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September 15, 2022 | Cataracts

About How Long After Cataract Surgery Can You Drive?

By Barrett Eubanks, M.D.

About How Long After Cataract Surgery Can You Drive?

Cataracts more than likely impaired your ability to drive. Trouble driving at night time is actually one of the first symptoms many people have when developing cataracts. So the brand new vision after cataract surgery allows you to get behind the wheel with reinvigorated confidence. But how long do you have to wait before driving?

In fact, it doesn’t take long for the vision to sharpen up enough to allow for driving after cataract surgery. With a typical cataract surgery, the vision sharpens up significantly within 24 hours. Following this point, driving may be resumed as long as one is comfortable with driving.

But there is more to explore than just simply waiting for the vision to sharpen up. The dramatic change in prescription often seen with cataract surgery as well as the new artificial lens also play a large part.

Initial Blurred Vision After Cataract Surgery

There are three main reasons why your vision is blurry right after cataract surgery. And of course, with blurry vision, you can have additional trouble driving. For a full in-depth explanation, check out This Is WHY You Have Blurry Vision After Cataract Surgery.

Dilation

During cataract surgery, the eye is dilated so that the full cataract lens can be visualized and removed. But this dilation doesn’t instantaneously go away. The eye drops used to dilate the eye must wear off gradually over time. Commonly most of this occurs within about 4-6 hours after cataract surgery; but depending on the eye drops and also how sensitive a person’s eyes are to those drops, sometimes it can last longer until the next day. Having dilated eyes creates more blurred vision as well as glare and halos.

Swelling

During cataract surgery, ultrasound energy is used to dissolve the cataract. This step occurs even if a laser is used to break up the cataract (although less energy is typically needed).

On the inside of the cornea is a thin layer of cells called endothelium.

Endothelium on the inside of the cornea
Endothelium on the inside of the cornea; Image by StemBook (CC BY 3.0) / modified from original

The endothelium acts as tiny pumps - pumping water out of the cornea and keeping it transparent. But ultrasound energy used during cataract surgery can stun these cells and temporarily prevent them from working. This causes swelling to build up in the cornea.

Swelling causes blurry and hazy vision with glare and halos. The more energy used (such as with dense cataracts), the more swelling. Typically, this swelling resolves in about a day or two but can take longer to resolve when more swelling develops.

Cloudy Surface

Adding to the dilation of the pupil and the swelling of the cornea, the surface of the cornea can also be a little cloudy.

The very front layer of the cornea is called the epithelium; see graphic above. The epithelial cells get cloudy when damaged or sick.

During cataract surgery, these cells are exposed to lots of eye drops, toxic betadine prep as well as dry out from time to time. All these eye drops and drying out cause some temporary damage to these cells making them cloudier than usual.

Again, this blurs the vision and causes some extra glare. But fortunately these cells heal very quickly and after a good night’s rest, frequently all is healed up.

These 3 main causes of blurred vision all exist to some degree during the first 24 hours after cataract surgery but mostly fade away beyond that time frame. Outside of those three causes, however, the prescription of the eye (and even the difference in prescription between eyes) can have a big impact on driving.

Eye Prescription After Cataract Surgery

It’s not a huge secret that cataract surgery changes the prescription of the eye. Many people see a large improvement in not only the quality of their vision after cataract surgery, but also their vision without glasses. In fact, there is a good chance you may not even need glasses after cataract surgery in order to drive!

This change in prescription comes from the artificial lens being placed in the eye. In fact, technology of this lens allows us to go beyond just simply changing the prescription of the eye. Advanced lenses can correct astigmatism or even eliminate reading glasses. Check out Your Complete Guide Of Lenses For Cataract Surgery to learn about all the different lens options with cataract surgery.

But not everyone will have perfect distance vision without glasses after cataract surgery.

  • If you don’t correct your astigmatism during cataract surgery, this will affect your ability to see without glasses. You may desire a pair of glasses in order to see off in the distance.
  • The sophisticated calculations used by surgeons to eliminate the prescription of the eye aren’t 100%. Some people may have some residual prescription of the eye making it more difficult to see off in the distance without glasses.

Depending on blurry your distance vision is, this remaining prescription or astigmatism may limit how comfortable you feel while driving and you may need a pair of glasses to see your very best distance vision.

But there is another unique scenario: cataract surgery is typically performed one eye at a time. When you are between surgeries, even if the first eye ends up perfect, you may still have to deal with a blurry second eye.

During this time, this second eye may have (and often does have) a completely different prescription compared to the final outcome of the first eye. Example: You were nearsighted or farsighted before surgery. The eye that hasn't had surgery is still nearsighted or farsighted but the eye that just had surgery is not.

This means your old pair of glasses no longer work very well. They may still correct the vision of the eye without surgery but can completely make your corrected eye very blurry since its the wrong prescription for that eye.

This difference between the two eyes can make driving more difficult. But there are some things you can do:

  • Many people will pop out the lens of the glasses for the eye that had cataract surgery. Thus, the glasses continue to correct the eye waiting for cataract surgery but no longer blur the completed eye. To avoid breaking your frames, this may best be done by your optician where you got your glasses. Sometimes a blank lens can be inserted in place to avoid making the glasses look weird. However, this technique doesn’t work as well with very large prescription differences; the brain will have a hard time merging the images from both eyes.
  • If you wore contact lenses prior to cataract surgery, then the solution is easy: just continue to wear a contact lens in the eye that hasn’t had surgery yet. Unlike with glasses, this also works with large prescription differences between eyes.
  • If trying to wear glasses or contact lenses aren’t working out for you, then you can always get an eye patch and cover up the bad eye. This can prevent the blurry vision from making you more uncomfortable.

Fortunately, this time frame between eyes tends to be short. It is common for the second eye to be scheduled for cataract surgery a week or two after the first.

Tips For Driving After Cataract Surgery

Regardless of anything, driving can be done ONLY when you can see well AND feel comfortable. Even if your vision meets the driving requirement, you should still not drive until you also feel comfortable. (And of course, if your vision doesn’t meet the driving requirement for your locale, you should also stay off the roads).

But when you do resume driving, there are most likely going to be a few scenarios more challenging than others. So until your comfort level increases, you should avoid those challenging scenarios.

  • Stick to familiar roads and routes. Avoid unfamiliar areas. Not only can you be more distracted by navigation devices, you also won’t have a good awareness of visual landmarks in that area. This can make driving more difficult and dangerous until your comfort level is fully restored.
  • Avoid bad weather. Now is not the time to go out driving in a torrential downpour. Visibility will be much more challenging and road conditions can become more dangerous.
  • Night time driving can be more difficult. Again, it is much more difficult to see at night. And while you may very well have a large improvement in glare by no longer having a cataract, you may still have some glare and halos from the new artificial lens. This is especially the case with the premium lenses used to get out of glasses completely. It will take some time to fully adjust to this new vision.

Summary

Amazingly, it doesn’t take long until driving can be resumed after cataract surgery. After about 24 hours, many people will see well enough after cataract surgery to allow for driving. However, this vision can be affected by the prescription of the eye and even whether or not the other eye has had cataract surgery yet. And lastly, driving should only be done when comfortable. Most ideally in good weather and in familiar locations.

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