• 10 Cataract Surgery Side Effects, and How to Cope

    Reviewed By Carol L Karp MD
    May. 17, 2021

    Cataract surgery is a safe procedure that improves vision for the vast majority of people. Serious complications are rare among the 4 million U.S. cataract patients who have surgery each year.

    Although the recovery process is different for everyone, there are some issues that people commonly encounter in the days after surgery, as the eyes heal.

    Here are 10 problems you might experience after cataract surgery, why they occur and what to do about them.

    Blurry vision

    It is very common to have blurry or unclear vision in the days and sometimes even weeks after cataract removal. Most of the time, this is caused by normal swelling in the eye which occurs as a part of surgery.

    Patients with larger, denser and/or firmer cataracts are more likely to experience more inflammation. These patients may have foggy vision or feel like they are in a steam room at first.

    What helps?

    Anti-inflammatory eye-drops prescribed by your ophthalmologist will help, and should be taken as directed. The swelling should decrease and your vision should clear up over a few days up to week. Patients who have cornea disease, such as Fuchs dystrophy, may take longer – up to a month or more – to get rid of the swelling.

    When to call the doctor

    If the blurriness does not subside after a week, consult your ophthalmologist. Other causes of ongoing blurry vision include residual refractive error (your eyes still need some additional correction with glasses), dry eye or Posterior capsule opacity (PCO).

    Dry eye

    After cataract surgery, almost all patients experience some level of dryness in the eye. A small number of nerves on the surface of your eye get cut when your surgeon makes the incisions necessary to reach your lens. These nerves are part of the feedback loop that tell your eye to produce tears for lubrication. The nerves generally will heal in about three months, but until then, your eye may not feel when it is dry and decrease tear production. If you had dry eye before your surgery, you may experience even more dryness afterward. Dry eye can cause discomfort, light sensitivity and/or blurry vision.

    What helps?

    If you experience mild dry eye, over-the-counter (OTC) preservative free artificial tears can help. Make sure to wait 5 minutes after applying prescription drops before using the tears so that the medicine does not get diluted.

    When to call the doctor

    If OTC tears don’t provide enough relief, reach out to your ophthalmologist, who can suggest other possible fixes to bridge you through the dry period.

    Discomfort/feeling that something is in the eye

    Many people complain that they feel like there is sand in the eye or that the eye feels scratchy after surgery. This is a normal sensation caused by the small incision in your eye, and it should heal within a week or so. If you have dry eye, the discomfort may last longer—up to three months. Some cataract patients require a stitch or suture in the eye during surgery. This shouldn’t bother you, but occasionally the suture needs to be removed after surgery.

    Posterior capsule opacity (PCO)

    Sometimes blurry vision is caused by PCO, a fairly common complication that can occur weeks, months or (more frequently) years after cataract surgery. It happens when the lens capsule, the membrane that holds your new, intraocular lens in place, becomes hazy or wrinkled and starts to cloud vision. PCO is a result of cells growing on the membrane over time, similar to scar tissue.

    What helps?

    This condition can be treated with a quick and safe laser procedure called a YAG laser capsulotomy. Your cataract surgeon will use a laser to make an opening in the cloudy capsule, allowing light to pass through for clear vision. The procedure takes about 5 minutes and does not require an incision.  

    Glare, halos and other unwanted images

    Many cataract patients experience “unwanted visual images” after surgery, also known as dyphotopsia. Glare, halos and streaks of light are examples of positive dysphotopsia. They occur more frequently at night or in dim lighting, and are more common with multifocal lenses. These effects can be more noticeable in between surgery on the first and second eye. Residual refractive error can also cause positive dysphotopsia, and the right glasses prescription will correct it. Other times, PCO can be the culprit, and YAG laser treatment can resolve the issue.

    What helps?

    If these problems have been ruled out but glare and halos persist, your ophthalmologist may recommend special drops at night to help reduce the unwanted images.

    Other patients see an arc of light or crescent shaped shadow in their visual field after surgery. This is called negative dysphotopsia, and occurs in approximately 15% of patients. Doctors are not exactly sure what causes it. In many patients, dysphotopsia resolves on its own within a few months.

    When to call the doctor

    If dysphotopsia continues to be a problem after 3 to 4 months, your ophthalmologist will suggest treatment options.

    Light sensitivity

    After cataract removal, a little bit of light sensitivity is expected due to dryness in the eye. But if your eyes reflexively squint or close with light exposure, it could be a signal of inflammation in the eye, or iritis.

    What helps?

    A steroid drop prescribed by your ophthalmologist can help. Sometimes, you may need to  wear sunglasses for a few months until iritis goes away. Most often it is caused by a “rebound” as you taper off your anti-inflammatory drops.

    When to call the doctor

    Ongoing dry eyes and blepharitis can also cause continued light sensitivity. Sometimes there are other causes that need to be addressed. Extreme light sensitivity can be a sign of infection. If you are experiencing this, call your ophthalmologist right away.

    Nausea or disorientation

    Feeling nauseated after surgery is typically an after-effect of IV anesthesia used for sedation. It’s not unusual to have lingering nausea for a day or two post operatively.

    What helps?

    Re-hydrating with a lot of fluids and eating a meal after you get home should help.

    When to call the doctor

    Elevated pressure in the eye, or ocular hypertension, can also cause you to feel like you want to throw up. Special gels used during surgery may temporarily raise the pressure in the eye. People with glaucoma may experience elevated eye pressure. Your ophthalmologist should check your ocular pressure the day after surgery and offer treatment if needed.

    Bloodshot or red eye

    A red or bloodshot eye after surgery is very common. It is normally caused by inflammation and/or a broken blood vessel, also known as a subconjunctival hemorrhage. This can create a scary-looking red spot on the eye, but it is usually harmless and heals on its own. It occurs more frequently in people who have had laser cataract surgery, which involves the use of a suction on the eye. It may be two or three weeks before the body reabsorbs the blood and the spot disappears completely.

    When to call the doctor

    If redness in the eye is accompanied by pain, light sensitivity and/or a change in vision, see your ophthalmologist right away.

    Floaters or flashes of lights

    You can experience floaters, or small dots or lines in your field of vision, after cataracts are removed. These are the shadows of small clumps of the vitreous gel that fills your eye. They are not serious, and tend to float out of the way on their own.

    When to call the doctor

    But if you experience bursts of floaters, like someone sprayed spots, or flashes of light, like a camera going off, or a shadow or curtain appears in your side vision, call your ophthalmologist immediately. These are signs of retinal detachment, a rare complication of cataract surgery that occurs when the retina pulls away from the back of your eye.

    Droopy eyelid

    Droopy eyelid is caused by ptosis, and is fairly common after surgery. It occurs more frequently in people whose eyelids swell post-operatively. It is likely instigated by the speculum, a tool your surgeon uses to pull back your lids and keep the eye accessible for the procedure. It can also stem from post-operative eye inflammation. Normally, droopy eyelid goes away on its own within six months.

    When to call the doctor

    If a droopy eyelid lasts longer than 6 months, you may need surgery to fix it.