A decision-making guide for patients diagnosed with cataract(s)

A decision-making guide for patients diagnosed with cataract(s)

Last Updated: July 8, 2022
HealthLinkBC File Number: 126
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What is a cataract?

The lens of the eye is usually clear for many years of life. When cataracts develop the lens becomes cloudy. Most people get cataracts with age and have them in both eyes. One eye may be worse than the other.

Most people with cataracts notice difficulties with daily activities (e.g., reading). Some people with cataracts get used to them and do not notice the change in their eyesight, even when they no longer meet legal driving requirements.

Cataracts progress slowly and are not likely to cause a sudden change in your vision. You may not need surgery right away. A change in your glasses or the use of a magnifier and extra light may help you see better. Your doctor may advise you that there are benefits from surgery. At that time, surgery should be considered, and delaying may not be best.

What symptoms will I have?

Some common symptoms of cataract(s) are:

  • Blurry, filmy, foggy, cloudy, fuzzy or hazy vision
  • Headlights being too bright at night
  • Problems with glare in the sun
  • Problems reading small print
  • Trouble seeing in dim light
  • Changes in the way you see colours
  • Vision "doubled" by a shadow image

How are cataracts removed?

Cataract surgery is a "Day Surgery" procedure with no overnight stay in hospital. It is performed using local anaesthetic to numb the eye. Most patients do not require a general anaesthetic.

Sedation medication may be available if you are anxious. You will need someone to take you home after and may need help putting in your eye drops or driving. If you need cataract surgery in both eyes, there is usually a waiting period between the two surgeries.

At surgery, the ophthalmologist removes the natural lens with its cataract through a tiny incision and replaces it with an artificial lens (IOL) which remains there permanently.

There are many types of artificial lenses (IOLs) available. Lenses covered by MSP provide fully satisfactory visual correction in the vast majority of patients.

Glasses are usually required after surgery for near and sometimes also distance vision.

Lenses that may not be covered by MSP may help you avoid the need for glasses. However, these lenses may not be appropriate for all patients due to individual suitability or side effects. Your surgeon will discuss the various options with you.

What will my recovery be like?

  • Most patients who have cataract surgery recover with better vision than before. However, it will take up to a few weeks for most patients to fully heal and adjust.
  • Most patients report a little discomfort during and after the surgery. Serious problems are not common.
  • In some cases, cloudiness may form behind the new artificial lens after the procedure (weeks to years later), which can be treated with a minor laser procedure.
  • A common feeling after the surgery is dryness, irritation, and some sensitivity in the eye. You may need to use lubricating drops to help.

What symptoms will I have and when should I call my doctor?

Expected symptoms:

  • Within 24 hours after surgery

    • Blurry vision
    • Mild redness
    • 'Sand' feeling in the eye
  • 24 hours to 1 week after surgery
    • Better vision
    • Mild redness
    • Less pain or 'sand' feeling
  • >1 week to months after surgery
    • Final new glasses prescription (if needed)

Call your doctor if:

  • Within 24 hours after surgery

    • Very bad eye pain or headache
    • Nausea/vomiting
  • 24 hours to 1 week after surgery
    • Very bad eye pain
    • Worse redness
    • Worse vision
    • Seeing flashes of light or many floaters
  • >1 week to months after surgery
    • Worse vision

In summary

  • Cataract surgery is common, safe, minimally painful and effective.
  • No surgery is zero-risk, your surgeon will review all risks and benefits ahead of time.
  • You should consider having cataract surgery if your vision gives you problems with your daily activities (e.g., reading or using a computer) or to improve your vision to maintain your driver's license requirements. Having cataract surgery can help increase your safety, self-confidence, and independence.
  • Be sure to share with your doctor how your vision difficulties have affected your life.