Home Care After Cataract Surgery

Before the operation: prepare the home

• Collect the prescribed drops and keep them in one place, away from heat and children. Write down the schedule.
• Prepare a recovery spot with a comfortable chair or bed, good but not harsh light, and a clear path to the toilet.
• Remove trip hazards: rugs, loose cords and clutter; see flooring, rugs and trip hazards.
• Keep essentials within reach: glasses, a phone, water and tissues.
• Arrange help: a family member to stay at least for the first day or two.
• Plan meals that are easy to prepare.
• Gather clean cotton pads or tissues for wiping the eyelids as instructed.
• Prepare the sleeping position: on the back or on the unoperated side, as the surgeon says.
• Wash hand towels and pillow cases and keep them clean.

The first day

• Rest quietly at home for the remainder of the day. Sleep is good.
• Keep the eye shield or patch on as instructed. Do not remove the first pad until the surgeon says so, often the next morning or at the first check.
• Expect mild scratchiness, watering, light sensitivity, a gritty feeling or a dull ache. A mild discomfort is common, and the surgeon may allow a pain medicine; ask what is safe for your parent, especially if on blood thinners or with kidney or stomach problems. Do not take anything unprescribed.
• Vision may be blurry at first, with swollen eyelids and some redness. This improves over days.
• Do not rub or press the eye. Even if it itches, do not touch.
• Eat and drink normally, unless the doctor has said otherwise, and take usual medicines as advised, including those for blood pressure, diabetes and heart conditions. Do not stop medicines without asking.
• Have someone stay nearby.

Eye drops: the routine

Eye drops are the core of aftercare, and mistakes are common. Typically the surgeon prescribes an antibiotic drop to prevent infection and a steroid or anti-inflammatory drop to calm the eye, sometimes with a third drop. The regimen usually runs for several weeks, often with the frequency reduced step by step. Follow the exact instructions on the prescription.

General principles (see also eye drops made easy: tips for older hands):

1. Wash hands with soap and water, and dry. 2. Check the bottle name, label and expiry. Shake if the label says so. 3. Sit or lie back, tilt the head, and look up. 4. Gently pull the lower eyelid down to form a small pocket. Do not touch the eye or lashes with the bottle tip. 5. Squeeze one drop into the pocket. One drop is enough, since the eye holds only a small amount; extra runs out. 6. Close the eye gently, without squeezing, and press lightly on the inner corner by the nose for a minute to keep the drop in. 7. Dab away excess with a clean tissue. 8. Wait at least five minutes before a second drop in the same eye, or follow the surgeon's advice, so that the first drop is not washed out. 9. Wash hands afterwards and recap the bottle. 10. Label the bottles with a number, colour or large-print schedule, and use a chart to tick off doses. A pill organiser or a daily checklist can help; see pill organiser guide.

Common problems:

• Cannot aim the drop: ask a family member to give it, or use a drop-guide device, which the pharmacist can suggest.
• Stinging: mild stinging is common; report severe pain.
• Missed dose: follow the surgeon's advice; do not double up.
• Using one bottle for both eyes: never share bottles between eyes, people or between operated and unoperated eyes if the surgeon says so.
• Bottle contamination: do not let the tip touch anything; discard the bottle after the period stated (often about a month after opening).
• Running out: order refills early.

Do not use any home remedies, herbal drops, kajal, surma, rose water, breast milk, honey or oils in the eye. They can cause serious infection.

Eye shield, patch and glasses

• Wear the plastic eye shield at night (and for naps) for the period the surgeon advises, to prevent rubbing or pressure during sleep. Tape it gently to the forehead and cheek as shown.
• During the day, many surgeons advise wearing glasses or sunglasses to protect against dust, wind and accidental knocks, and to ease light sensitivity.
• Keep the shield clean, wiping it with a clean damp cloth.
• Do not wear contact lenses or eye make-up on the operated eye, until the surgeon allows.

Washing, head baths and hygiene

• Keep water, soap, shampoo and oil out of the eye for the period the surgeon states, often about a week or more.
• Bath from the neck down, and wash the face with a damp cloth, avoiding the eye area.
• Head wash: lean back, as at a salon, and have someone pour water carefully, or wait until the surgeon allows. Avoid hair oil, head massage, and steam on the face.
• Clean the eyelids only as instructed, using cooled boiled water and sterile cotton, wiping from the inner corner outward, with a fresh pad for each wipe.
• Wash hands often and keep towels and pillow covers clean.
• Avoid swimming pools, hot tubs and dusty places for several weeks, or as advised.
• No eye make-up, kajal or creams around the eye for the period advised.

Activity and rest

Ask the surgeon about timing. Typical advice for the first one to two weeks:

• Light activity is fine: walking, reading, watching television, sitting in the home. These do not harm the eye.
• Avoid heavy lifting, straining, vigorous exercise, bending over for long periods and anything that raises pressure in the head, until the surgeon says it is safe. Be careful with constipation; see constipation in older adults.
• Avoid rubbing, pressing or bumping the eye, and take care with children, pets and crowds.
• Avoid dust, smoke and wind: keep away from construction, sweeping, cooking fumes, incense, mosquito coils, bidi or cigarette smoke and heavily polluted air. See indoor air quality for older lungs: dust, smoke and damp and a pollution season plan for older adults.
• Sleep on the back or on the side that is not operated, with the shield on.
• Avoid crowded or risky places where the eye might be knocked.
• Gradually resume normal activities as advised.

Preventing falls

Vision may be uneven while one eye is blurred or patched, affecting depth perception.

• Light the path, including at night; use night lights.
• Take care on stairs and kerbs; hold a rail.
• Wear sturdy, non-slip footwear.
• Use a stick or have someone's arm if unsteady.
• Move slowly, especially when getting up from bed.
• Do not bend suddenly to pick up things; use a reacher; see reacher grabber guide.
• Be careful with bifocals or varifocals when old glasses no longer match; see reading glasses, bifocals and varifocals: falls and choices.

See falls risk assessment at home.

Vision after surgery: what is normal

Blurry or hazy vision, light sensitivity, a gritty feeling, watering and some redness are common in the first days and usually settle over a few weeks; colours often look brighter. Attend every follow-up visit. See also living with cataract: daily adjustments before and after surgery.

Glasses, driving and returning to hobbies

• New glasses are usually prescribed once the eye has healed, often a few weeks later. Do not rush to buy new glasses before the surgeon or optometrist advises. Old glasses may be removed for the operated eye or replaced with a plain lens if the other eye still needs correction.
• Driving: wait until the surgeon says the vision meets the standard for safety and the law, and avoid driving at night at first. See safe driving tips for the elderly.
• Reading and screens: fine, and they do not harm the eye. Use good lighting; see lighting for older eyes: brightness, colour and glare.
• Sunglasses: protect from glare and UV; see best sunglasses for seniors.
• Travel: ask the surgeon before air travel or long journeys, especially in the first weeks.

Warning signs: call the surgeon or go to hospital the same day

• Increasing pain not eased by usual comfort measures.
• Increasing redness, swelling or discharge, or crusting with pus.
• Drop in vision, vision worsening after initial improvement.
• Sudden flashes of light, many new floaters, or a curtain or shadow across the vision.
• Increasing sensitivity to light.
• Nausea or vomiting with eye pain.
• Fever or feeling unwell.
• The eye shield fell off and the eye was knocked or rubbed hard.
• An injury to the eye.

If your surgeon cannot be reached, go to an eye hospital emergency or call 112 for severe symptoms, or if there is weakness, facial droop, speech difficulty or confusion.

When to ask a professional

Contact the surgeon or eye hospital for any worry, drop confusion, or symptoms. Ask the pharmacist to explain the drops and help label them. Ask the doctor about the safe use of pain relief, and review blood pressure and sugar. Ask an optometrist about glasses after healing. Seek urgent care for severe pain, vision drop, flashes or a curtain. Call 112 for stroke signs.