Stanger Hospital Eye Care Centre.

CATARACT SURGERY
YOUR QUESTIONS ANSWERED

YOUR QUESTIONS ANSWERED AFTER CATARACT SURGERY You are soon to be admitted to hospital to have your cataract removed. This booklet is designed to provide the necessary information regarding your admission to hospital, the operation and its aftercare. Having a cataract removed should not disrupt your life greatly, but some extra care is required for at least three weeks after surgery. During this time, your eye is still fragile and could be vulnerable to the smallest knock.(slightest injury) We suggest, if possible that you arrange for some one to help at home during the first 3 weeks after discharge. Overleaf are some guidelines to help identify your limitations and understand why these limitations are necessary.

WHAT IS A CATARACT?

The natural lens of the eye is a transparent flexible structure suspended within the eye. In many older people, however, and in a few younger people, the lens gradually becomes cloudy and discolored, preventing clear vision. This tends to become worsen, usually over a few years .Often both eyes are affected and the patient will become more visually handicapped. In the early stages, a change of glasses may help, but eventually a cataract operation is needed.

PRE-OPERATIVE ASSESSMENT: Once your name is on the waiting list for cataract surgery, you will be called to a pre-operative assessment clinic one month before the cataract surgery. This is to assess your fitness for cataract surgery and any special factors that may affect the way the operation will be done. The following tests will be conducted before we admit you for cataract surgery. Tests are; Blood sugar. Blood pressure. E.C.G for any significant heart diseases and patients who are above 45 years and undergoing general anesthesia. Please note that any abnormality in the above mentioned test will delay or cancel your admission. Therefore make sure that your blood pressure and blood sugar is well controlled. Your blood sugar should be below 7 mmol/l for 3 months consecutive readings. Please feel free to ask questions and express your concerns.

HOW CATARACT SURGERY IS DONE: The operation takes about 30 to 45 minutes and is done under local anesthesia (the patient remaining awake throughout the procedure). While lying on the operating tables please lie very still and listen to the doctors orders to avoid complications. (i.e. do not cough, sneeze, talk or move the head)

POST-OPERATIVE ASSESMENT AND RECOVERY: At the end of the operation you will return to the ward and after one hour you allowed to eat a soft diet. Prior to going home, you will be shown how to wash your eye and instill your eye drops. The patent is usually able to go home

next day afternoon and we would advise you to have an adult relative or friend give you company on the first night at home. Most patients will then notice an improvement in brightness and color, although quite often the vision is also somewhat misty or out of focus at first. A period of healing is then required. Usually there is very little post operative pain, the eye may feel bruised at first and a gritty feeling is common in the first few days. Normal over the counter analgesics (pain killers) will usually suffice. The area around the eye may look bruised, and the white area of eye may look red at first. This is not a cause for concern and will clear up within 2 to 3 weeks. Post operative eye drops will be supplied to you and a plastic eye shield for use at night for three weeks following surgery. You can return to most ordinary activities after 2 weeks, however bending and lifting are usually not permitted. Things you must avoid for 3 weeks 1. Touching or rubbing the operated eye. 2. Heavy gardening (e.g. Digging) 3. Carrying heavy shopping bags. 4. Dusty housework. 5. Swimming and contact sports. 6. Getting soap or shampoo in the eye. 7. Driving unless you have confirmed that you are within the legal limit to drive. 8. Traveling abroad before your 1st follow up appointment. When can I return to work? This really depends on the work you do. Discuss this at your pre-operative assessment clinic visit. Your sight will not be at its best until your eyes are refracted for a new pair of spectacles usually after 3 months.

Care needs to be taken when.. Hair washing (use shield for protection). Bending Cooking. Things are not affected.. Walking Watching television Most normal daily activities Reading Follow-up appointment.. Usually your first follow-up appointment will be one week after the surgery. Your second follow-up appointment will be three weeks after the first follow-up. If no postoperative complication, then you will be discharge on that day after a refraction test if needed. If you have any problems before your follow-up appointment then you should phone Eye clinic nurse for advice on 032-4376188.

WHAT ARE THE RISKS? All operations carry some element of risk; cataract surgery in our Stanger hospital setup with its limitation which includes post operative non-compliance by the patients, we find about 90% patient experience an improvement in sight, 8% end up with the same level of sight as before, and 2% are sadly worse off because of complications. Some time due to unwanted post operative complications one in 100 cataract surgery patient may lose all of the sight in the eye. Disease like diabetes, hypertension or any other pre-existing eye diseases in addition to the cataract, can affect the final visual outcome, as the presence of a cataract limits a full examination of the eye before surgery.

We hope you will gain lasting benefit from your cataract operation, and we will try to make it as stress free as possible. HOW TO APPLY YOUR EYE DROPS WASH YOUR HANDS BEFORE APPLYING EYE DROPS NEVER PUT MEDICATION BY YOURSELF, ALWAYS ASK SOME ONE TO PUT IT IN YOUR EYE. 1. Gently pull the lower eyelid down until there is a small pocket.

2. Squeeze the upturned dropper bottle to release a drop into your eye. Avoid touching the tip of the bottle against your eye.

DO NOT RUB YOUR EYES AFTER APPLYING THE DROPS.

STORAGE OF EYE DROPS AND OINTMENT 1. Store eye drops and ointments in a cool place out of childrens reach. 2. Only store drops in the fridge if requested to do so. 3. Dispose of all opened eye drops and ointments after one month. 4. Never share your eye drops with any one else.

Compiled by. Dr.Chowdhury Chief Medical Officer. Stanger hospital eye care Centre.