Neurological · Topic 5 of 27
Cataracts & Cataract Surgery
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Cataracts & Cataract Surgery
The lens clouds slowly and painlessly, and surgery restores clear vision. After surgery, protect the eye from pressure and report pain or vision loss.
Why it happens
The lens clouds — vision blurs over years
What causes it
Aging is the main risk factor
What you'll see
Painless — clarity fades, not the visual field
A nuclear cataract can briefly improve near vision ("second sight"), so some clients read better without glasses.
Before surgery
Outpatient lens removal with an intraocular lens (IOL)
The lens is usually broken up with ultrasound and suctioned out (phacoemulsification) through a self-sealing incision, in under 30 minutes. Usually one eye is done at a time, often 1–2 weeks apart.
Red flags after surgery
Timing: infection (endophthalmitis) or raised pressure in the first week, macular swelling in the first month, retinal detachment months later.
Treatment
Outpatient lens removal with an IOL implant
Use exactly as ordered; wash hands first
Don't touch the tip to the eyeWear the shield while sleeping
Patch or shield until the next-day visitBefore surgery is needed, recovery and later
Nursing priorities
Cataract or glaucoma?
Cataract clouds the lens and surgery restores it · glaucoma's loss is permanent
| Cataract | Glaucoma | |
|---|---|---|
| What's damaged | The lens clouds | The optic nerve |
| Pain | Painless | Open-angle painless · angle-closure severely painful |
| Vision | Blurring, glare, halos, faded colors | Peripheral vision lost first (open-angle) |
| Lost vision | Restored by surgery | Permanent |
| Treatment | Lens removal with an IOL implant | Drops for life to stop further loss |
Teach your patient
Cataract = painless clouding of the lens that surgery restores. After surgery, keep pressure off the eye — no bending, lifting, straining or rubbing — and report pain, vision loss or a curtain over vision.
Sources · Cataracts (National Eye Institute) · Cataract (Merck Manual Professional) · What Is Cataract Surgery? (American Academy of Ophthalmology) · Cataract Removal (MedlinePlus) · Retinal Detachment (National Eye Institute) · Glaucoma (National Eye Institute) · Follow your facility's protocol for postoperative eye care.
Cataracts & Cataract Surgery
A cataract is clouding of the eye's lens that causes gradual, painless blurring of vision, usually over years. The client notices glare and halos around lights, faded colors and trouble seeing at night. Aging is the main risk factor, with diabetes, smoking, heavy alcohol use, sun exposure, long-term corticosteroids and eye injury adding to it. Surgery is the only cure: an outpatient removal of the cloudy lens with an intraocular lens implant, after which about 9 in 10 clients see better. The client stays awake for the procedure and needs someone to drive them home. Afterward, the nurse teaches the client to keep pressure off the eye by avoiding bending at the waist, heavy lifting, straining, forceful coughing or sneezing, and rubbing the eye, to wear the eye shield while sleeping, and to use antibiotic and steroid drops as ordered. Mild scratchy discomfort is expected. Sudden eye pain, decreased vision, nausea, increasing redness or discharge, or new flashes, floaters or a curtain over vision must be reported. Unlike glaucoma, a cataract's vision loss is restored by surgery.
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