Cataracts aren’t easy to live with. This condition, in which the eye’s natural lens becomes clouded over and hard to see through, can make it difficult to read, drive, take care of basic responsibilities, and even enjoy seeing the faces of your friends and loved ones. So the prospect of being able to restore your vision—and in some cases even achieve better vision than you enjoyed before cataracts—is attractive, especially given cataract surgery’s impressive record for efficacy and safety. But what should you expect in terms of cataract surgery recovery? Can you fit it into your schedule right now? If you have grandchildren to take care of, how long after cataract surgery can you bend over to pick them up? When will you be able to drive again? How long will you need to wear an eye shield or dark glasses?
There are a few methods for taking care of cataracts, but they all do essentially the same thing. Unlike other cells in our bodies, the cells in the eye’s natural lens do not die off and get replaced when new ones grow. Instead, they accumulate over a lifetime, which causes the lens’s proteins to clump together, stiffen, and lose their shape, which distorts light and makes it difficult to focus. In cataract surgery, the natural lens is not repaired but rather replaced by a synthetic lens called an intraocular lens or IOL.
The surgery is done on an outpatient basis. It’s quick and painless, and only involves a miniscule incision in the cornea. After the procedure, you’ll be given a protective eye cover and a prescription for eye drops to relieve irritation and prevent infection. Someone will need to drive you home.
Cataract surgery recovery time is typically about four weeks, but that certainly doesn’t mean you’ll be lying in a dark room for a month. You can move around as soon as you get home, and your vision should improve within the first few days.
Specifics regarding your instructions and expectations for after the surgery will vary based on the surgeon, the type of surgery performed, and the type of intraocular lens implanted. In general, however, they will include the following elements:
A protective eye shield. Most people leave surgery wearing a patch over their eye and a plastic cup-shaped shield over the patch. This is to keep the eye free of infection as the incision heals. Often, doctors tell people they can remove the shield and patch the day after surgery. Many people are instructed to sleep with the shield over their eyes for the first few days or even a week. Some doctors want their patients to wear the shield for a full week.
Discomfort. The eye will have been numbed for the surgery, and within a few hours its feeling will return. You might think that having had an incision made in your eye just a few hours before would cause significant pain, but the aftermath of cataract surgery, like the surgery itself, is surprisingly pain-free. That’s not to say that you won’t experience discomfort, though. The eye might feel gritty and watery for a couple of days. If the discomfort is too distracting, you may take an over-the-counter pain medication to relieve it.
Return of vision. Don’t expect your vision to be perfect immediately after surgery. For a few days, you might have blurriness and doubling in the eye that’s been worked on. This is normal and should steadily improve over the four-week recovery period. It can be tempting to rub your eye, but it’s important that you refrain from doing so.
Drops and medications. Despite how common cataract surgery is, doctors use a variety of protocols for medicating after the procedure. Almost all people are given a topical antibiotic to help protect against infections from bacteria such as staphylococcus and streptococcus. This should be taken exactly as instructed. Many doctors also prescribe eyedrops containing non-steroidal anti-inflammatory drugs (NSAIDs), which help with pain as well as preventing a side effect called cystoid macular edema (CME). A typical dosing schedule is one drop four times per day for four weeks. Some ophthalmologists put their patients on corticosteroid drops. These, too, help protect against CME but also are effective in preventing swelling of the lid and eye. Doctors may prescribe corticosteroids for two to six weeks post-surgery. However, prolonged usage of this class of drugs is a known risk factor for the development of cataracts, and they may increase risk of bacterial and viral infections.
Return to normal activities. For the most part, getting back to your usual routine is pretty quick, but there are certain activities you should refrain from, and you need to be extra-careful about getting things in your eye during recovery, which might cramp your style a little. Plan for a couple of take-it-easy days right after surgery. You can read, watch TV, and use your smartphone or computer to keep yourself entertained. That doesn’t mean you need to stay off your feet. Just be careful about falling, especially while you’re wearing a patch or shield, and while you’re experiencing blurred vision.
Stay out of the gym for the first week. You can go for walks to get your heart rate up, but don’t do any strength training or strenuous cardio training until your doctor says it’s OK. That doesn’t just apply to the gym, but also to tasks around the house that require lifting and straining.
Many people’s first question about recovering from cataract surgery is, “How soon will I be able to drive again?” There’s no standard answer to that question except, “When your doctor says it’s OK.” For some people, this might be a few days after surgery. For others, weeks. You also should not fly before getting cleared by your doctor.
To protect the eye from infection, don’t go swimming for the full month after surgery. You may, however, shower from day one. Just be extra careful about getting shampoo in your eye. Many doctors recommend wearing the eye shield while you’re washing your hair. And don’t put on any eye makeup for four weeks.
If you have an important social event coming up, you might wonder, “How long do I need to wear dark glasses outside after cataract surgery?” Most doctors highly recommend it for at least the first few days, because it helps protect the eye from the sun’s harmful rays even on days that aren’t particularly bright, which can slow healing. After that, unless instructed otherwise, you can go by how it feels. If your eye is still highly sensitive to normal sunlight, keep wearing the dark glasses until this is no longer the case. When it comes to bright sunlight, some doctors urge their patients to wear UV-protective glasses for a full year after surgery.
Although millions of people get cataract surgery each year without any complications, all surgeries come with risks, so it’s possible that you could experience troubling symptoms in the days following the procedure. Remember, while you might have some mild irritation in the affected eye, significant pain and discomfort are not a normal part of recovery from a cataract procedure. If your eye hurts and turns more than a little red, it’s time to call the eye doctor.
And your vision should be improving, not getting worse. Call your doctor immediately if you have more trouble seeing after surgery than before, if you start seeing “floaters” or have a flashing sensation, and especially if you have lost all vision in the eye. Also, cataract surgery should not cause you to produce significant mucus or other discharge or crust around the eye. If you have any of these symptoms, make the call.
