Cataract operations are the most common ophthalmic surgery performed not only in Mumbai but the world over. After finishing the surgery the most important thing for surgeons to do is to explain to the patient and their families what are the precautions one needs to take for the next few weeks.
Before we list out what we follow at Eye Solutions in Mumbai it is important to note that this is not the only way eye doctors manage their cataract patients. There can be variations and all these variations are correct because they all work. Sometimes doctors get comfortable with one system and follow that system. Also in larger hospitals or chains of hospitals like ours, it is essential to establish a system and the following is ours.
The precautions after cataract surgery can be divided into a few categories.
The biggest fear ophthalmologist has after performing cataract surgery is an eye infection. The eye is a small organ with very delicate tissues. The retina, which is like the film of the camera (olden day camera) once damaged is not repairable. Eye infections are treatable but there is always some residual defect that remains and there is always a high risk of losing vision completely. Sometimes if the infection spreads one may also have to actually remove the eyeball. This infection is known as Endophthalmitis.
The idea is not to scare you but to inform you that performing cataract surgery is not like popping a pill. It is after all a surgery and the do’s and don’ts after cataract surgery must be strictly followed.
Instilling eye drops are the single most important thing after your cataract surgery. There are mainly three types of eye drops that we give to our patients. These eye drops must put in the eye taking due care that the tip of the bottle does not touch anything. The bottles should be brand new and never use old bottles.
Cataract surgery like any other surgery in the body is nothing but controlled injury to the body. Eye surgeons make wounds and inject stuff into the eye. The body will react after any surgery with inflammation. For eg if you keep hitting your forearm for 15 minutes you will notice that there is a slight swelling or slight redness. This is inflammation. The body’s reaction to injury. Steroids are anti-inflammatory drugs and help in reducing that inflammation. If steroids are not used the inflammation can be very severe and infect can harm the eye. Usually these we give for 4 weeks in tapering doses.
These drugs are also anti-inflammatory drugs but are not steroids. You see steroids have certain disadvantages. We cannot use them for very long and sometimes they raise eye pressure. Now, diabetics can get retinal edema post-cataract surgery and these patients may need anti-inflammatory drugs for longer periods of time. NSAIDs are very useful in this type of situation. We routinely prescribe these drugs for a period of one month.
Earlier we have mentioned that eye infections after cataract surgery is the worst nightmare. To prevent these infections we prescribe antibiotics eye drops for a period of 2 weeks.
Keeping the eye and the area around the eye is very important. Here are the instructions
No head bath for 10 days – which means one cannot let water enter the eye. One cannot wash the face but only wipe the face with a napkin.
No touching itching or rubbing the eyes.
After instilling the eye drops it is important to remove the excess medicine which may settle on the eyelashes or the corners of the eye. This we can do with some sterile cotton.
We advise patients to not venture out of home for that and the next day to avoid dust and particulate matter from entering the eye. If someone works in an office environment then yes they can resume work the next day taking due precautions.
After the cataract surgery, we give our patients protective glasses. You can see how these glasses look in the video below. These glasses tend to cover the eyes and the temples and prevent dust from entering the eyes.
We also request patients to wear a protective cup on their eyes when they sleep. We also provide skin tape for them to stick this cup onto their face. This cup prevents patients from inadvertently poking their eyes while they are sleeping. Use this cup for at least the first 2-3 days after the surgery.
We don’t want you to perform those exercises that would increase the pressure of the eye. Performing intense breathing exercises while doing yoga is one example. Even trying to maintain tough postures during yoga is not at all advised. Doing a headstand is a big no-no. In fact, Dr. Deepak did a study along with his colleagues at Sankara Nethralaya in which they measured the eye pressure in patients who did the headstand also knows as Shirshasana. There is a rise in eye pressure. This is something we definitely do not want in the first week after eye surgery.
When we perform cataract surgery we expect patients to start seeing well by the same evening. Sometimes they start seeing well the next day. There are however certain conditions that may cause blurry or hazy vision after cataract surgery.
The harder the cataract the more post-surgery inflammation and this inflammation can cause blurry vision. Sometimes this inflammation can take a few days to clear. Fewer times this inflammation can take up to 3-4 weeks to clear completely.
Retinal edema post-cataract surgery is another cause of blurry vision. The inflammation that occurs after cataract surgery can sometimes cause the retina to develop swelling. This swelling is also known as retinal edema or Cystoid Macular edema causes the vision to become hazy. The NSAIDs play an important role in reducing this swelling
Eye infections – these are the most dreaded complications of cataract surgery. We instruct our patients that they must inform us if there is any pain, redness, or blurry vision after cataract surgery. If required we see these patients the same of the next day to rule out an infection. These days the infection rates after cataract surgery significantly reduced.
As mentioned we prescribe eye drops for as long as 4 weeks after cataract surgery. Sometimes these eye drops tend to cause dryness in the eyes and this dryness leads to watering. It may also lead to a gritty sensation and your eye surgeon would prescribe lubricants to relieve you of these symptoms. These symptoms can take after 3-6 months to completely go away.
If the watering is significant and very soon after surgery then we would suggest you see your eye doctor immediately. It could mean a leaky wound that has to be dealt with.