is cataract surgery painful melbourne

Is Cataract Surgery Painful?

Pain can be a subjective experience. Ask one person who just got an immunisation injection and they may say they felt nothing at all, yet the next person getting the same jab by the same nurse found it a very painful procedure. Procedures in eye care are no different. If you’re contemplating undergoing cataract surgery, you may have been told some horror stories by friends or family who had a bad experience. Is cataract surgery painful and is it something you should be afraid of? 

What Happens During Cataract Surgery

Cataract surgery is performed exceedingly often in the developed world. This is due to cataracts being considered part of the natural human ageing process. It is found less commonly in developing countries not due to a lower incidence of cataracts but because of poorer accessibility to trained doctors and eye care facilities. 

During cataract surgery, the pupil of the eye is dilated, or widened, with eye drops. This allows the cataract surgeon to access the cataract behind the iris. Your eye is also numbed with topical anaesthetic eye drops or a local anaesthetic injection, and many surgeons will provide a light sedative to help you relax. 

The removal of the cataract involves a few steps, including a small incision made through the cornea, which is the clear dome of tissue at the front of the eye. This incision is typically created near the edge of the cornea and may be performed with either a manual blade as in conventional cataract surgery or with a computer-guided femtosecond laser. This corneal incision then allows the cataract surgeon to insert various tools into the eye to work on the cataract, including opening the membrane containing the cataract, breaking the cataract into smaller fragments, and then suctioning these pieces out from the eye. An artificial lens implant, called an intraocular lens, is then inserted into the membrane through the corneal incision. 

All these invasive steps as part of a routine cataract operation may leave you questioning, “is cataract surgery painful?” 

Is Cataract Surgery Painful During the Operation?

All eye care professionals will reassure you that cataract surgery is generally considered a painless procedure. However, as previously mentioned, the perception of pain and discomfort can be subjective. If you’re leading up to a cataract operation yourself, it’s important to know that the experience of pain doesn’t mean that something has gone wrong. For example, some people find that dilating eye drops can be painful while others have no issue at all. For those who do notice any discomfort, this experience can range from a mild sting to a significant burning sensation. 

There is a lot of research dedicated to reducing pain and discomfort for patients during cataract surgery, such as the type, dosage, and timing of anaesthetic. There are also preventative steps your cataract surgeon can take to minimise the risk of causing any discomfort that may occur during the operation, some of which may be as simple as ensuring the adhesive of the sterile drapes used to cover the skin around the eye is not roughly ripped off after the procedure. 

cataract surgery treatment pain melbourneSome patients may have a heightened pain response, which can make eye care procedures more uncomfortable. People with anxiety who are on oral anti-anxiety medications may be more sensitised to the sensation of pain. 

Cataract surgeons will typically administer a light intravenous sedative in preparation for the surgery. For some people who are particularly anxious, the dosage may need to be increased or the surgeon may need to use a stronger sedative.

However, very rarely are heavy sedatives used as the cataract operation is more successful and less risky if you are kept awake. Despite this, the light sedation tends to be enough for most people to largely be unable to recall the procedure afterwards. 

 

Is Cataract Surgery Painful Post-Operatively? 

It is not uncommon for patients to feel some degree of discomfort after a cataract operation though this isn’t often reported as significant pain. One of the most common sources of post-operative discomfort after a cataract procedure is dry eye. As the operation involves disrupting the corneal nerves, post-operatively, the eye may be temporarily impaired in tear production, leading to a dehydrated corneal surface. Experiences of people with dry eye, including those not induced by cataract surgery, can range from mild irritation of the eye to severe, debilitating pain. Fortunately, there are ways to help alleviate dry eyes, such as artificial tears or medicated eye drops. 

Prolonged eye inflammation is another potential source of pain or discomfort, and is part of your body’s natural healing response to the surgery. Your eye surgeon will have given you a prescription for anti-inflammatory medications to use in the postoperative period, including a steroid eye drop and a non-steroidal anti-inflammatory. It’s important to use these medications as frequently and for as long as you’ve been instructed. 

Some people experience glare in the weeks after having their cataracts removed. This is entirely normal but can be a source of discomfort for some. Over time, your glare sensitivity will settle. 

If you are particularly anxious about pain during cataract surgery, discuss your concerns with your cataract surgeon as they may be able to offer you reassurance and strategies to reduce your anxiety. 

Note: Any surgical or invasive procedure carries risks. Before proceeding, you should seek a second opinion from an appropriately qualified health practitioner.

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Post Cataract Surgery Care

All surgical procedures come with a recovery period. Depending on the type of surgery and your own body’s healing response, the post-operative period can be long or short, complicated or smooth. Cataract surgery is considered to be a safe and effective procedure with very low rates of complications. However, it is possible to further minimise your risk of complications by adhering to certain post-cataract surgery care guidelines. Read about how to make your cataract surgery recovery as uneventful as possible. 

 

Do I Need Cataract Surgery?

Prior to going under the metaphorical knife, you want to be sure that the timing for cataract surgery is right and that it’s a necessary procedure. It is sensible to be guided by your trusted eyecare professional, whether ophthalmologist or optometrist, however, here are a few things for you to consider. 

Can you see what you need to be able to see, as comfortably as you’d like to see it?  One of the main factors that guide the recommendation for surgery is a patient’s visual demands. A person’s daily requirements of their vision will vary widely from one individual to another. For example, a taxi driver who often works at night-time will be more affected by the glare of headlights caused by a cataract compared to an accountant. The point where you feel your vision is no longer adequate for your usual activities is typically when you may decide to pursue extraction of your cataract. If you’ve been told you have a cataract developing but are still content with your vision, there’s no need to rush into surgery.

 

post cataract surgery melbourneDo you meet the vision requirements to hold a driver’s licence in your state? In Australia, the general minimum vision requirement is 6/12 vision with your two eyes together. As this number may not mean much to you, it’s important to keep up with regular visits to your optometrist if you have a cataract to ensure your vision doesn’t drop below this level.

Your optometrist will be able to tell you if your vision is approaching the minimum visual acuity to be able to keep your licence.

 

Even if you’re content with your vision as it relates to your daily activities, if you are unable to read the 6/12 line on the letter chart due to cataracts, your eye care professional will advise you to undergo surgery. 

Are you going via the private or public health system? Waitlist times tend to be much longer in the public health system compared to private. If you are unable to afford surgery with a private specialist, and your cataract has been progressing, you may consider putting your name onto the public waiting list sooner rather than later. 

 

Post Cataract Surgery Care

If you’ve decided that it’s time for cataract surgery, it pays to know these cataract surgery recovery tips. Post cataract surgery care is not complex, but following your cataract surgeon’s instructions can help to minimise your risk of complications occurring during the cataract surgery recovery period

Use all your prescription eye drops as directed.

Your surgeon will give you a prescription for an antibiotic and one or two anti-inflammatory drops. You will need to use all of these medications several times a day for about 4 weeks. It’s important to keep using the eye drops until the end of the course even if you think your eye is better. Stopping the drops too early can put your eye at risk of catching an infection or sparking new inflammation. 

Don’t let anything contaminate your eye.

Although this is a good idea even when you’re not needing to think about post-cataract surgery care, it’s especially important as your eye is healing from a cataract procedure. Contaminants like dirt and dust are easy to think of, such as avoiding the attic of your house or the garden on a windy, dusty day. However, there are also other sources of potential infection that may not come to mind so quickly, such as swimming pools and saunas. Unsterile sources of water contain a multitude of pathogens that can readily infect an eye vulnerable from recent cataract surgery. During the early days of your cataract surgery recovery, you will also want to avoid any cosmetics, skin products, soaps, and aerosols around your eye. 

Seek attention if anything feels not right.

Immediately after your cataract surgery, you can expect your eye to be red, gritty, and slightly blurry. In some cases, it can take a few weeks for the eye to feel more comfortable and some people experience persistent dryness after having a cataract operation. Your vision may also take some weeks to stabilise completely; typically it can take up to 4 to 6 weeks. However, if you experience any of the following, it’s important to contact your cataract surgeon as soon as possible. 

  • An increasingly red eye
  • Increasing eye pain
  • A mucous or pus discharge from the eye
  • Deteriorating vision
  • Unexpected visual symptoms, such as haloes around lights or gaps in your visual field
  • Flashing lights in the vision or new floaters
  • Headaches and nausea

If you’re unable to get hold of your cataract surgeon, go to your local optometrist or hospital emergency department.  

Throughout your recovery process, your cataract surgeon will conduct two or three routine review appointments. When he or she observes that your eye has healed as expected and your vision has settled, you will be referred back to your optometrist to recheck your prescription and for ongoing care. 

 

Note: Any surgical or invasive procedure carries risks. Before proceeding, you should seek a second opinion from an appropriately qualified health practitioner.

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