October 6, 2022 | Cataracts

Adjusting And Training Eyes After Cataract Surgery

By Barrett Eubanks, M.D.

Adjusting And Training Eyes After Cataract Surgery

Cataract surgery will lead to remarkable improvements in the eyes. But sometimes not immediately. But while a lot will happen right away, there is still a decent chunk of vision that requires adjusting to. Surprisingly, in some ways, vision can initially appear somewhat worse after cataract surgery! Sounds bizarre? Sure does. But it all relates to how our brain interprets our vision.

After replacing the cataract with an artificial lens, the brain receives a different picture. Although that picture may be clearer, the brain still has to adjust to the new vision. This adjustment process, called visual neuroadaptation, allows for continued improvement in vision months out after cataract surgery. All that is required is continuous exposure or training of our eyes after surgery.

But before we get to training the eyes after cataract surgery, it is important to know what exactly is going on and what training will actually do.

So coming up:

  • Why the immediate recovery after cataract surgery can / will blur your vision
  • Why vision may still feel a little blurry despite a successful operation
  • Extra visual effects that require adjusting to after cataract surgery
  • How we adjust to our vision
  • How you can train your eyes to adjust faster

Lots of good info here. So read on!

Initial Recovery After Cataract Surgery

Don’t expect your vision to be 100% immediately after cataract surgery. It takes time for the vision to heal up. Your vision can be blurry the first day or two after cataract surgery from dilation of the eyes, swelling and generalized irritation from the surgery. Beyond that, your vision can be blurry from residual prescription error, dryness and other causes.

Check out This Is WHY You Have Blurry Vision After Cataract Surgery to learn about it all.

But once all those other causes of blurred vision are addressed, it is still possible to initially have vision that doesn’t feel quite as sharp as it is supposed to. This is what requires adjusting to.

Vision Not Quite As Sharp After Cataract Surgery

But even after that short recovery after cataract surgery, things can still be a little blurry. To understand why, let’s take a look at how we “see".

Light focusing in the eye by the cornea and lens
Light focusing in the eye by the cornea and lens; image by Sunshineconnelly at en.wikibooks, CC BY 3.0, via Wikimedia Commons

Light passes travels through our cornea and our lens and hits the back of the eye on the retina. The retina is like the photo sensor for the brain. The retina captures the image and sends it off to the brain for processing.

The brain is actually responsible for determining what we see. In whatever way the brain processes and interprets that image is what we see. (aside: this is how optical illusions work - by tricking the brain with weird patterns).

Throughout our life, the brain doesn’t actually receive a perfectly perfect image signal. Our cornea and lens create subtle distortions in our vision. These distortions go uncorrected, even with glasses on. But the brain has learned that these extra distortions don’t help us.

So when the brain processes and interprets the vision, it sharpens up what we “see". (as long as the vision isn't TOO distorted)

What the retina sees due to subtle distortions in your cornea and lens and what you interpret the image as after the brain processes the image
What the retina sees due to subtle distortions in your cornea and lens and what you interpret the image as after the brain processes the image

All of this happens in the background without us really being aware of it.

Even when cataracts develop slowly over time, the brain attempts to sharpen up what we see; But eventually it hits limits as to what it can interpret from the blurry image on the retina.

However, when our vision changes dramatically, this whole adjustment can make us feel our vision is “off".

Change In Vision

Ever get a change in a pair of glasses and your vision doesn’t feel quite as sharp initially; and then gradually over the course of a few weeks, things settle down? You’re experiencing changes in how the brain processes your vision.

This is magnified after cataract surgery.

Leading up to cataract surgery, the brain has adjusted to quite a bit. It has reduced the subtle distortions in your cornea and lens and also tried to adjust to the cataract. It automatically applies these corrections to your vision without you realizing it.

But after surgery, the cataract is removed and replaced with a new artificial lens. Not only is this lens perfectly clear (unlike the cataract), it many cases it will also actually cancel out the subtle distortions from the cornea.

After cataract surgery, the image that makes its way to the retina can be clearer than ever before!

But here’s the problem: the brain is still automatically processing out distortions that don’t exist anymore. This takes the clear image on the retina and makes us interpret it not quite as sharp. Although the cataract is gone, everything is brighter and more colorful and in many cases much clearer, things can still appear a little blurry because the brain hasn’t adjusted.

Fortunately, the brain gradually adapts. This is called visual neuroadaptation.

Halos and Glare After Cataract Surgery

As if that wasn’t enough, sometimes with cataract surgery, we throw an extra challenge at the brain.

All lenses after cataract surgery can create a small degree of halos and glare. This is partly due to the change in image that our retina sees and how we interpret that image. (see section above)

But some advanced lenses to get out of glasses completely, such as multifocal lenses, create even more unique visual challenges for the brain.

Halos in vision
Halos in vision; generated image courtesy of

These lenses split light to focus simultaneously for distance, computer and reading. This simultaneous focusing of vision creates additional halos and glare in vision as a side effect. For example: when looking off in the distance, you are seeing residual halos and glare from the computer and reading portion of the lens. This splitting effect can also reduce our ability to discern subtle details by reducing contrast.

To learn more about these lenses and more, see also Your Complete Guide Of Lenses For Cataract Surgery

In addition to the type of lens used during cataract surgery, certain techniques can create additional halos and glare for us to adjust to.

During monovision, one eye is corrected for the distance while the other is corrected for up close and reading vision. This means that when looking off in the distance, one eye is sharp and clear while the other is blurry (and vice versa for up close). This eye focused differently will cause halos and glare in our vision.

But fortunately, our brain is up to the task of adjusting to these unique visual challenges.

How Visual Neuroadaptation Works

After cataract surgery you have a brand new vision transmitted to the brain. But initially the brain may have some trouble processing and interpreting the vision due to the reasons described above. And of course, this is further complicated by the extra halos and glare with advanced lenses or monovision.

This can make things harder to see.

In fact, we are more acutely aware that things are difficult to see. The parts of our brain involved with attention are very active with this new visual information. We must focus harder to try to make out details that came easily before cataract surgery.

But here’s the brilliant thing about our brain. As we work to do a task, it becomes easier and easier. This is the same way with vision. As we work to see things, we begin to see them clearer over time until eventually we no longer have to work to see those things. Our brain improves its visual processing until we are able to see without effort.

In fact, this has actually been studied in patients who received multifocal lenses after cataract surgery. By 6 months out after surgery, these patients were able to see things that initially the glare from the lens prevented them from seeing. These patients adapted to the halos and glare and their vision improved. Also interesting, as these patients adapted, the parts of the brain involved in attention became less active. These patients no longer had to work to be able to see things.

What are the takeaways from this?

  • When we work our brain, our brain is able to improve the way we do things - this translates over to vision as well. When we work to see things, the brain gets better at processing vision and our vision becomes better.
  • This process doesn’t happen immediately, visual neuroadaptation can take months and months.
  • Eventually, as we continue to adapt, we stop paying attention and let our brain do its thing.

Role Of Training Eyes After Cataract Surgery

So working the brain makes it stronger… sounds like something training can help with!

Training the brain
Training the brain; image by Tumisu, CC0, via Wikimedia Commons

In fact, this phenomena isn’t just limited to the eyes. You may have heard about this concept from brain training video games or puzzle books. While there is disagreement about whether these programs improve brain function in all areas of life, these training activities have been shown to improve the brain’s ability to perform these activities.

The same thing can happen for the eyes. By working to see, our brain gets stronger and faster at processing vision.

But for most people after cataract surgery, a dedicated training program is unnecessary. What provides the best visual training after cataract surgery? It’s our own environment.

“Training" In Own Environment

Our own environment provides the definitive training ground for our eyes. After-all, the primary goal is to see things clearly in our own environment. The subtle difficulties you have seeing in your own environment are continuously working your brain and your vision.

Simply using your eyes throughout the day provides enough exposure for our brain to learn.

Having trouble with halos around light at nighttime? Forcing yourself to see through these halos works the brain to sharpen up the vision over time. No additional dedicated training is needed.

Using your eyes in your own environment tailors the training to exactly what you need to see.

But what if these vision difficulties are especially bothersome or start to limit activities such as night-time driving? Having distress over vision can limit how much work you can or are willing to put in to adjust.

This is where training can potentially help. Training forces you work your vision.

Dedicated Training

Training can be as simple as increasing your exposure to difficult vision tasks in less distressing scenarios.

  • For example: instead of driving at night time, walk around your neighborhood at night trying to see things with the street lamps around. This works your eyes in a less stressful environment.
  • Stressed out by having trouble reading tiny numbers on spreadsheets at work? Work on your eyes at home by doing sudoku puzzles on the internet zoomed out to a similar size. (with your eyes corrected with reading glasses as needed)

But want to work even harder? Computer programs also exist to provide challenging visual tasks for the brain to process. Like lifting weights, routinely working the brain through these exercises strengthens the ability of the brain to process vision quickly and efficiently.

  • Galaxy Vision is a Free app for Apple iOS devices which combines a matching game with special patterns to improve vision processing
  • RevitalVision is a web-based vision training program using those special patterns and is clinically proven to treat conditions such as Amblyopia

Whether you work out your eyes just by living, by focusing on certain environments or by using a training program, the more the eyes are worked after cataract surgery, the more your vision can improve.


Training your eyes really can improve your vision after cataract surgery. However, what you don’t realize is that you are constantly training your eyes all the time in your own environment. As you work to see things, your brain becomes stronger at processing your vision and vision becomes more natural. This process continues to occurs months out from cataract surgery.

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