Why so anxious about cataract surgery?

Some patients postpone their cataract surgery in spite of not seeing well. They claim, that ‘they are fine’. Over the time, I have realised, the reason behind postponing the surgery is nothing but the fear of undergoing a surgery and the pain caused due to it.

Some even tell that they are anxious about undergoing surgery and ask, “Is cataract surgery painful?”

I would like to clear, that anxiety or fear should not be the reasons behind cancelling a cataract surgery.

How is cataract surgery done?

Cataract surgery is performed by a technique called phacoemulsification. Modern cataract surgery involves making a small 2mm incision on cornea. Through this incision, an opening is created in the lens of the eye, which is now cataractous. This opening is created in lens capsule, a bag holding the lens in place. The hard lens material or cataract is then liquefied and sucked out. Once this is done, an intraocular lens is inserted. After this, steroid and antibiotic drops are inserted and eye is patched. These days when we operate on cataracts, we use eye drops known as topical anaesthetic agents. For all our surgeries we have a standby anaesthetist in the operation theatre.

So, is the cataract surgery painful?

No. Let me explain. During surgery we place an instrument on the side of your eye to keep them open. Due to numbing eye drops you don’t feel any pain. You may feel heaviness and a mild pain in the eyes which happens when we inject a certain jelly to keep the eye formed and prevents it from going soft and also while inserting lens. This pain or pressure lasts for just a few seconds. You will be aware that something is going on, but there is no real pain.

What about pain after cataract surgery?

One can say that cataract surgery is usually uneventful. However, there can be pain in some cases like increased eye pressure, increased inflammation. This can also lead to watering and light sensitivity for the first few days after surgery. One may have blurry vision and this too subsides a week after surgery. All of which can be taken care of by using certain tablets and eye drops. These drops are steroid drops, antibiotic drops and sometimes NSAID drops.

Most important thing to remember is that two weeks after cataract surgery, if not sooner your eyes have almost completely healed. You would have to continue drops but can take a head shower without worrying about eye infections.

What is the difference in pain between the first eye and second eye surgery?

Ophthalmologists perform surgery for your cataracts in both eyes the same way and there is no such difference. But usually, patients complain that the second eye surgery is more painful.

Reason is when a patient walks in for the first cataract surgery, he/she is very anxious. Now, after the patient undergoes the cataract surgery, most likely the patient tells oneself that “Oh well, that was not that bad”. So, the reality was way better than expectation.

Because of this wonderful experience with the 1st surgery, the patients come in for the second eye surgery expecting it to be a walk in a park and when he feels a bit during the second surgery, he/she feels the second eye surgery was more painful.

So, all in all cataract surgery is not painful and please don’t let anxiety be a reason to not undergo cataract surgery. Yes, cataract surgery is not an emergency so if it has to be postponed, that’s fine, but if you are not enjoying your vision then do consider getting your surgery soon.

(Dr Deepak Garg is a Cataract and Squint specialist and Founder Eye Solutions, Mumbai)

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