeon may be able to prescribe something stronger. Read the patient information leaflet that comes with your medicine and if you have any questions, ask your pharmacist for advice.
Looking after your eye
To help your recovery, follow these simple tips after your surgery.
- Don’t touch or rub your eye for a few weeks. If you’re a restless sleeper, you can wear an eye shield at night to protect your eye.
- Keep soap, shampoo and dirty water out of your eyes.
- Don’t do any heavy lifting, bending or strenuous exercise for the first few weeks after your surgery.
- Don’t wear eye make-up, use hair spray, drive or go swimming until your surgeon tells you it’s safe to do so.
- If you go out when it’s windy, protect your eye from grit and dust.
Signs of infection
You’re very unlikely to develop an infection after cataract surgery. But it’s important to be aware of the symptoms of an infection, just in case you do. These include:
- severe pain
- loss of vision
- blurred vision
- redness in your eye that keeps getting worse
If you have any of these symptoms, you’ll need immediate antibiotics. Your surgeon may have given you information on who to contact in an emergency. If you can’t get in touch with them, go to your local accident and emergency department and tell them you’ve recently had cataract surgery.
Returning to normal
Most people recover quickly from cataract surgery, but you may feel more tired than usual for a few days. It usually takes about two to six weeks to make a full recovery. This varies from person to person though, so it’s important to follow your surgeon’s advice. You’ll be able to go back to work once you feel ready, depending on what your job involves.
There aren't any restrictions on flying after cataract surgery. But remember to take your eye drops with you when you go away. You can’t go swimming in the first few weeks after your operation. Once your eye has healed, usually four weeks after your surgery, you’ll need to have an eye test. You’ll probably need to wear reading glasses. You may also need to wear glasses for distance vision, even if you didn’t need them before the surgery.
After cataract surgery, most people’s vision will meet the driving requirements of the UK. But follow your surgeon's advice on when you can drive again. You’ll need to have recovered from surgery and be free from pain and sedating medicines. You’ll need to be able to read a number plate 20 metres away with both eyes open to be within the legal limits for driving. You may need to wear glasses to be able to do this. You must also meet the other minimum eyesight standards for driving. Ask your surgeon or contact the Driver and Vehicle Licensing Agency (DVLA) if you're unsure.Back to top
Side-effects of cataract surgery
Side-effects are the unwanted, but often mild and temporary problems you may expect to happen as a result of surgery. Side-effects of cataract surgery include:
- redness and bruising around your eye or eyelid for a couple of days afterwards
- raised eye pressure for a few days
- an itchy or gritty eye and blurred vision
- mild bruising or a black eye for around a week if you’ve had a local anaesthetic by injection
- sensitivity to bright light – lights and colours may seem much brighter than usual
Back to top
Complications of cataract surgery
Complications are unexpected problems that may happen during or after your treatment. Complications of cataract surgery are rare but can include:
- a tear in your lens capsule
- problems with the new lens, such as its position in your eye
- a severe eye infection
- a detached retina (when the thin lining at the back of your eye pulls away from the blood vessels that supply it)
- bleeding inside your eye (suprachoroidal haemorrhage) – your surgeon may need to stop your operation and you’ll have it another day
- fluid gathering in small spaces on your retina (cystoid macular oedema)
If you do get any of these complications, they may affect your vision and you may need to have another operation. Ask your surgeon about the risks of cataract surgery and how these apply to you.
Around one in 10 people who have cataract surgery develop posterior capsule opacification (PCO) some time later. This is when cells from the removed lens are left behind after surgery and begin to grow back. This causes blurring of your vision, similar to having a cataract again. You can have laser treatment to correct this.Back to top
Accessing cataract surgery
You’ll usually be offered cataract surgery on the NHS if your cataracts are beginning to affect your daily life. But there are no national guidelines about when people should and shouldn’t have cataract surgery. Your eligibility will depend on your personal circumstances. It may also depend on where you live or if you have another eye condition such as glaucoma.
Most people with cataracts will need surgery eventually, as cataracts get worse over time. You’ll usually be referred to an NHS eye clinic by your local optometrist, unless you already see a hospital consultant for another eye problem. You’ll need to have your eyes assessed by an ophthalmologist. They’ll discuss with you the pros and cons of having cataract surgery.
If you’re not eligible for NHS surgery, or you don’t want to wait for it, your optometrist can refer you to a private ophthalmologist. If you have private treatment, you may have access to a wider range of lenses than are available on the NHS.Back to top
FAQ: Will I be able to feel anything during surgery?
Most people have cataract surgery under local anaesthesia. Your surgeon will use anaesthetic eye drops or an injection. You won’t feel any pain but you may feel touch and pressure. You’ll still be able to see bright lights and movement. You won’t be able to make out any of the details though.
Your surgeon won’t start the operation until they know the anaesthetic has worked. They’ll check your eye to make sure it’s numb. To do this, they may ask you to look in different directions.
FAQ: How long will my artificial lens last?
Your artificial lens is designed to be permanent and shouldn’t need to be replaced. It’s made of silicone or plastic. These materials last for many years.
Sometimes, after cataract surgery, you can develop posterior capsular opacification. This is when some cells from your natural lens are left behind after surgery and begin to grow back. This causes blurring of your vision, which can seem like your cataract is coming back. You can have laser treatment to correct the problem so the artificial lens won’t need to be replaced.
FAQ: Are different lenses used for cataract surgery?
Artificial lenses come in different strengths, just like the lenses in glasses. They also vary in their ability to focus on objects at different distances. Some lenses can help you to see things both in the distance and close up. Your surgeon can discuss with you the pros and cons of each type to help decide which one’s best for you.
Monofocal lenses are used most often in cataract surgery, especially on the NHS. These are set at one level of vision, usually distance vision. This means you’ll probably need to wear reading glasses to focus on things that are close up.
Multifocal lenses allow you to see both near and distant objects without glasses.
Toric lenses can correct an astigmatism. They may help you see distant objects more clearly. If you have an astigmatism, the curve of your cornea or natural lens isn’t perfectly round. This means light doesn’t bend evenly and objects appear blurry or wavy.
Accommodating lenses change shape within your eye, in a similar way to the natural lens. This allows you to focus on both near and distant objects without glasses. If you have multifocal lenses, you may notice rings around lights (halos) and problems seeing in bright light (glare). You’ll need to discuss this with your ophthalmologist before your surgery, as these lenses may not be right for you.
Some types of lens are only available if you’re being treated privately, rather than through the NHS. Ask your surgeon for more information.
FAQ: What if I can't use eye drops after cataract surgery?
The nursing staff at the hospital will show you how to use your eye drops either after your surgery or beforehand during your pre-operative assessment. Ask your surgeon or nursing staff how often you need to put the drops in and for how long.
If you think you might have trouble putting in drops, mention it at your pre-operative assessment. It may be that a friend or relative can help you. But if not, your hospital or GP may be able to arrange for a district nurse to visit you at home. If your eye drops are in a plastic bottle, you may also be able to get an eye drop dispenser device through your local pharmacy. Your doctor may be able to prescribe this on the NHS.Back to top
- Cataracts: Summary. BMJ Best Practice. bestpractice.bmj.com, last updated August 2016
- Cataracts and cataracts surgery. PatientPlus. patient.info/patientplus, last checked November 2015
- Eyes. Oxford handbook of geriatric medicine (online). 2nd ed. Oxford Medicine Online. oxfordmedicine.com, published July 2012
- Local anaesthesia for your eye operation. Royal College of Anaesthetists. 4th ed. 2014. www.rcoa.ac.uk
- Nursing patients with sensory system problems (ears, ears, nose, and throat). Oxford handbook of adult nursing (online). Oxford Medicine Online. oxfordmedicine.com, published August 2012
- Ocular local anaesthetics. PatientPlus. patient.info/patientplus, last checked February 2017
- Understanding cataracts. The Royal College of Ophthalmologists. July 2016. www.rcophth.ac.uk
- Post-operative pain. OSH Post-operative Complications (online). 2nd ed. Oxford Medicine Online. oxfordmedicine.com, published October 2011
- Ophthalmology. Oxford handbook of general practice (online). 4th ed. Oxford Medicine Online. oxfordmedicine.com, published April 2014
- Cataracts. The MSD Manuals. www.msdmanuals.com, last full review/revision July 2014
- Recovering from surgery: cataract surgery. Royal College of Surgeons. www.rcseng.ac.uk, accessed May 2017
- Cataracts. Clinical Knowledge Summaries. cks.nice.org.uk, last revised September 2015
- Advice for medical professionals for drivers with visual disorders. www.gov.uk, first published 11 March 2016
- Commissioning guide: cataract surgery. The Royal College of Ophthalmologists, February 2015. www.rcophth.ac.uk
- Refraction and refractive errors. PatientPlus. patient.info/patientplus, last checked November 2016
- Implantation of accommodating intraocular lenses for cataract. National Institute for Health and Care Excellence (NICE), Interventional Procedures Guidance IPG209, 2007. www.nice.org.uk
- Administration of drugs to the eye. NICE British National Formulary. www.evidence.nhs.uk/formulary/bnf/current, reviewed April 2017
We’d love to know what you think about what you’ve just been reading and looking at – we’ll use it to improve our information. If you’d like to give us some feedback, our short form below will take just a few minutes to complete. And if there's a question you want to ask that hasn't been answered here, please submit it to us. Although we can't respond to specific questions directly, we’ll aim to include the answer to it when we next review this topic.
Let us know what you think using our short feedback form
Reviewed by Pippa Coulter, Specialist Health Editor, Bupa Health Content Team, July 2017
Expert reviewer, Professor Simon Taylor, Consultant Ophthalmic Surgeon
Next review due July 2020
About our health information
At Bupa we produce a wealth of free health information for you and your family. We believe that trustworthy information is essential in helping you make better decisions about your health and care. Here are just a few of the ways in which our core editorial principles have been recognised.
We are certified by the Information Standard. This quality mark identifies reliable, trustworthy producers and sources of health information.
What our readers say about us
But don't just take our word for it; here's some feedback from our readers.
“Simple and easy to use website - not alarming, just helpful.”
“It’s informative but not too detailed. I like that it’s factual and realistic about the conditions and the procedures involved. It’s also easy to navigate to areas that you specifically want without having to read all the information.”
“Good information, easy to find, trustworthy.”
Meet the team
Head of Health Content
- Dylan Merkett – Lead Editor
- Graham Pembrey - Lead Editor
- Laura Blanks – Specialist Editor, Quality
- Michelle Harrison – Specialist Editor, Insights
- Natalie Heaton – Specialist Editor, User Experience
- Fay Jeffery – Web Editor
- Marcella McEvoy – Specialist Editor, Content Portfolio
- Alice Rossiter – Specialist Editor (on Maternity Leave)
Our core principles
All our health content is produced in line with our core editorial principles – readable, reliable, relevant – which are represented by our diagram.
In a nutshell, our information is jargon-free, concise and accessible. We know our audience and we meet their health information needs, helping them to take the next step in their health and wellbeing journey.
We use the best quality and most up-to-date evidence to produce our information. Our process is transparent and validated by experts – both our users and medical specialists.
We know that our users want the right information at the right time, in the way that suits them. So we review our content at least every three years to keep it fresh. And we’re embracing new technology and social media so they can get it whenever and wherever they choose.
Here are just a few of the ways in which the quality of our information has been recognised.
The Information Standard certification scheme
You will see the Information Standard quality mark on our content. This is a certification programme, supported by NHS England, that was developed to ensure that public-facing health and care information is created to a set of best practice principles.
It uses only recognised evidence sources and presents the information in a clear and balanced way. The Information Standard quality mark is a quick and easy way for you to identify reliable and trustworthy producers and sources of information.
Certified by the Information Standard as a quality provider of health and social care information. Bupa shall hold responsibility for the accuracy of the information they publish and neither the Scheme Operator nor the Scheme Owner shall have any responsibility whatsoever for costs, losses or direct or indirect damages or costs arising from inaccuracy of information or omissions in information published on the website on behalf of Bupa.
British Medical Association (BMA) patient information awards
We have received a number of BMA awards for different assets over the years. Most recently, in 2013, we received a 'commended' award for our online shared decision making hub.
If you have any feedback on our health information, we would love to hear from you. Please contact us via email: firstname.lastname@example.org. Or you can write to us:
Health Content Team
Battle Bridge House
300 Grays Inn Road