One of the major concerns many people have leading up to cataract surgery is “is cataract surgery painful?”. As the eye is such a delicate and sensitive organ, it’s not uncommon to be apprehensive about any eye care procedure. With cataract surgery being such a frequently performed operation in Australia, it’s most likely that you know at least one person who has undergone this eye care procedure. Perhaps they reported a smooth and uncomplicated operation, or perhaps they regaled you with stories of unbearable pain during the surgery.

If you’re considering cataract surgery yourself in the near future, the idea of pain around the eye can be highly unpleasant. So, is cataract surgery usually painful or is pain something you need to consider at all? 

The Cataract Surgery Operation in Brief

Cataract surgery in Australia is the most commonly performed eye care operation. Since cataracts are a natural part of ageing, you can expect to develop some degree of cataract eventually. However, this does not necessarily mean cataract surgery is inevitable. Some people reach the end of their life span still feeling quite content with their vision despite the presence of cataracts, and it never becomes necessary to remove them. 

If you have developed visually significant cataracts that bother you or interfere with your daily tasks, your GP or primary eye care professional (your optometrist), can refer you to a cataract surgeon. 

The cataract operation is typically straightforward and uncomplicated. Your pupils, the black circle in the centre of your coloured iris, will be dilated with pharmaceutical eye drops. The pupils need to be widened as the cataract sits behind it. If your pupils do not dilate adequately with eye drops, the surgeon may use another technique, such as an expander ring to make sure the iris is not in the way of the surgery. 

Your eye area will be numbed with either topical eyedrops or a local anaesthetic injection. If you’re feeling anxious or restless, you can be offered a light sedative to help you relax. 

Once you’re comfortable, an incision is made in the cornea, through which various instruments will be inserted to work on the cataract. The cataract is fragmented into smaller pieces and then suctioned out from the eye. Once it’s removed, an artificial lens implant known as an intraocular lens is inserted into its place, through the same corneal incision. This incision typically then self-seals. 

Is Cataract Surgery Painful? 

Cataract surgery is not typically considered to be a painful operation, mostly due to the use of effective anaesthesia. However, the sensations of pain and discomfort can be subjective and there are some factors that can increase your likelihood of experiencing some degree of pain. What you might feel as discomfort might be felt as pain by another person.

Different eyes and bodies can also respond differently to medications or procedures. For example, the eye drops used to dilate the pupil can be felt as a mild to strong stinging in some, while others notice no discomfort at all. Furthermore, in one individual, one eye might find the drops sting but are not bothered when the other eye is treated. 

There are some steps that your cataract surgeon can take to improve your comfort leading up to, and during, your cataract surgery. Some surgeons will apply a topical anaesthetic eyedrop to minimise any stinging from the dilating drops. Other ways to minimise your likelihood of discomfort during the operation can be as simple as ensuring the adhesive sterile drapes applied around your face aren’t pulled away roughly when the surgery is over. 

Studies have found that patients with pre-existing anxiety and who are taking anti-anxiety medications may have a heightened perception of pain due to the way their medications affect pain receptors. Those who undergo surgery for particularly advanced, dense cataracts, also tend to be more likely to experience some degree of pain during their surgery. There are additional pain-relieving drugs or sedatives that can be used during cataract surgery for patients thought to be an increased risk of pain or significant discomfort. 

Is Cataract Surgery Painful Afterward? 

Once your cataract operation is over, the hard part is done but there are still a number of weeks for recovery ahead. Immediately after your surgery, you can expect to experience some discomfort, though this isn’t usually identified as pain. Your eye may feel gritty, dry, and look red and bloodshot. Cataract surgery is known to have the potential to exacerbate or induce dry eye disease. Dry eye disease is its own condition, which can cause sensations ranging from a mild dryness of the eye to debilitating pain. 

Your body’s natural response to any surgery is inflammation and wound healing. However, inflammation in the eye can be another source of pain or discomfort, especially if it’s excessive or poorly controlled. Some people also experience increased glare sensitivity in the following weeks to months after their cataract surgery, which can be painful in very bright environments.

There are ways you can reduce your post-operative discomfort. Tear lubricants can be used if your eye is feeling irritated or dry while using your prescribed post-op eye drops will help to manage inflammation. Oral painkillers can also be useful. 

If you’re still experiencing an unanticipated level of pain or discomfort after your cataract surgery, make sure you speak to your ophthalmologist. Call us on (03) 9070 5753 today.

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

References

Cataract Surgery: Everything You Need to Know
https://www.allaboutvision.com/en-au/conditions/cataract-surgery/

15 Things You Need to Know About Cataract Surgery
https://visioneyeinstitute.com.au/eyematters/15-things-need-know-cataract-surgery/

Cataract surgery
https://www.healthdirect.gov.au/cataract-surgery

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