Eye Care Blog

For the first two weeks or so of the immediate postoperative period vigorous activity is discouraged. Stooping, lifting heavy objects, sneezing or coughing, and any very violent physical effort should be avoided. Any activity that makes the patient feel that his collar is too tight or that his neck is swelling should be stopped because movements which cause congestion in the head also provoke an increase in pressure within the eye. Until the wound is properly healed this could lead to its leaking, to haemorrhage, to poor healing, and, in the worst event, to loss of the eye. After two weeks, however, the surgical wound should be well healed. At the routine outpatient visit which should be made at this time, the state of healing will be assessed by the surgeon, who will tell the patient what physical activities may be undertaken.

Over the next weeks the level of physical exertion can be gradually increased. Patients should not lean forward to wash their hair; rather it should be back-washed, which is less stressful to the eye. After a month or so the patient is allowed to return to the office, to light work, light weeding in the garden, and similar activities. Two to three months after the operation a return to full pre- surgery activities should be possible, and most surgeons will give an all-clear reassurance at this stage.

What, though, of the long term? In most cases the patient who has had a cataract operation is elderly and is not likely to take part in energetic sports like squash or tennis. However, cataract is by no means a condition confined to the elderly, and there is no reason why the younger patient who has had a cataract extraction should not return to his former activities. When glasses are worn rather than contact or intraocular lenses some sort of protection should be put over the spectacles while playing vigorous racket games like squash — but this, of course, should be done by any glasses-wearer anyway. The only sport which should be totally avoided is boxing, an activity in any case frowned upon by most ophthalmologists.

Older patients may return to their normal pursuits — gardening, housework, jogging, etc. — and indeed should be encouraged to do so because it is important to avoid becoming an ocular cripple, as some do, fearing that any physical activity might result in loss of vision. Of course there are certain restrictions, but this is largely a question of common sense. For example, swimmers should remember to remove their contact lenses before entering the water (if they do not, their lenses will float away). They should avoid diving or any similar activity in which a sudden and vigorous force is applied to the eyes.

Reading and television

There is widespread belief that eyes have a potential visual life that can be exhausted by reading or watching television or engaging in similar pursuits. This is quite untrue; the use of the eyes for close reading or anything else cannot in any way harm them, either before or after cataract surgery. The idea that the eyes must be rested at regular intervals is completely erroneous. Use your eyes as much as you like, for it can do them no harm.

Driving

Those who have had conventional spectacles fitted rather than a contact or intraocular lens will undoubtedly find some difficulty with driving at first because of magnification changes and the restriction in the visual field. It is wise to practise away from general traffic initially. The greatest difficulty will probably be found with reversing.

A particular problem arises in the case of holders of heavy goods vehicle (HGV) licences because under the present regulations neither conventional spectacles nor contact lenses are acceptable to the licensing authority. After cataract extraction HGV licences may be held only by those who have had a successful intraocular lens implant. The regulations state that the vision in the worse eye must be better than 6/36 without correction and better than 6/12 in the better eye with optical correction — a level of visual acuity which is exceedingly unlikely to be achieved without an intraocular lens implant. Thus the only way a driver of a heavy goods vehicle can keep his licence is to have an intraocular lens of the appropriate power inserted.

It is not generally known that some insurance policies stipulate that the insured may not drive for 21 days following a general anaesthetic. It is well worth checking one’s policy before undergoing any form of surgery.

Make-up

Provided that ordinary ocular hygiene is followed, there is no reason to stop using eye-shadow, mascara or other forms of eye make-up.

Sex

There is no reason whatever to curtail sexual activity once the eye has completely settled down after the operation. Furthermore, there is no contra-indication either to the use of the contraceptive pill or to pregnancy and child‑birth.

Air and sea travel

There is no need to avoid flying after any form of cataract surgery. However, in the first few weeks after surgery bad travellers should take precautions against motion sickness, as vomiting could be dangerous to a less than satisfactorily healed wound.

In short, whatever form of visual correction is employed, a completely normal life can be led after cataract surgery. It cannot be too strongly stressed that the use of the eyes does them no harm.

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