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February 22, 2023 | Cataracts

Learn What Activities Should Be Avoided After Cataract Surgery

By Barrett Eubanks, M.D.

Learn What Activities Should Be Avoided After Cataract Surgery

Although cataract surgery will allow you to see details you haven’t seen in a long long time, it doesn’t give you a free pass to just go out and do any activity you want; at least in the initial post-operative period after cataract surgery.

Despite the surgery being quick and the recovery also very quick, it does take a little time for everything to heal up. And so, during the first week or two after cataract surgery, it is important to avoid certain activities to prevent any issues with healing.

But before we get into which specific activities and types of activities should be avoided, let’s first take a look at what we are trying to prevent after cataract surgery.

Infection After Cataract Surgery

The biggest reason to avoid certain activities after cataract surgery is to reduce the risk of developing an infection in the eye.

An infection after cataract surgery can wreak havoc to the eye. If bacteria start growing inside the eye, it can permanently damage the delicate retina in the back of the eye.

Luckily, infections are rare. The risk of developing an infection is 1 in 2,500 or even less.

But because of how bad they can be, its important to take all steps to prevent an infection as much as possible.

By the time you get through the surgery, much of this has already been done. Most of the major ways an infection is prevented after cataract surgery is by sufficiently using betadine antiseptic to clean the eye and there is some extra benefit to additional antibiotic medication inside the eye at the end of the procedure before the tiny cataract incision is sealed up.

You go home and take your antibiotic drops for the first week after cataract surgery.

But what if that cataract incision were to leak in that first week or two? This gives a potential opportunity for bacteria to make their way into the eye!

This is exactly what we want to prevent. And this is done in two ways:

  • Keeping the incision from leaking
  • Avoiding getting excess bacteria on the surface of the eye

And so, the main activities that should be avoided after cataract surgery are activities that increase the risk of one of those two scenarios.

Activities That Increase Risk Of Incision Leaking

Almost all cataract incisions made today are designed to allow for the quickest vision recovery. By design, these incisions seal up without needing any sutures or stitches.

But these incisions are most watertight at normal pressures in the eye. If the pressure gets too high (such as by directly pressing in on the eye), fluid can leak out. But perhaps more concerning is that if the pressure gets too low, the incision can gape open and fluid can leak in. This creates a highway for bacteria to travel into the eye.

So in summary, it’s important to avoid the fluctuation of pressure in the eye in general.

Some causes of pressure fluctuation are unavoidable. In fact, simply blinking your eyelids can cause the pressure of the eye fluctuate to some degree. But there are other bigger causes which we can avoid after cataract surgery.

Valsalva Maneuver

Ever lift something heavy and you hold your breath as you strain to pick it up? You were experiencing the valsalva maneuver. In short, the Valsalva maneuver is when you forcibly try to exhale against a closed airway. This WILL increase the pressure in the eye.

So during which activities does this happen? (activities to avoid after cataract surgery)

  • Lifting weights, this is the main way this happens and so it’s important to stay out of the gym for the first few weeks after cataract surgery
    • This may also include bringing in heavy groceries into the house or taking out a heavy load of trash
  • Short bursts of intense activity such as tennis and other strenuous activity
  • Coughing or Vomiting, thus, its important to avoid getting sick or food poisoning after cataract surgery
  • Playing a wind instrument. Your brass band can wait.
  • Constipation. Excessive straining when having a bowel movement leads to the Valsalva maneuver. While you can’t avoid having bowel movements, you can increase the amount of fiber or fiber supplements in your diet.

Bending Over

When our head drops below our chest and waist, the pressure of the eyes will increase. Once again, this will cause the pressure to fluctuate within the eye. And as hard as it may be, activities that involve bending over should be avoided after cataract surgery. In particular, this means avoiding having your head drop below your waist.

This includes:

  • Reaching down to your feet to wash them in the shower or to tie your shoes
  • Picking up things off the floor while doing housework
  • Grabbing pans from the bottom cabinets for cooking

Also check out Until How Long After Cataract Surgery Can You Bend Over?

Pushing on the eye

And finally, applying force to the eye will directly cause the pressure of the eye to increase.

What causes this?

Activities That Increase Excess Bacteria

In addition to preventing the incision from leaking, it is also helpful to reduce the amount of bacteria that exist on the surface of our eye at any given time. That way, if the incision does spontaneously leak, we reduce the risk of harmful bacteria getting into the eye.

I hate to break it to you, but bacteria exist everywhere around you. In fact, you may already have bacteria that exist on the surface of the eye (which is why using the betadine antiseptic during cataract surgery is important).

But we can avoid getting excess bacteria as much as possible after cataract surgery. This is done by keeping the eye clean and avoiding water.

So the activities to avoid are pretty straightforward:

Bonus from avoiding water

While avoiding an infection is one of the primary aims of the restrictions after cataract surgery, there are also other benefits from avoiding water.

After any eye surgery and even after just being on prescription eye drops, the surface of the eye can become irritated. The same thing happens after cataract surgery. This extra irritation can cause the eye to feel uncomfortable, scratchy, dry or even cause extra sensitivity to light or the vision to fluctuate.

Gradually, as you get further and further from the procedure and off of the post-operative eye drops, this extra irritation heals up. For many, this happens quick, for others, this can take a few months to resolve.

But to allow this irritation and inflammation to heal up the quickest, it is important to not only treat this irritation with things such as preservative free artificial tears, but also to avoid irritating the eye further!

What can irritate the eye further?

  • Getting soap and shampoo in the eye
  • Chlorine from pools or salt water from oceans

Just more reasons to avoid getting the eyes wet after cataract surgery.

Summary

The biggest thing to prevent after cataract surgery is an infection. This risk can be reduced by avoiding excess pressure fluctuation in the eye as well as avoiding getting excess bacteria on the eye. Avoiding bending over, strenuous activity and avoiding getting water in the eye are the best way to allow the eyes to heal up after cataract surgery without incident.

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