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What to expect from cataract surgery

Here’s what you need to know before surgery

Young GP discussing cataract options with a female patient
Young GP discussing cataract options with a female patient

This very common procedure is also very safe. Here’s what you need to know pre surgery.

The idea of surgery on your eye might seem a little unsettling, but cataract surgery is a relatively straightforward procedure with a high success rate. In fact, cataract surgery – the most common elective surgery in Australia – usually only requires local anaesthesia and you should be back into most normal activities within days.

To help you feel confident leading up to your surgery, here’s a breakdown of what you can expect.

What are cataracts?

A cataract happens when the clear lens of the eye becomes cloudy. When proteins in the eye break down and clump together, less light is able to pass through to the retina, which can impact your vision. It can happen in just one or both eyes.

Cataract is a common issue – in fact, more than 700,000 Aussies are living with cataracts. Not everyone will need surgery, but if cataracts are interfering with your day-to-day life, your ophthalmologist (a specialist eye surgeon) might recommend cataract removal.

What causes cataracts?

Ageing is the biggest cause of cataracts, but having diabetes and being a smoker also raises your risk. Other contributing factors include:

  • Prolonged steroid use

  • Long exposure to UV light without protection

  • Injury to the eye

  • Family history

  • Radiation treatment on your upper body (for cancer)

What are the symptoms of cataracts?

Cataracts develop slowly, so by the time you notice them, you may experience:

  • Blurred or distorted vision

  • Increased sensitivity to light and glare

  • Difficulty seeing at night

  • A change in your perception of colour – such as fading, ‘browning’ or ‘yellowing’

  • Seeing halos around light

  • Double vision

  • Difficulty reading or seeing detail clearly

What happens in cataract surgery?

To prepare for this day surgery, you’ll have to fast up to 12 hours in advance (your ophthalmologist will advise you on the specific number).

Find out more about preparing for the day of surgery.

During the procedure, you’ll be given eye drops to dilate your pupil, and an injection around the eye, or eye drops, to make the eye go numb. You might be given a sedative to help you relax, and in some cases, general anaesthetic will be used.

Most people don’t feel any pain during the procedure, describing the sensation as a mild pressure around the eyes.

In a 30 to 45-minute procedure, the cataract will be removed and replaced with an artificial lens. To do this, your ophthalmologist will make a small cut in the eye. Usually, no stitches are needed as the incision heals by itself. Only one eye can be done in a procedure.

A close up photo of a young man with dark brown eyes who may have cataracts

There are two techniques to remove the cataract:

Phacoemulsification (phaco)

Your surgeon will insert a needle-thin vibrating probe into your cornea. This ultrasonic device breaks the cataract lens into microscopic pieces, then suctions them out.

Extracapsular extraction (ECCE)

This technique is used if there are eye complications. In ECCE, surgical tools are used to remove the lens. In some cases, stitches will be needed.

Related: Going to hospital? Here's why you should contact nib first.

What are my lens options?

There are several types of lenses (sometimes called IOLs, meaning ‘intraocular lenses’) available. Not all will be covered by Medicare or your health insurance, so don’t be afraid to ask your ophthalmologist for advice. Call nib or log into your member account to view your policy online and get personalised information.

Monofocal lenses

These lenses, the most common type, offer vision at a set distance, meaning you might need glasses for longer distances, or use your glasses for reading and have your monofocal lenses set for long distance.

Multifocal lenses

This option allows you to see both near and far objects.

Extended depth-of-focus lenses

Extended depth-of-focus lenses have one corrective zone, stretched to allow distance and intermediate vision.

Accommodative lenses

A type of lens that uses the natural movements of eye muscles to change focus.

Toric lenses

If you have astigmatism (where the cornea or lens of the eye are irregularly curved, causing blurry vision), this lens may help correct the condition.

What happens afterwards?

Immediately after the surgery, you’ll be monitored in recovery for 15 to 30 minutes before being discharged.

If all has gone well, your vision will start to improve within a few days – although things may look a little blurry for a while as your eye adjusts. You’ll need to use eye drops to prevent infection and reduce inflammation.

Full recovery usually takes eight weeks, and you’ll need a few follow-up appointments to check how well your eye is healing.

As part of your recovery, you’ll need to wear sunglasses and eye-protective wear, such as a patch or shield, for a few days.

Your ophthalmologist will likely ask you to avoid:

  • Strenuous activities such as exercise

  • Bending and lifting

  • Driving – until your ophthalmologist gives you clearance (so make sure you have someone collect you after the surgery)

  • Rubbing, pressing, or scratching your eyes

  • Getting soap or water in the eye.

What are the risks?

Complications are rare, but can happen. With cataract surgery, there are risks of inflammation, infection, bleeding or swelling.

In some cases, the artificial lens may slip out of position, other times the retina may become detached from the eye tissue. Vision problems such as seeing halos, glare, shadows and blurriness as well as vision loss are all possible. A dropping eyelid is another possibility.

You may also develop glaucoma or, rarely, a secondary cataract. But remember, all these complications are rare.

When do I need help?

If your vision becomes impaired or you lose sight, start seeing light flashes, eyelid swelling, increased eye redness, fluid coming from the eye, multiple ‘floaters’ or pain that isn’t eased by over-the-counter painkillers, contact your ophthalmologist immediately.

Is the surgery covered by Medicare or my health fund?

Cataract surgery is covered by Medicare, but waiting lists can be long in public hospitals – in some cases you could be waiting around a year! If you hold gold or silver tier private health insurance, you may be covered for cataract surgery. Not only will you be able to choose your own specialist, but waiting times are much shorter. You can log into your member account or use the nib App to check your cover.

If you’re an nib member going to hospital for cataract surgery, it’s important to get in touch with one of our experts to help you navigate through any out-of-pockets, waiting periods and annual limits. Call nib on 13 16 42 and head to our Going to Hospital page so we can support you through the journey.

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