Cataract surgery is a short operation, but good preparation makes it simpler and calmer. These are the general instructions for Dr. Stern’s patients before surgery at Hadassah Ein Kerem or at the Hadassah Beit Shemesh center. The personal instructions you receive from the team before your surgery are the ones that apply.
The consultation and the tests before surgery
At the consultation the whole eye is examined, not only the lens: visual acuity and prescription, intraocular pressure, a slit-lamp examination and an examination of the back of the eye with the pupil dilated. At the end of the visit we decide together whether it is time to operate, and choose the type of lens.
Before surgery, precise measurements of the eye are taken, on which the calculation of the intraocular lens is based:
- Optical biometry – measurement of the length of the eye and the curvature of the cornea.
- Corneal topography or tomography – especially when there is astigmatism, or when a toric or multifocal lens is being considered.
- OCT of the retina – as needed, to make sure the centre of vision is healthy.
Dilating the pupil blurs vision for a few hours, so it is best not to drive after the consultation.
Contact lenses before the measurements
Contact lenses temporarily change the shape of the cornea and may distort the lens calculation. That is why you stop wearing them before the measurements: soft lenses – usually a few days to a week; hard or rigid gas-permeable lenses – usually several weeks. The team will tell you exactly how long to stop.
Medications and blood thinners
- Do not stop any medication – including blood thinners, such as aspirin, warfarin (Coumadin), apixaban (Eliquis) or rivaroxaban (Xarelto) – without explicit instructions from your doctor. In most cases they are continued as usual for cataract surgery, but the decision is individual.
- Tell us about all the medications you take, and especially about medications for an enlarged prostate (such as tamsulosin) – even if you have stopped them. They affect the pupil during surgery, and knowing in advance lets us prepare for it.
- Regular eye drops, for example for glaucoma – continue them, unless you were told otherwise.
- Diabetes: tell us about your treatment, and check with the team how to take your medications on the day of surgery.
Eating, drinking and fasting
The instructions on eating and drinking before surgery are given together with your surgery date, and they depend on the type of anaesthesia and the time of the operation. Follow them exactly. If you have not received instructions or are not sure – call and ask before the day of surgery.
What to bring on the day of surgery
- Your ID card.
- The funding approval from your health fund or insurer, if required – Dr. Stern’s clinic helps you obtain it.
- An up-to-date list of all your medications.
- Your glasses.
- Someone to take you home – you cannot drive after surgery.
On the day of surgery
- Come without make-up and without face cream around the eyes, in comfortable clothes.
- The stay at the hospital lasts a few hours: preparation, pupil dilation, the operation itself – which is short – and a short recovery.
- You go home the same day, with a shield over the eye, drops and written instructions.
Is cataract surgery painful? What you see and feel
The operation is performed under local anaesthesia with numbing drops and gel, and sometimes also a gentle injection of anaesthetic into the eye. You are awake, but you do not feel pain. You may feel touch or slight pressure, and you mainly see a bright light and blurred colours – not the instruments. All you need to do is lie comfortably and look towards the light.
When a parent has difficulty understanding or cooperating
If a parent has memory loss or difficulty understanding, tell us at the consultation itself. That way we can plan together the explanation, the consent to surgery, the type of anaesthesia and the support on the day of surgery. It is recommended that a family member come both to the consultation and on the day of surgery.
Preparation checklist
- The consultation and measurements have taken place.
- Contact lenses have been stopped as instructed.
- The full list of medications has been given to the team.
- You have received the fasting instructions and arrival time.
- The funding approval has been received, if required.
- Someone will take you home.
- The drops prescribed for after surgery are at home, if you received the prescription in advance.
And after surgery: What not to do after cataract surgery – instructions and drop schedule
Frequently asked questions
Do I need to fast before cataract surgery?
The instructions on eating and drinking are given together with your surgery date, and depend on the type of anaesthesia and the time of the operation. Follow them exactly, and if anything is unclear – call before the day of surgery.
Do I need to stop blood thinners before cataract surgery?
Do not stop blood thinners or any other medication without explicit instructions from your doctor. In most cases they are continued as usual, but the decision is individual.
How long before surgery do I stop wearing contact lenses?
Soft lenses – usually a few days to a week before the measurements; hard lenses – usually several weeks. You will receive exact instructions from the team.
Can I come to cataract surgery alone?
You need someone to take you home: after surgery the eye is covered with a shield, and you cannot drive.
How long will I be at the hospital on the day of surgery?
The operation itself is short. With the preparation, pupil dilation and recovery, the whole stay lasts a few hours, and you go home the same day.
Is cataract surgery painful?
No. The operation is performed under local anaesthesia; you may feel touch or slight pressure, but not pain.