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Can You See During Cataract Surgery?

Can You See During Cataract Surgery?

Are you going to see all the surgical instruments operating on your eye during cataract surgery? Yikes. Cataract surgery can be anxiety-provoking enough let alone if you have to watch the whole thing.

As cataract surgery is performed while you are awake, you will be able to see during cataract surgery. But fortunately, you won’t be able to see all the instruments operating on you. What you mostly end up seeing is a very bizarre light show.

So while you can see during cataract surgery, it really doesn’t end up being very bad. Instead it becomes a unique experience to go through as you get your vision restored.

You Are Awake During Cataract Surgery

If you were asleep during cataract surgery you of course wouldn’t be able to see anything. But cataract surgery is done while you are awake (unless you happen to fall asleep on your own).

For other surgeries, major anesthesia is required in order to prevent you from feeling pain as they operate on your back or abdomen. You need to be asleep to get through the surgery.

But cataract surgery is different. All the pain control for cataract surgery comes from medication directly applied to the eye. In fact, anesthetic or numbing eye drops can provide all the pain control that you need for cataract surgery! Sometimes these eye drops are also combined with extra lidocaine medication placed in the eye at the beginning of the cataract surgery. But that’s all you really need. General anesthesia (where they put you asleep) is not required for routine cataract surgery.

This means you are awake during cataract surgery.

But this doesn’t mean you get nothing; of course going through any surgery is stressful. To help with this anxiety, pills such as Xanax or Valium and IV medication such as Versed is frequently given in order to help relax you during the procedure. This is just to simply make the procedure easier for you to go through (and also impairs your memory of the procedure).

But because you are awake, you will see some strange things during cataract surgery.

What Do You See During Cataract Surgery?

When we look out of our eye, the object we are looking at focuses at a distinct point on our retina. This allows us to see sharp and clear objects. Both the cornea and the lens inside our eye contribute to focusing light properly onto our retina.

Note: it is this same lens which turns into a cataract and is removed during cataract surgery. (see also Your Comprehensive Handbook To Learn What Are Cataracts)

But your vision won’t be quite as distinct during cataract surgery.

Vision Will Be Blurry

  1. During cataract surgery, objects such as instruments that are brought into your vision are just too close to the eye in order to properly be in focus. This causes you to see very blurry objects in your vision. This is especially true when these instruments are placed inside the eye. It is impossible for the eye to focus on things inside the eye.
  2. Because the lens (and now cataract) contributes to focusing light in our eye, removing the cataract really impairs your ability to focus light. This is the reason an artificial lens is used after cataract surgery to restore that focusing power.

In essence, light has a hard time focusing perfectly on your retina. And unless you are severely nearsighted (where up close objects are super in focus), you will only make out blurry shapes of objects during cataract surgery.

Colorful Light Show

In addition to things being blurry, you really get to experience bizarre light and color sensations.

Normally, when light enters our eye, it travels through a straight line to the back of our eye. But what happens if something causes this light to suddenly shift directions? Well that’s what happens during cataract surgery.

Underneath the operating microscope you will see 2-3 lights overhead. Because of how blurry these lights are, they will look like giant marshmallows in the sky (this is actually a very common description from cataract patients!).

The first thing you will notice is that lights will bounce around all over your vision. Cushioning gel placed within the eye to protect the delicate structures of the eye and manual manipulation of the lens will cause those lights to suddenly shift their direction of focus in your eye. As these lights will suddenly focus on a different part of your eye, they will appear to bounce around in your vision - like a light show.

But not to stop there, you will see a kaleidoscope effect of colors. Blues, reds, pinks, yellows, greens. These colors will take on various shapes such as circles, ovals and hexagons similar to a kaleidoscope.

Similar to how a prism separates the colors of light forming a rainbow, during cataract surgery the same effect will be happening throughout the entire surgery. The cushioning gel can create a scatter of colors. The pieces of the cataract as it is being removed can also do the same. Creating many colors for you to see.

Vision Can Fade In And Out

Once light hits the retina in the back of the eye, it travels through the optic nerve to the brain to give us vision. This process is sensitive to the pressure within our eye. When the pressure in the eye goes up, vision can fade away. There are a few steps during cataract surgery when this can happen.

  • Lasers can be used during cataract surgery to correct astigmatism, create an opening to the cataract as well as break up the cataract. To prevent the eye from moving around while the laser is treating, the laser device will suction onto the surface of the eye. This suction will cause the pressure of the eye to increase and can cause the vision to fade out.
  • During cataract surgery, a cushioning gel is used to protect all the delicate structures of the eye. When this gel is placed within the eye at the beginning of cataract surgery, it can cause the pressure of the eye to increase and also can cause the vision to fade away.

Not everyone will experience their vision fading out. And for those that do, these fluctuations of vision are temporary and go away once those steps are completed.

Everything Will Become Brighter

One of the main ways cataracts blur vision is by preventing light from reaching the back of the eye. A cataract lens is dense and light has a hard time passing through this dense cataract. This makes it harder to see in low light situations. It’s almost as if the cataract is a built-in pair of sunglasses.

At the beginning of cataract surgery a bright operating microscope light is brought into your view. This light can seem very bright. But progressively over the course of cataract surgery, the light can continually get brighter and brighter. (typically however, you adjust to the level of light and so it doesn’t become more uncomfortable). As that cataract is removed and more light is able to reach the back of the eye, that operating microscope light will really shine through. At the end of the case, with no cataract in place, light will easily reach the back of the eye and appear bright.

This extra brightness is often one of the first improvements you notice after cataract surgery as well.

Summary

Because you are awake during cataract surgery you will be able to see. However, you won’t be able to see all the details of the procedure. You instead see lights, shapes and colors moving around in your vision.

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