The short answer
- Home the same day, but not drivingThe NHS says the operation usually takes 20 to 45 minutes under a local anaesthetic, and that your relative should go home the same day but must not drive themselves.
- The eye drops are the main jobThe NHS says the drops are usually needed for about four weeks. The number each day is on the discharge letter, and it usually comes down week by week.
- Some redness and grittiness is normal, severe pain is notSevere pain, an eye getting more painful each day, loss of vision or increasing redness means ringing the eye unit straight away.
- What a few days of help costsA few days of visits for the drops and meals covers the busiest part. Carers on PrimeCarers charge £18 to £25 an hour with our fee included.
Clinical points come from the NHS and NHS trust leaflets, linked beside each one. The eye unit's own instructions come first. Agencies charge £28 to £35 an hour for a similar visit.
The operation and getting home
What the operation involves, and getting home the same day
A cataract is a clouding of the lens inside the eye. The operation takes the cloudy lens out and puts in a clear artificial one.
The NHS guide to cataract surgery says it is usually done under a local anaesthetic, given as eye drops, an injection or both, so your relative is awake but should not feel pain. It usually takes between 20 and 45 minutes, stitches are not usually needed, and people should be able to go home the same day. If both eyes have cataracts, they are done on separate days. Our page on sight loss and care at home covers cataracts alongside the other common eye conditions of later life.
- 1
Someone to take them home
The day of the operationThe NHS says not to drive yourself home. The eye may be covered and the vision blurred for a few hours from the drops that widen the pupil, so a relative, a friend or a carer should travel home with them. - 2
The shield stays on overnight
The first eveningGuy's and St Thomas' says to keep the pad and shield on overnight without touching them, rest for the first 24 hours, and take extra care on steps and stairs, because judging depth may be harder. - 3
Somebody else does the kettle and the cooker
Until they can see clearlyThe same leaflet says reading and television do no harm, but to avoid boiling kettles, stoves and other hazards until your relative can see clearly. - 4
The first drops, then a check in a few weeks
The next morningThe shield comes off in the morning, the eyelids are gently cleaned and the drops begin. For a routine operation there is usually no visit the next day, and a follow-up within about six weeks, which may be at a local optician.
The 24-hour rules that follow sedation or a general anaesthetic do not apply after a local anaesthetic alone. If your relative is having either, do you need someone to take you home after surgery? explains what the hospital will expect, and can you get a taxi home after sedation? answers the usual next question. The first evening, the shield and the follow-up come from the Guy's and St Thomas' leaflet on the weeks after cataract surgery. The hospital discharge and post-operative care guide covers operations more widely.
The eye drops and the shield
The eye drops are the main job for about four weeks
The drops help the eye heal and prevent infection. They come with a written plan, and the plan usually starts with several drops a day and tapers down.
The NHS says the drops are usually needed for about four weeks. Which drops, how many and for how long is set by the eye unit and written on the discharge letter and the bottle labels, and trusts differ. The chart below is one example, copied from the Hull University Teaching Hospitals leaflet on care after cataract surgery, to show how the day's drops fall as the weeks go on.
An example, not your relative's prescription
Four weeks of eye drops, from one NHS leaflet
Week 1
Drop A (for example, an antibiotic and steroid drop)4 a dayDrop B (for example, an anti-inflammatory drop)2 a dayDrops a day: 6
Week 2
Drop A (for example, an antibiotic and steroid drop)3 a dayDrop B (for example, an anti-inflammatory drop)2 a dayDrops a day: 5
Week 3
Drop A (for example, an antibiotic and steroid drop)2 a dayDrop B (for example, an anti-inflammatory drop)StoppedDrops a day: 2
Week 4
Drop A (for example, an antibiotic and steroid drop)1 a dayDrop B (for example, an anti-inflammatory drop)StoppedDrops a day: 1
- Where there are two kinds of drop, the leaflet says to wait a few minutes between them.
- The bottle is thrown away four weeks after it was opened, and the drops are not used for longer than the eye unit said.
In the first week that example comes to six drops a day. Keeping that up alone is harder if the other eye is poor, the hands are unsteady, or there are several tablets as well. Hull gives patients a chart of their drops when they leave. Put it on the fridge and tick off each drop, so everyone who helps works from the same sheet and a missed dose shows at a glance.
The Hull leaflet says that if your relative finds the drops difficult, it may be better to ask someone to put them in for them, following the leaflet's instructions. A family member can do this. A carer can remind your relative when each drop is due, and some carers will put the drops in as the label directs. Putting drops in for someone counts as giving a medicine rather than reminding, so agree it with the carer before the operation. PrimeCarers does not check carers' training, so ask them about their experience with eye drops. Can a private carer give medication? explains the difference, and can carers give medication? covers the wider rules.
Guy's and St Thomas' says the unit cannot supply any more drops, so if the bottle runs out before the course ends, the prescription goes to the GP, with time allowed for the repeat. The leaflet also says to carry on with any glaucoma drops unless the doctor has said to stop.
What to avoid, and driving
What to avoid in the first weeks, and when they can drive again
The list is short, and most of it keeps the eye free of knocks, rubbing and water while it heals.
What the NHS and the trust leaflets advise
- Simple painkillers, such as paracetamol or ibuprofen, if the eye is sore
- Wiping a watering eye gently with a clean tissue
- Sunglasses if lights seem brighter than normal, and glasses or the shield outdoors on a windy day
- Hair washed with the head tipped back, as at a salon, for the first week
What to avoid
- Rubbing or knocking the eye
- Soap, shampoo or water in the eye, and eye make-up until it has healed
- Swimming, even with goggles, and gardening for at least a month
- Heavy lifting, bending down and energetic exercise
These come from the NHS page and the two trust leaflets. Bending and lifting are where help matters most, so the shopping, the bins and anything on a low shelf are the jobs to take over for a while.
DrivingSection titled Driving
The NHS says not to drive until the vision is back to normal, and the Hull leaflet says not for 48 hours and not until your relative meets the legal eyesight standard. The gov.uk driving eyesight rules set that standard: being able to read a number plate from 20 metres, with glasses if needed, and a minimum sharpness of sight and field of vision that an optician can test. Ask the optician or the eye unit to confirm it is met before your relative drives, and Guy's and St Thomas' suggests checking with the car insurer too. If driving was already a worry, elderly parents and driving covers how to raise it.
The second eye, and new glassesSection titled The%20second%20eye%2C%20and%20new%20glasses
If the other eye has a cataract too, NICE guidance on cataracts says the second operation should be offered on the same basis as the first, and discussed at the first appointment after surgery. Guy's and St Thomas' says to wait until the follow-up before seeing an optician about new glasses, and that people having the second eye done may want to wait until both are finished.
When to ring
The signs that mean ringing the eye unit straight away
Guy's and St Thomas' says some redness, watering or grittiness is normal, and should ease as time passes, but that there should never be severe pain. The leaflets are clear about what to do if something changes.
Ring the eye unit immediately
Treated as an emergency
NHS 111 urgently
An optician, when it is not urgent
The discharge letter carries the eye unit's number, and may give a separate out-of-hours number. Put both next to the drops chart so whoever is with your relative can find them. If a carer is visiting, they see the eye each morning. They do not give clinical advice, but they can tell you what they notice. Avoiding readmission covers the wider picture of what goes wrong after an operation.
Help at home, and the cost
How much help is needed at home, and what it costs
Compared with a hip or a knee, the help needed is modest, but the drops go on for weeks.
| What needs doing | Who can do it | |
|---|---|---|
| The first evening and night | The journey home, a meal, the kettle, and somebody around while the vision is blurred | A relative staying over, or a carer for a few hours |
| The first few days | The drops, meals, washing hair without water in the eye, the shield on at night | A morning and an evening visit, with family covering the drops in between |
| Weeks two to four | Fewer drops each week, shopping and lifting, the lift to the follow-up | Family, or a visit or two a week if your relative lives alone |
The first evening and night
- What needs doing
- The journey home, a meal, the kettle, and somebody around while the vision is blurred
- Who can do it
- A relative staying over, or a carer for a few hours
The first few days
- What needs doing
- The drops, meals, washing hair without water in the eye, the shield on at night
- Who can do it
- A morning and an evening visit, with family covering the drops in between
Weeks two to four
- What needs doing
- Fewer drops each week, shopping and lifting, the lift to the follow-up
- Who can do it
- Family, or a visit or two a week if your relative lives alone
PrimeCarers introduces families to self-employed carers and does not provide or manage care. Hours and rates are agreed between you and the carer.
For the first three days, a morning and an evening visit of an hour each is six hours, about £120 at the typical rate of £20 an hour on PrimeCarers, with our fee included. Through an agency at £28 to £35 an hour, the same six hours cost £168 to £210. The smallest booking is a single one-hour visit, so a drops-and-lunch visit on the days the family cannot manage is possible. Hourly care after a hospital stay explains how short arrangements work, and recovery at home after a knee replacement covers a heavier recovery in the same series.
If you want someone to call in for the eye drops and meals in the first week, you can search for carers near you and compare their rates. Every carer on PrimeCarers has had an identity check, a right to work check, an accepted criminal-record check (Enhanced DBS issued within the last 18 months, DBS Update Service, Scottish PVG or Access NI), and an online interview. Separately, every visit booked through PrimeCarers is insured, by the carer's own policy or by cover PrimeCarers arranges where they do not hold one. We do not check qualifications or training, so ask the carer about eye drops directly.
Questions
Questions families ask about recovering from a cataract operation
After a local anaesthetic she does not need someone with her for 24 hours in the way she would after sedation, but the first evening is easier with company. Her vision may be blurred for a few hours, the eye is covered overnight, and Guy's and St Thomas' advises avoiding kettles and the cooker until she can see clearly. After that, the main question is whether she can manage the drops.
The NHS says usually about four weeks. The number of drops each day is on the discharge letter and usually comes down week by week. If the bottle runs out early, the GP prescribes more.
Some carers will, following the directions on the label. It counts as giving a medicine, so agree it with the carer before the operation. PrimeCarers does not check training, so ask the carer about their experience. A carer can always remind your relative when a drop is due. Can a private carer give medication? explains more.
Not for at least 48 hours, one trust says, and only once they meet the legal eyesight standard, which includes reading a number plate from 20 metres. Ask the optician or eye unit to confirm it, and check with the car insurer.