When To Have Cataract Eye Surgery and What Happens if You Wait?

The transparent cornea and eye lens in a healthy human eye bend light in such a way that it falls on the retina. The retina acts like a screen by capturing this visual information and converting it into signals that the brain can understand. While this process of image creation happens within a fraction of a second, every individual part of the eye holds its significance. Even a slight deviation from the natural setup distorts the way your eye processes the images. For instance, cataract patients see a foggy image due to the formation of a cloudy mass within the eye lens. 

Patients face difficulty seeing due to blurry eyesight, halos, and glare around lights. It begins with difficulties in reading and watching the screen. However, as it advances, cataract patients experience blindness and face difficulty in performing their routine activities. The World Health Organization (WHO) states that cataracts are the leading cause of blindness across the world.^[1]    

Why Have Cataract Surgery?

Cataract patients suffer a diminished quality of life with difficulty seeing nearby and far-off objects. Cataracts during their initial stages appear as a white, dense mass localized in one portion of the lens. They grow and appear as a visible mass during the advanced stages. While the eyelens are clear and transparent in a healthy human eye, the proteins that occur naturally in the eyelens undergo certain changes. They break down and settle as a white, cloudy mass. This dense mass either scatters or obstructs the light rays, causing hazy vision. 

If you ask us, will cataract surgery improve eyesight? Of course, it does! Ophthalmologists remove this cloudy portion surgically in order to restore clear vision. Are you wondering about non-surgical alternatives for cataracts? Unfortunately, there aren’t any proven non-surgical methods for treating cataracts. Despite claims about herbal medicines, home remedies, or oral medications, it's worth mentioning that non-surgical methods aren’t proven to cure or reverse cataracts. The cloudy, dense cataract-formed lens should be removed surgically, followed by the placement of an artificial lens in order to restore clear vision.   

What Happens if You Don’t Have Cataract Surgery?

Untreated cataracts progress gradually, leading to partial or complete blindness. They start with impaired night vision, glare, and halos around lights, and difficulty in color perception. However, with advancing stages, candidates experience difficulty carrying out routine tasks and are prone to accidents or falls. This is dangerous, especially in elderly people, and may lead to severe injury-related issues. 

Where To Get Cataract Surgery?

Cataract eye surgery can be performed by a qualified, skilled, and certified ophthalmologist at local eye hospitals or specialized vision centers. You can look for reputable hospitals with renowned ophthalmologists and well-equipped surgical facilities. Suppose you are looking to get it done through insurance; it's better to check the approved list of eye surgery providers covered by your insurance. Most insurances require patients to choose an in-network provider. At Envoy Health, we recommend that you check out the clinic's reputation, patient satisfaction rate, surgeon's qualifications, years of experience, and the technology they use for surgery. 

Are you ready to take the next step with confidence? Sign up with Envoy Health to get matched with top-rated cataract surgeons, vetted clinics, and transparent treatment plans so that you can make an informed decision, stress-free. Let us help you see clearly sooner.

What Are the Three Types of Cataract Surgery?

There are three types of cataract surgeries, but the main intent of removing the cataract and placing an artificial lens remains the same.

• Phacoemulsification: This is the regular method of cataract removal using high-energy ultrasound waves to break down the cloudy cataract and its capsule. Ophthalmologists make surgical incisions in the cornea, break down cataracts using ultrasound waves, and use suction devices to remove the broken cataract pieces.   
• Extracapsular cataract extraction: Ophthalmologists remove the cataract, leaving its capsule intact, and place the artificial lens within the capsule. This procedure is better suited for advanced stages of cataracts that are not suitable for phacoemulsification. However, the surgical incisions are relatively larger to remove the damaged eye lens as it is. Unlike the other procedures, the incisions require sutures. 
• Femtosecond laser-assisted cataract surgery: Ophthalmologists use preset lasers to make incisions and create a circular, centered opening on the lens capsule. The lasers soften the cataract, which is further fragmented using ultrasound waves. The fragments are then removed using suction devices.   

The three types of cataract surgery vary in procedure and, hence, in technology. Since healthcare prices vary based on technology, we listed the cataract surgery cost below.

Types of cataract surgery and cost in the US:

• Phacoemulsification: $3,000 and $5,000 per eye
• Extracapsular cataract extraction: $3,000 and $5,000 per eye
• Femtosecond laser-assisted cataract surgery: $4,000-$6,000 per eye

Planning for Cataract Surgery

The series of events before a cataract starts with you attending an initial consultation. Your ophthalmologist will examine your eye condition to qualify you as an eligible candidate and discuss the procedure, its pros and cons and specifics of your case. Cataract surgery may be performed manually or using preset lasers. While the procedure remains the same, these methods vary in technique and treatment duration. Eye surgeons discuss the step-by-step procedure and brief you on the different artificial lenses (IOLs), their pros and cons, along with the cataract surgery costs. IOLs are made from silicone, plastic, or acrylic. While a few artificial lenses allow you to see far-away objects, some respond to eye muscle movement, offering better nearby and distant vision. Some lenses can even correct the issues of astigmatism. You will choose the right surgical method and lens type prior to the surgery with your ophthalmologist's help. 

Who Qualifies for Cataract Surgery?

While cataracts may develop at any age, surgeries are more common in the elderly. Ophthalmologists suggest surgical removal of cataracts for patients who face severe difficulties in vision due to cataracts. So, does every elderly person who has developed cataracts qualify for surgery? No, that depends on the stage of cataract and other eye and overall health conditions. Well, we addressed this below.

How Bad Do Cataracts Have To Be To Qualify for Surgery?

Cataracts that are too severe interfere with daily tasks, making it difficult to lead a life independently, and curbing quality of life should be removed surgically. Cataract surgery may be considered mandatory treatment in any of the following conditions.

• Difficulties in reading, driving, or watching TV, and increased dependence on others for daily activities.
• Impaired night vision, making it difficult to drive and eliciting safety concerns or falls.
• Inability to pass the vision test, as some countries hold a minimum of 20/40 vision as legal eligibility to acquire a driving license.  
• Severe cataracts that interfere with other eye treatments, like diabetic retinopathy or age-related macular degeneration.

While cataract surgery offers relief, it's worth mentioning that ophthalmologists consider certain factors before recommending it. They consider the severity of the eyesight problem and its impact on the quality of life. Besides, they consider your overall eye health, medical history, and potential for improvement specific to your case. Not every eye condition is the same. Nor is the patient's condition. Cataract surgery cannot be a suitable solution for some candidates.  

When Should You Not Have Cataract Surgery?

One should not get cataract surgery in any of the following conditions:

• Other serious eye problems: Cataract removal increases the risk of complications in certain eye conditions. Ophthalmologists need to be extra cautious if you suffer from severe glaucoma, retinal detachment, or advanced macular degeneration. This is because cataract surgery may further damage the retina or may not provide the expected results as it does for normal patients.
• Health complications that may interfere with or worsen overall health: Cataract surgery is not an option for people who suffer from health problems like a compromised immune system or conditions that interfere with healing. Candidates suffering from autoimmune diseases, uncontrolled diabetes, or high blood pressure are not the right candidates for cataract eye surgery.
• Too early cataracts that are not causing any significant issues:  Cataracts in their early stage may not significantly impact daily activities. Surgical removal is typically not suggested. Ophthalmologists suggest visual aids like eyeglasses or contact lenses for better eyesight in these patients. Speaking of that, here are a couple of questions that most patients ask us.

Is It Better To Have Cataract Surgery Early?

Yes, having cataract surgery early is often the smarter choice. Once cataracts start interfering with daily activities, it's time to consider treatment. While it’s never “too early,” addressing the problem in its early stages comes with real advantages: a shorter procedure time, quicker healing, and a smoother recovery overall. In contrast, delaying surgery until the cataract fully matures can make the removal more challenging. Most ophthalmologists recommend operating before the condition worsens, typically when vision loss starts to affect quality of life.

How Long Does It Take Before Cataracts Need Surgery?

The timeline to wait before cataract surgery typically depends on the case. A few cataracts progress slowly without much impact on routine tasks. During this period, ophthalmologists generally wait for a few years and suggest visual aids for enhanced vision. However, cataracts progress rapidly in some candidates, requiring surgery within a few months or years. You should consult your ophthalmologist when you notice the symptoms of blurry vision and get a comprehensive eye examination. They will suggest an appropriate treatment plan specific to your case.

Understand the Cataract Eye Surgery Procedure

Cataract eye surgery involves removing cloudy cataracts from the eye lens. Ophthalmologists either perform manual surgery or advanced laser-assisted cataract removal. While both procedures differ slightly in equipment and technique, the core intent remains the same. 

Eye surgeons numb your eye and dilate the pupil using eyedrops. They make incisions in your cornea to reach the internal portions of the eye. They break down the cloudy cataracts using ultrasound waves. Ophthalmologists use special suction devices to remove fragmented cataracts and place an artificial intraocular lens within the capsule. The type of incisions and the method of fragmentation vary, depending on the type of cataract surgery. 

What To Expect When You Have Cataract Surgery?

Expect slight discomfort or pressure in your eyes during the cataract eye surgery. Your surgery will be quick, taking 15-30 minutes. It will be virtually painless, performed while you are still awake. Since the eye doctor will numb your eyes using eye drops, you won’t be able to see anything, although you are aware of your surroundings. You might notice slight movement, light, or some pressure while the procedure is being carried out. Further, cataract surgery is an outpatient procedure at a hospital or eye surgical facility, so don’t expect an overnight hospital stay. More importantly, self-driving is strictly not safe on the same day. Your eyes may still feel hazy, blurred with glare and halos. So have a friend or a family member by your side to drive you home safely. 

Can Both Eyes Be Done for Cataract Surgery?

While cataract surgery for both eyes at a time is technically possible, it's usually not recommended. Ophthalmologists usually keep a few days to a few weeks' gap between both eyes to check out the surgical outcomes for the first eye. While this also reduces the complications and infection risk, it also smoothens your healing journey. Imagine how difficult a surgical recovery would be with both your eyes covered with a protective shield. Further, ophthalmologists also aim for enhanced refractive correction through the second eye cataract. They check out the vision correction through the first eye cataract and adjust the IOL for better vision. 

What Happens After a Cataract Surgery?

Your ophthalmologist will bandage the treated eye, and you will return home after cataract eye surgery. You will experience mild blurred vision, itching or burning sensations, double vision, glare, halos, and sensitivity to light. This will continue for a few days after surgery. While these symptoms may cause discomfort, using the prescribed eyedrops works as a lubricating agent. So you will feel comfortable within a few days, after which performing routine activities becomes easy.   

How Long Does It Take for Cataract Eye Surgery To Heal?

The initial healing after cataract eye surgery takes between 1-3 days, after which you can slowly resume daily tasks. However, you still need 4-8 weeks for the eyes to heal completely and attain stable vision. Your immediate side effects may slow down in a few days after cataract eye surgery. We briefed on the stage-wise healing after cataract eye surgery.

• 1-2 days: Common side effects include blurry vision, itching, burning sensation, and light sensitivity. Sleep adequately and offer rest for your body as you heal. Use the prescribed painkillers and eye drops, and strictly avoid screens and rubbing your eyes. 
• 1-2 weeks: The side effects slow down a bit, but they may still occur.  Your eyes have healed initially, and you will still need to care for them properly. Resume work and other less strenuous activities like walking, gardening, reading, or watching TV. However, avoid dusty environments and long stretches of screen time. Take short breaks for a comfortable experience. Limit exposure to direct sunlight and refrain from using hot tubs, showers, or swimming pools.
• 2-4 weeks: Your vision stabilizes, and the incidence of side effects lessens. Resume routine work schedules, driving, and exercise. Attend the scheduled follow-up check-ups so your ophthalmologist can monitor the progress.  
• 4-8 weeks: Your eyes have healed completely and have attained a stable vision correction. Ophthalmologists suggest a second cataract based on these results. 

Note that the burning sensation, light sensitivity, and other discomforts should gradually subside during the initial 2-3 weeks. 

What Are the Disadvantages of Cataract Surgery?

In rare cases, cataract eye surgery may cause serious issues that require immediate attention. Do not ignore symptoms such as immense pain, swelling, inflammation, redness, and bleeding. Below, we list a few problems caused by cataract removal. 

Lens Dislocation

The artificial intraocular lens positioned within the lens capsule during cataract eye surgery moves out of its place. This may happen immediately or years after the surgery. Although uncommon, lens dislocation occurs due to damage or weakening of the muscles holding the lens capsule. This is indeed a serious complication that requires immediate attention.^[2] 

Droopy Eyelid Problem

Although rare, ptosis or droopy eyelid issues may arise after cataract surgery, with an incidence of 5-20%.^[3] Ptosis occurs primarily due to muscle weakness caused due to the use of the eyelid speculum or surgical trauma. While the symptoms may be temporary, lasting a maximum of 6 months, for some candidates, it may be permanent for some candidates.

Retinal Detachment

Cataract surgery elevates the risk of retinal detachment. Removing cataracts and placing an artificial lens may sometimes cause the vitreous humor to pull away from the retina. Symptoms of sudden flashes of light, curtains, or shadows should not be ignored.^[4]

Glaucoma

Cataract surgery may not directly cause glaucoma, but it increases the risk in some patients. The fluctuations in intraocular pressure may contribute to a candidate's incidence of developing glaucoma. 

How Long Between Cataract Surgery on Each Eye?

Most ophthalmologists suggest planning for a second cataract for the other eye, usually after 4 weeks from your first surgery. This period may vary according to your ability to heal, refractive errors, and the severity of the cataract. While it's not wrong to remove cataracts for both eyes at a time, patients may face difficulty with the healing process. Leaving 4 weeks between surgeries for each eye allows your first eye to heal and adjust to the new eyesight.  

When To Have Second Eye Cataract Surgery?

Eye surgeons typically plan cataract removal for the second eye around four weeks after the first. They will monitor your recovery and progression toward stable vision and then schedule your second surgery. Your ophthalmologist will plan your second surgery efficiently based on your healing ability and the severity of your cataracts. Following strict aftercare and attending the scheduled follow-ups makes a real difference.

Final Word

Cataract eye surgery should not be delayed unnecessarily. It’s indeed a safe and highly effective procedure, especially when performed at the right time by an experienced ophthalmologist. While prescription glasses can help manage early-stage cataracts, waiting too long allows the cataract to become too dense, making it harder to break apart and increasing the risk of complications like corneal damage. Timely surgery ensures a smoother procedure, better outcomes, and faster recovery.

Don’t let cataracts cloud your life any longer. Sign up with Envoy Health; we will connect you with trusted cataract specialists. Book your consultation today, because a clearer vision shouldn’t have to wait.

References

1. Blindness And Vision Impairment
2. Intraocular Lens Dislocation: Manifestation, Ocular And Systemic Risk Factors
3. Comparison Of Incidence Of Ptosis After Combined Phacotrabeculectomy With Mitomycin C And Phacoemulsification
4. Incidence And Risk Factors For Retinal Detachment Following Cataract Surgery At A Tertiary Center In Jeddah, Saudi Arabia