The day I said goodbye to cataracts and hello to the world without glasses

A single patient is just a small part of the daily routine of a busy cataract surgeon. But to the patient this operation is a monumental event that can be confusing and frightening. What is it like to undergo a cataract operation from a patient’s perspective? A look at the surgical experience from the patient’s point of view can throw up useful insights and reminders about the role of each member of the team in producing a successful outcome.
The following is a diary of a real patient recently operated on in a north European city. Despite having diabetes and moderate retinopathy, she did quite well and was happy with the results.

MY vision had been worsening for some time. It was getting difficult to read the newspaper, especially the fine print. I really noticed it most when I was driving, particularly at night.

I had learned from an earlier visit that I had cataracts forming in my eyes, but at that time the doctor said it was not necessary to operate. I was relieved because I am very squeamish about my eyes and did not enjoy the thought of eye surgery one bit. Finally, when driving was becoming all but impossible, I made an appointment to visit an ophthalmologist for a check-up.

The referral
My general ophthalmologist gave me a comprehensive eye examination and said it might be time to consider cataract surgery. She referred me to a cataract surgeon. I visited the surgeon shortly after that and he checked my chart and examined my eyes. After a discussion he said I was a suitable candidate for surgery.
Next he sent me to the eye nurse who measured my eyes to determine what kind of lenses I would need. This was a painless process. The nurse explained what she was doing as we went along. I learned that because I had ‘steep’ eyes I would need special lenses that would need to be ordered from Sweden.
The manner of both the doctor and the nurse was very reassuring. I no longer had any dread of going through the surgery. It also helped that some of my friends had had it done and they were very relaxed about it.

The first operation
I went to the hospital in the early afternoon and I was given a private room. The same eye nurse came in and talked to me about the schedule for the next day. She explained everything very well and I felt prepared for the experience. After I settled in I was sent to the phlebotomist for some blood tests. Then I was escorted downstairs for a chest x-ray. My surgery would be the first one performed the following day.
My eye surgeon visited me to see if I had any questions. I was pleased that he took the time to talk with me. Next, the anaesthetist came in to make sure I was not allergic to drugs he was going to use. After a light breakfast I was escorted downstairs for an electrocardiogram.

After returning to my room I was given something “to help you sleep”. I was also given an intravenous anaesthetic and don’t remember much after that. My surgeon removed the cataract lens in my left eye and replaced it with an IOL.
I awoke sometime in the early evening with my eye bandaged. I had a slight pain in my eye but it wasn’t too bad. I awoke again later feeling nauseous but managed to get back to sleep.

The day after
The next day I was still in hospital. Early in the morning, the eye nurse took off the bandage and washed my eye with sterile water. Everything in the ‘new eye’ looked pale compared to my normal eye. The trees and grass outside my window were pale green and red flowers were paler. The eye nurse explained how to wash my eye with cool boiled water and how to apply my eye drops. I was given two bottles of eye drops: one anti-inflammatory and one antibiotic, and instructed to put them in four times a day. I was also given an instruction sheet. This told me about washing my eye, using the shield, and among other things advised that I perform “no heavy housework”.
The surgeon then came and told me not to worry about the pale colours. It would settle down. He was right; the colours were normal in about 24 hours. I had no pain in the eye but had a severe pain in the roof of my mouth from the breathing tube. The pain lasted six days before I could do without painkillers.

I went home about 11.00 a.m. and rested. I don’t know about anyone else but I was in no condition to do any kind of housework, heavy or otherwise. I spent the next couple of days in bed feeling very tired. The vision continued to improve in the new eye. Now the colours were brighter than in the old eye. The flowers looked brilliant! Things were in better focus than before the operation.
The eye operated on seemed bloody so I called the nurse. After some discussion, they asked me to come in for a visit. The doctor had a look and told me it was a burst blood vessel, nothing to worry about, and everything else was fine.
Four days after surgery I bestirred myself to go out to lunch with friends. I could now read to some extent with my new eye, but not for very long. I was very excited when I did the crossword puzzle in the morning paper without glasses.

The two-week follow-up
By one week, the pain from the breathing tube was finally easing and my appetite was returning. The full moon looked much whiter and rounder with the ‘new’ eye. At the second week I made a follow-up visit to the surgeon. The eye looked fine to him. He told me I could stop using the eye shield at night and cut down eye drops to twice a day. My vision has become very good for distance and quite good for close work, although I will need glasses for reading. Arrangements were made for the operation on my second eye.

The second operation
One month after my first cataract operation, I went into hospital to have my second eye done. This time I was in a semi-private room. There was less privacy, but it was a bit jollier, because all of us were four grannies in for cataract operations. The nursing care was excellent and I had the same surgeon for the first eye.
Before the surgery, a young doctor repeated the eye measuring procedure. Later, as I was lying on the trolley waiting to go to surgery, my surgeon came up and checked the chart. He questioned the results obtained by the second doctor so they repeated the measurement. I reminded them that both eyes had been measured before the first surgery. The repeat measurement agreed with the original one.
Once that was settled, I was rolled into the operating room. I mentioned my sore mouth from the last time to the anaesthetist and he used a smaller tube. Thanks to that, I had no problem with pain.

The follow-up
About a week after my second cataract operation, I went to my optometrist and was examined for glasses. He said my vision was 20/30 and for reading I would need +2.75.
He was able to put reading lenses in the frames from my bifocals, which I no longer needed. I’ve been reading comfortably since then.
Two weeks after my second operation I visited my surgeon and he said everything was fine. I saw him again a month later and he was pleased with results in both eyes and said I could stop using the eye drops.
I am delighted at the outcome of the cataract surgeries. I am so happy to be able to see without glasses.
I really appreciated the help of the team that cared for me. The nursing was wonderful. They were professional, but personal and caring, and that made a big difference all the way through.

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