Does Cataract Surgery Hurt?

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Video Transcript

Does cataract surgery hurt?
Hi, I’m Dr Rylan Hayes — ophthalmologist at The Vision Surgeon in Maroochydore on the Sunshine Coast. Cataract surgery is remarkably well-tolerated, and most patients are genuinely surprised by how comfortable the experience is. During the procedure, the eye is numbed with anaesthetic drops and you’ll also have sedation — so you’re relaxed and comfortable throughout. Sharp pain during cataract surgery is uncommon. You may be aware of some light, pressure, or gentle movement — but not pain. After surgery, the eye may feel gritty, slightly sore, or sensitive to light for the first day or two — similar to having dust in the eye. This typically settles quickly with the prescribed post-operative drops. Serious post-operative pain — particularly if it is sudden and worsening — should always be reported to us promptly, as this can be a sign of elevated eye pressure or, rarely, infection. This is one of the reasons we schedule a review the day after surgery. But for the vast majority of patients: cataract surgery is far more comfortable than they expected. Come and see me if you have any concerns.

Does Cataract Surgery Hurt?

Fear of pain is one of the most common reasons patients delay seeking cataract surgery — and it’s a concern worth addressing directly. The good news is that modern cataract surgery is remarkably well-tolerated, and patient-reported pain scores are consistently low.

During the procedure

Cataract surgery is performed under a combination of local anaesthetic and intravenous sedation administered by an anaesthetist. This means:

• The eye itself is thoroughly numbed so sharp pain is not experienced
• The sedation keeps you relaxed, calm, and comfortable — although some people are asleep throughout, though goal is not to put you so deep you need breathing tubes and support.
• You may be aware of bright lights, a sense of pressure, or gentle movement — but this is not pain

The surgical team monitors you throughout. If you experience any discomfort, it is important to tell the team — do not move suddenly, but communicate verbally. Additional anaesthetic or sedation can be given.

After surgery

In the hours after surgery, as the local anaesthetic effect wears off, you may notice:

• A gritty or scratchy feeling — similar to a grain of sand in the eye
• Mild sensitivity to light
• Slight soreness or aching around the eye area

These sensations are normal and typically mild. They are managed with prescribed anti-inflammatory and lubricating eye drops. Most patients find paracetamol is sufficient for any discomfort.

When to be concerned about pain

While mild discomfort is normal in the first 24–48 hours, the following require urgent contact with Dr Hayes or your nearest emergency facility:

• Sudden, significant, or worsening pain after the initial post￾operative period
• Severe pain accompanied by nausea or vomiting
• A rapid deterioration in vision
• Increasing redness, discharge, or swelling

These can be signs of elevated intraocular pressure or, rarely, intraocular infection (endophthalmitis) — both of which require prompt assessment.

The patient experience

Studies consistently report that the majority of cataract surgery patients experience little to no pain during the procedure, and that anxiety about pain in the pre-operative period far exceeds the actual experience.

Key Takeaways

• Cataract surgery is performed under local anaesthetic drops and sedation — sharp pain during the procedure is uncommon
• Post-operative discomfort is typically mild (grittiness, light sensitivity) and usually managed with paracetamol and drops
• Sudden or worsening pain after surgery requires urgent review — it can indicate elevated eye pressure or infection
• Most patients are surprised by how comfortable the experience is compared to their expectations

Questions about pain and cataract surgery?

Book a consultation with Dr Rylan Hayes at The Vision Surgeon, Maroochydore.

References

• American Academy of Ophthalmology. Cataract in the Adult Eye — Preferred Practice Pattern. aao.org
• Pager CK. Expectations and outcomes in cataract surgery: a prospective test of 2 models of satisfaction. Arch Ophthalmol.
• Nijkamp MD, et al. Determinants of patient satisfaction after cataract surgery in 3 settings. J Cataract Refract Surg. 2000.