Cataract operations are the most common ophthalmic surgery performed in Mumbai and worldwide. After finishing the surgery, the essential thing is for surgeons to explain to the patient and their families 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 essential 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 plan, and the following is ours.
We will divide the precautions after cataract surgery into a few categories.
The biggest fear ophthalmologist has after performing cataract surgery is an eye infection. This infection is the most dreaded complication of cataract surgery. The eye is a small organ with very delicate tissues. Once damaged, the retina, which is like the camera's film (olden day camera), 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 remove the eyeball. This infection is known as Endophthalmitis.
The idea is not to scare you but inform you that cataract surgery is not like popping a pill. It is, after all, a surgery, and you must strictly follow the dos and don'ts after cataract surgery.
Instilling eye drops are the single most important thing after your cataract surgery. There are three types of eye drops given to our patients. These eye drops must be 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.
Like any other surgery in the body, Cataract surgery 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. E.g. if you keep hitting your forearm for 15 minutes, you will notice a slight swelling or slight redness. This swelling is inflammation—the body's reaction to injury. Steroids are anti-inflammatory drugs and help in reducing inflammation. If one does not use steroids, the inflammation can be very severe and harm the eye. Usually, these we give for four 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, people with diabetes can get retinal oedema post-cataract surgery, and these patients may need anti-inflammatory drugs for more extended periods. NSAIDs are beneficial in this type of situation. We routinely prescribe these drugs for one month.
Earlier, we have mentioned that eye infections after cataract surgery is the worst nightmare. To prevent these infections, we prescribe antibiotic eye drops for two weeks.
Glaucoma Eye Drops
Glaucoma is a condition in which eye pressure increases. Sometimes after cataract surgery, the pressure inside the eye can increase. Following are the reasons for this pressure increase.
If the pressure increases, your eye doctor will prescribe glaucoma eye drops or certain tablets to lower the eye pressure.
Keeping the eye and the area around the eye is very important. Here are the instructions
No head bath for ten days 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 for a week
After instilling the eye drops, it is essential to remove the excess medicine, which may settle on the eyelashes or the corners of the eye. We can do this with some sterile cotton.
We advise patients not to venture out of home for that and the next day to avoid dust and particulate matter entering the eye. If someone works in an office environment, they can resume work the next day, taking 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 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 increase the eye's pressure. Performing intense breathing exercises while doing yoga is one example. Even trying to maintain challenging postures during yoga is not at all advised. Doing a headstand is a big no-no. Dr Deepak did a study with his colleagues at Sankara Nethralaya, in which they measured the eye pressure in patients who did the headstand, also known as Shirshasana. There is a rise in eye pressure. We do not want this 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. However, certain conditions 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 oedema post-cataract surgery is another cause of blurry vision. The inflammation after cataract surgery can sometimes cause the retina to develop swelling. This swelling, also known as retinal oedema or Cystoid Macular oedema, causes the vision to become hazy. The NSAIDs play an essential role in reducing this swelling.
Eye infections – these are the most dreaded complications of cataract surgery. We instruct our patients to inform us if there is any pain, redness, or blurry vision after cataract surgery. We see these patients the same or the next day to rule out infection if required. These days the infection rates after cataract surgery are significantly reduced.
As mentioned, we prescribe eye drops for as long as four weeks after cataract surgery. Sometimes these eye drops tend to cause dryness in the eyes, which 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 soon after surgery, you should see your eye doctor immediately. It could mean a leaky wound, and your cataract surgeon would like to deal with that as soon as possible.