I recently had cataract surgery on both eyes (2 weeks apart). I thought I would share my experience since it is such a common surgery and one most of us will have to have, provided we live long enough! You can read Part One of this series here.
Cataracts (clouded lenses in your eye) are most commonly due to aging. Normal proteins in the lens start to break down usually after the age of 40 and that is what causes the lens to get cloudy. People over age 60 usually start to have some clouding of their lenses but vision problems may not happen until years down the road. According to my ophthalmologist’s website, more than 50% of people age 60 or older are diagnosed with cataracts during a routine comprehensive exam. Cataracts can also tend to run in families and can be caused my certain medical problems, such as diabetes. They can sometimes be caused from an eye injury, eye surgery, or radiation treatments. The use of certain medications can also cause cataracts, such as corticosteroids.
Cataracts can be removed only with surgery. When the cataracts become worse and keep you from doing things you want or need to do, then surgery should be considered.
I scheduled a surgery consultation with my eye clinic which was thorough and detailed. I was there over an hour. The tech rotated me through about three different rooms with various machines that performed various eye tests. Then the tech dilated my eyes and the ophthalmologist came in. She did an eye exam and said I was very ready (I had been told last year my cataracts were ready for surgery but due to COVID and other surgeries in our family, I had put it off). My vision at that point was like looking through a dirty or dusty window. Things looked blurry, hazy and less colorful. I was also having some double vision. I was having trouble reading writing on the TV as the words were superimposed on each other making it appear that there were two sets of words. I was not however having any trouble reading from books or magazines.
The ophthalmologist gave me two brochures to read on cataracts. One was on cataracts in general and one on cataract surgery.
She explained a little about the surgery, that she always does the bad eye first and the second eye two weeks after that. She said I would be awake during the surgery but would be put in a twilight sleep to ease my anxiety. She said they numb the eye very well and I would not feel anything.
My ophthalmologist explained that cataract surgery is an operation to remove your eye’s natural lens, which has become cloudy due to the cataract. A small incision is made into the eye and tiny instruments are used to break apart and remove the cloudy lens from the eye. Your cloudy lens is replaced with a clear artificial lens, called an intraocular lens or IOL.
During the pre-op visit, they go over any medications you are taking and discuss any health considerations you might have. I had to also meet with a surgery scheduler who did measurements of both my eyes to determine the proper focusing power for my IOLs, and who explained more details about the surgery. At that time, she gave me a bag which contained pre-op instructions and a bottle of very expensive eye drops ($90) that I would be using after the surgery. The drops contained an antibiotic, a steroid, and an NSAID.
Starting a week before my surgery, I was told to wash my face daily, especially around my eyelids and lashes, I was told to purchase a cleanser such as SteriLid or OCuSOFT (found in the eye drop section of drug stores). I used OCuSOFT lid scrub.
I pre-registered online which involved filling out a long form which covered my medical history and surgical history and the usual COVID screening questions. They wanted to know all COVID tests I had had, dates and results.
A surgery center nurse called two days before my surgery to go over any medications and tell me not to eat or drink anything after midnight before my surgery. I was the first surgery of the morning (out of 8 cataract surgeries my doctor was doing that day). I was told to be there at 6 am (ugh) and my surgery would be 7-7:30. I was told the surgery was a 10-20 minute procedure and I would be in recovery a short time and home by 10. The nurse told me to dress comfortably and to preferably wear a button up shirt so they could apply the heart monitor pads easily.
My first surgery, which was on my left eye, was Wednesday, July 28th. I arrived at the surgery center at 6 am. After a brief check-in and COVID screening, they had me remove the mask I had worn and said I was required to wear one of their masks. I was taken to the back where I was weighed and my temperature taken, and immediately put in a bed. I would remain on this bed during my entire time, even during the surgery. I was allowed to keep my clothes on (i.e., I didn’t have to put a gown on) and even kept my shoes on. They joked that this would be one time I would be allowed to get in bed with my shoes on. I was hooked up to a cardiac monitor and a blood pressure cuff was applied as well as a pulse oximeter. A nasal canula was put on under my mask, so that oxygen could be administered during the surgery. I was covered in warm blankets (it was very cold in this surgery center)! An IV was put in my hand so that the anesthesia medications could be administered. The anesthesiologist came and talked to me as did a student nurse anesthetist. I told them how I always get nauseated with surgeries so they brought me a Zofran tablet to take. They told me I would be awake during this surgery because my doctor would be giving me verbal commands during surgery so she needed me to be awake. My head was put in a foam cradle head positioner at the top of the bed and a pillow was put under my knees. During this time, they were periodically putting a lot of drops in…. numbing drops and dilation drops.
Finally it was time to wheel me to surgery. The anesthesiologist injected Versed (a fast-acting benzodiazepine to relieve anxiety and make me drowsy) and Fentanyl (a narcotic analgesic). They told me the Versed would cause some amnesia. I never went to sleep and I didn’t have amnesia. I remember them wheeling me into the surgery room. My doctor talked to me the entire time and told me everything being done. I remember them telling me they were going to wash out my eye and I remember them squirting what appeared to be a gel in the eye and rinsing it out (I didn’t feel any of it as I was quite numb). I remember them turning on the oxygen to my nasal canula. I remember the doctor telling me she was applying the drape over my eye and then telling me she was applying the eyelid retractor to keep my eye open wide during surgery
And then I remember her telling me she was beginning the surgery. I remember seeing bright lights and then a red color filling my eye which became a swirling red eddy. I assumed this was blood. Every now and then a clearing would form and I could see a nurse standing by my side. At this point, I started thinking I wasn’t deep enough because I was feeling anxiety and wished I was more sedated. About that time, I felt pressure and then a pin prick that made me involuntarily jump. I immediately thought that it wasn’t too smart to jump when someone has a sharp instrument in my eye so I verbally told the ophthalmologist that I was feeling things. I heard her tell the anesthesiologist to give me more juice. It wasn’t long after that, that she was finished.
They covered my eye with a bandage and I was wheeled out to recovery. I was put in a chair and given a small sprite to drink but I didn’t want it as I was very nauseated. I remember the nurse asking me if I was ready to see Steve and I said, “Yes, I guess I am even though I don’t know who Steve is.” She said, “Isn’t your husband’s name Steve?” I said, “No, it’s Rick.” We had a good laugh. So the rest of the day, whenever hubby would put my eye drops in, I would say, “Thank you, Steve!” Hubby was brought to the back and I was glad he was there to hear the discharge instructions because I was trying hard not to vomit at that point and didn’t pay much attention. I remember the nurse saying we were going to have to do something different on the second eye (for the nausea).
I was walked to the car and given an emesis bag for the trip home. We were home by 9 am.
I reclined the seat and slept on the drive home. I hit the bed when I got home due to nausea and slept until about 4:30.
As far as post op instructions, I was told to remove the eye bandage one hour after getting home. I was told to NOT rub my eye and was given an eye shield that I was to wear only at night when I slept for one week.
I was to start the eye drops immediately and use them four times a day for one week and then twice a day for 14 more days. The purpose of these drops was to reduce pain and inflammation and to prevent infection.
I was also told I could use artificial tears/lubricant OTC drops if my eye felt irritated or to increase comfort throughout the day. I used Refresh drops.
There were no limitations of bending, walking, reading, TV, travel, bathing/showering. I was told not to rub my eye hard for 4 weeks but to gently clean my lashes daily with warm water. I was told to wear sunglasses for any light sensitivity, if needed, and not to do any strenuous lifting or pushing for one week.
I had no pain or discomfort in this eye whatsoever. I honestly could not even tell anything had been done to my eye. I had no redness or watering in that eye and could not even tell you where the incision had been made.
I was amazed at how much brighter and whiter everything was in that eye. My kitchen floor was white again and no longer dingy yellow. Covering up each eye and comparing the two was absolutely amazing! Just looking at my socks with my surgery eye and then with my remaining cataract eye was such a difference. I couldn’t believe how white my socks were!
I went for a post-op exam the next afternoon and everything looked good. My intraocular pressure was up a little in that eye which is typical for 1-2 days after cataract surgery. My eye was still dilated and so things were still a little blurry. The doctor told me they use much stronger dilating drops and more of them for this surgery than they would for a routine eye exam so it was normal for my eye to still be dilated. The dilation lasted about 36 hours. I told her how amazed I was at how much brighter everything was and she said that is about the most common comment she hears after cataract surgery and she warned me that sometimes the brightness is a little overwhelming at first until you get used to it. Having that surgery made me realize how dark my world had been. It was such a gradual darkness, that I guess I hadn’t realized how bad it had gotten. I was told to come back in a week. At that visit both my intraocular pressures (IOPs) were normal as the doctor expected them to be. I was told everything looked good and the ophthalmologist was pleased with how everything had gone. She said the surgery had gone perfectly.
Coming soon…. part 3… cataract surgery in the second eye