Cataract surgery in Nigeria: what happens on the day and in the first week

Step by step

1. 1

   At the assessment

   Your eye is measured for the new lens, the pressure and retina are checked, and you list all your medicines.

2. 2

   The day before

   Wash your hair, arrange someone to take you home, and confirm any fasting instructions.

3. 3

   On the day

   Drops widen and numb the eye. The operation itself is short, you are awake, and you go home the same day with a shield.

4. 4

   The first evening

   Rest, start the drops as instructed, take simple painkillers if needed, and sleep with the shield on.

5. 5

   The first week

   Use the drops on time, avoid rubbing, dust and water in the eye, and attend your first check.

6. 6

   A few weeks on

   Your follow-up check, then new glasses if you need them, and the second eye if both are to be done.

Before the day

At the assessment the eye is measured so the lens power can be chosen, your eye pressure is checked, and your general health is reviewed. Bring all your medicines, or photos of the packs. Keep taking blood pressure and diabetes medicines unless you are told otherwise. Blood thinners are often continued for cataract surgery, but only your surgeon should decide that.

Arrange someone to take you home. You will not be able to drive, and in Lagos traffic a long ride with one eye covered is easier with company. Wash your hair the day before, because you will be asked to keep water out of the eye for a while afterwards.

On the day

Eat a light meal unless you are told to fast. You will usually be at the hospital for a few hours, most of it waiting and preparing. Drops are put in to widen the pupil and to numb the eye, and sometimes an injection of local anaesthetic is given around the eye. You stay awake.

In theatre you lie flat with a sheet over your face, leaving the eye uncovered. You will see bright light and shapes, and feel some gentle pressure, but it should not hurt. Tell the team if it does. The surgeon removes the cloudy lens through a tiny cut and puts in a clear artificial lens. Stitches are not usually needed.

Afterwards a pad or shield is put over the eye, you rest for a short time, and you are given your drops and written instructions before you go home.

The first week

The eye may feel gritty, watery or a little sore, and vision is often blurred at first. Many people notice brighter colours within days, but it can take a few weeks for sight to settle. Simple painkillers such as paracetamol are usually enough.

• Use the drops on time, every time. Wash your hands first. Set phone alarms
• Wear the shield at night for as long as you are told, so you do not rub the eye in your sleep
• Do not rub or press the eye
• Keep soap, shampoo and water out of the eye. Wipe your face with a clean damp cloth instead
• Avoid dust, smoke, and harmattan wind where you can. Wear sunglasses outdoors
• Do not wear eye make-up, and do not swim
• Avoid heavy lifting and bending right down for the first days, unless your surgeon says otherwise
• Do not drive until your surgeon says your vision is good enough

Warning signs: call the surgeon the same day

Infection after cataract surgery is rare, but it is serious and needs treatment fast. Contact your surgeon or go to an eye emergency service immediately if you have:

• Pain that is getting worse instead of better
• Vision that is getting worse instead of better
• An eye that is becoming more red, or a discharge
• Flashes, a shower of new floaters, or a shadow or curtain across your vision

After the first week

You usually have a check soon after surgery and another a few weeks later. New glasses, if you still need them, are usually prescribed once the eye has settled, often a few weeks on. Months or years later some people find their vision clouding again. This is usually thickening of the thin capsule behind the new lens, and a quick laser treatment in clinic fixes it. The cataract itself does not come back.

Common questions