Cataract surgery removes a cloudy lens from the eye and replaces it with an artificial lens. Most adults are awake, but numbing eye drops or an injection help prevent pain; medicine may also help them relax. Through a tiny opening, the surgeon breaks up and removes the cloudy lens, then places the new lens. The procedure usually takes less than an hour, and most people go home the same day.
What happens before cataract surgery?
Before surgery, an ophthalmologist, a doctor who specializes in eye conditions and surgery, examines your eyes and checks your vision. The team measures the size and shape of your eye to help choose the correct strength of the artificial lens, also called an intraocular lens (IOL). These measurements are important because the replacement lens needs to focus light properly for your visual needs.
Your ophthalmologist will discuss the available lens options, what you can reasonably expect from surgery, and whether you may still need glasses for reading or distance vision. Your other eye conditions, medical history, and usual activities may influence the plan. The Mayo Clinic's cataract surgery guide explains how eye measurements and a discussion of artificial lens options help prepare patients for the procedure.
You will also receive instructions about preparing for the day of surgery. Depending on your surgical center and anesthesia plan, you may be asked to avoid food and drinks for a specified period. Tell the team about all medicines and supplements you take, including blood thinners and medicines for prostate conditions. Do not stop or change prescribed medicines unless your clinician specifically instructs you to do so. Follow the clinic's directions about eye drops, contact lenses, and eyelid cleaning.
Arrange for someone to take you home afterward because you should not drive immediately after the procedure. If you are having surgery on both eyes, your surgeon will explain whether the procedures will take place on separate days and how the timing will be decided.
What happens on the day of the operation?
Cataract surgery is usually performed as a day procedure, so an overnight hospital stay is generally unnecessary. Before the operation, the medical team confirms which eye will be treated and reviews your preparation and consent. Eye drops are used to widen the pupil, and the skin around your eye is cleaned. A sterile covering is placed over your face, leaving the eye being operated on accessible to the surgeon.
Most adults receive local anesthesia, which numbs the eye while they remain awake. The anesthetic may be given as eye drops, an injection, or both. You may also be offered medicine to help you relax. You might notice bright lights, movement, or changes in light and shade, but you are unlikely to see the surgical details clearly. According to MedlinePlus, adults are usually awake during cataract removal, whereas children generally need general anesthesia.
What are the main steps of cataract surgery?
The most common approach is called phacoemulsification. During this procedure, the surgeon uses a small instrument and ultrasound energy to break the cloudy lens into tiny pieces before removing them. The natural lens is replaced with an artificial one, which remains inside the eye. The following steps explain what typically happens during the operation.
1. The eye is numbed
Before starting, the surgeon makes sure the eye is adequately numb. You remain awake in most adult procedures, and the team monitors you throughout the operation. Although you may notice pressure, light, or movement, the anesthetic is intended to prevent pain. Tell the surgical team if you feel significant discomfort or need help during the procedure.
2. A tiny opening is made
The surgeon makes a small incision in the cornea, the clear front surface of the eye. Through this opening, the surgeon can reach the cloudy lens. The incision is usually small enough to heal without stitches, although stitches may be needed in some cases.
3. The cloudy lens is broken up and removed
In phacoemulsification, a fine instrument delivers ultrasound energy to break the cloudy lens into smaller fragments. The surgeon then removes those fragments using suction. The thin, clear capsule that surrounded the natural lens is usually left in place because it helps support the replacement lens.
Not every cataract requires the same surgical technique. If the cataract is particularly dense or other eye circumstances make the usual approach unsuitable, the surgeon may use a method that involves a larger incision and removal of more of the lens at once. The NHS guide to cataract surgery describes the typical steps, including lens removal and placement of the artificial replacement.
4. The artificial lens is inserted
Once the cloudy lens has been removed, the surgeon places an artificial intraocular lens inside the remaining lens capsule. Many replacement lenses are flexible, allowing them to be inserted through the small incision before unfolding into position. The new lens helps focus light onto the retina, the light-sensitive tissue at the back of the eye.
The type and focusing strength of the lens depend on the measurements taken before surgery and the visual goals discussed with your ophthalmologist. Some lenses are designed mainly for distance vision, while other designs offer different focusing options. No lens guarantees that you will never need glasses again.
5. The surgeon checks the eye before finishing
After positioning the replacement lens, the surgeon checks the eye and makes sure the incision is secure. Most small incisions seal without stitches. A protective dressing or eye shield may be placed over the eye, depending on the surgeon's usual practice and your needs.
How long does cataract surgery take?
The operation itself usually takes about 20 to 45 minutes, although the exact time depends on the surgical technique and the complexity of the eye. The full appointment takes longer because it includes preparation, anesthesia, the procedure, and a period of observation afterward.
Most people return home on the same day once the medical team is satisfied that they are ready. If there are additional eye problems or unexpected difficulties during surgery, the procedure or recovery period may take longer than planned.
Does cataract surgery hurt?
Cataract surgery is generally painless or associated with minimal discomfort because the eye is numbed. You may notice pressure, bright lights, or movement while the surgeon works. Being awake does not mean you should have to tolerate significant pain. Let the team know immediately if you experience pain, marked discomfort, or difficulty remaining still so they can assess what you need.
After the anesthetic wears off, the eye may feel mildly sore, itchy, gritty, or sensitive to light. Temporary blurred vision can also occur. These symptoms usually improve as the eye begins to heal, but symptoms that become worse or are more troublesome than your surgical team described should be reported.
What happens immediately after cataract surgery?
After the operation, you will usually rest in a recovery area while staff check your condition and give you instructions for looking after the eye. You may receive prescribed eye drops to reduce inflammation and help prevent infection. A protective shield may be recommended, especially while sleeping, to prevent accidental rubbing or pressure on the operated eye.
Before leaving, make sure you understand how and when to use your eye drops, when your follow-up appointment is scheduled, and which activities you should avoid. You will need someone else to take you home. Your vision may initially be blurry, partly because of the dilating drops used before surgery.
How does recovery progress over the following weeks?
Vision may begin to improve within the first few days, but it is normal for it to take time to settle. Colors may appear brighter because the artificial lens is clear, unlike a natural lens that has become cloudy. Some temporary sensitivity to light, mild itching, or discomfort may occur during early healing.
The National Eye Institute's cataract surgery guidance notes that many people are fully healed by around eight weeks, although recovery varies. The eye may feel better well before healing is complete. Attend scheduled follow-up visits so your ophthalmologist can check your eye and assess your vision.
During recovery, follow your surgeon's specific instructions. You may need to use prescribed drops for several weeks, wear an eye shield at night, and temporarily avoid strenuous activity, heavy lifting, swimming, or getting water directly into the eye. Do not rub or press on the operated eye. Wait until your vision meets the required standard and your clinician says it is safe before driving again.
You may still need glasses after the eye has healed. Your glasses prescription can change after surgery, so your ophthalmologist will advise you when to have your vision checked for a new prescription.
What are the possible risks of cataract surgery?
Cataract surgery is generally successful, and serious complications are uncommon. However, as with any operation, problems can occur during or after the procedure. Possible complications include:
- Infection or inflammation inside the eye.
- Bleeding or swelling in or around the eye.
- Changes in eye pressure.
- Problems with the position of the artificial lens.
- Retinal detachment, in which the retina separates from the back of the eye.
- Blurred or reduced vision that may require further assessment or treatment.
Some people do not achieve completely clear vision after surgery because another eye condition, such as glaucoma or macular degeneration, also affects sight. Your ophthalmologist will discuss relevant risks based on your eye examination and medical history before you decide to proceed.
Which symptoms need urgent medical attention after surgery?
Follow the instructions provided by your surgical team about when and how to seek help. Contact your eye surgeon urgently if you develop symptoms such as:
- Sudden loss or marked worsening of vision.
- Severe or persistent eye pain.
- Increasing redness or swelling around the eye.
- New flashes of light or a sudden increase in floating spots or lines in your vision.
- A dark shadow or curtain moving across your field of vision.
These symptoms can indicate a complication that needs prompt assessment. Do not wait for a routine follow-up appointment if they occur. Sudden vision changes, severe pain, or a curtain-like shadow warrant urgent medical attention.
What should you ask your ophthalmologist before surgery?
A clear discussion before the procedure can help you understand the plan and prepare for recovery. Consider asking which artificial lens is recommended and why, whether you may still need glasses, what type of anesthesia will be used, and how long you should avoid particular activities. Ask how your current medicines should be managed, which eye drops you will need, and whom to contact if you develop concerning symptoms after going home.
Knowing what to expect can make cataract surgery feel more manageable. The essential process is straightforward: the surgeon removes the cloudy lens, replaces it with an artificial lens, and checks the eye before you go home. Following your personalized aftercare instructions and attending follow-up visits help the surgical team monitor your recovery.