Flyer: Putting patients at the heart of cataract care

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Respectful care at every step, from referral to follow-up and refraction, keeps patients coming back.

The World Health Organization (WHO) has urged all countries to improve access to high-quality and safe cataract surgery. One in every two people facing cataract-related blindness worldwide still needs access to surgery. Around 17 million people are blind due to cataract, while nearly 83 million people have significantly reduced vision. Women are also less likely than men to receive treatment.

However, even the best cataract services can only reach people if patients come forward for examination and treatment. It is therefore important to treat patients with respect and compassion and communicate with them in simple language at every step.

During screening

A patient’s first interaction with eye care services often takes place during screening in the community or at a nearby health centre. The screening team should correctly identify cataract and check for other possible causes of reduced vision. Explain to patients and their families, in simple language, what was found during the examination and where they need to go next. This helps build trust and ensures timely treatment.

At the referral centre

Respectful and compassionate communication with patients and their families is vital. Take time to listen to their fears and concerns. If family members are discouraging or preventing an older person from having cataract surgery, try to understand the reasons and discuss their concerns with them.

Before surgery, understand the patient’s visual needs and explain the available options for the intraocular lens (IOL). This can help patients feel more informed and satisfied with their care.

During surgery

Keep patients calm and give them simple instructions so that they do not move during surgery. A signal, such as raising a hand, can be agreed upon beforehand so that patients can indicate pain or discomfort. A trained staff member can also stay beside the patient and talk to them. This can help reduce fear and anxiety.

After surgery

It is important to help patients feel calm and comfortable. Teach patients and their families how to put in eye drops correctly. Clearly explain hygiene, warning signs, when to return for follow-up, and where to seek urgent care if needed. Before discharge, make sure that they have understood all the important instructions.

Explain to patients and their families that regular follow-up is very important. After surgery, patients should also receive the correct spectacles according to their needs, including spectacles for near vision. Most importantly: A patient is not just someone receiving treatment, but a human being. From screening through surgery and follow-up, treating patients with respect and compassion is what builds their trust.

Taking care of the eye after cataract surgery

Even if you feel well after surgery, be aware that you have had a major operation.

What to do

• If you are feeling uncomfortable, take your prescribed pain medication and wear sunglasses during the day to help with light sensitivity.

• Clean your eyelids gently morning and evening with a clean, moist cloth (avoid pressure on the eyeball). Avoid water entering the eye.

• Protect the operated eye for the first week: wear an eye shield at night, and sunglasses or spectacles during the day.

• Instil prescribed eye drops exactly as instructed.

• Resume your normal diet and any regular medications.

• Attend all follow-up appointments without fail.

• You may wash your hair after 1 day (avoid anything entering the eye).

• Take it easy for at least 2 weeks. You can resume sexual activity when comfortable.

What to avoid

• Don’t stop or restart any glaucoma or other regular eye medications unless specifically told to do so.

• Don’t use cotton wool near your eyes (the fibres can cause infection).

• Avoid sleeping on the operated side.

• Don’t lift heavy weights (>5 kg) for at least 2 weeks.

• Don’t wear eye make-up for at least 1 week.

• Avoid swimming for 2 weeks.

Normal signs and symptoms after cataract surgery

How does it feel?

• Mild discomfort, scratchy or gritty sensation (you can take the prescribed pain medication)

• Slight redness or watering

• Sensitivity to light

• Mild blurred vision that gradually improves

• Feeling of a ‘foreign body’ in the eye

What does it look like? The following are normal:

• Slightly red or bloodshot eye

• Mild swelling of the eyelids

• Small red patch on the white of the eye (sometimes)

Danger signs: Come back to the clinic immediately if you notice any of these

Some discomfort, redness, or watering of the eye is normal, but it should get better over time. Come back immediately if the appearance of the eye, pain/discomfort, or your eyesight gets worse instead of better.

Pain/discomfort Come back if any of the below are true:

• You have pain in your eye that is very strong, or getting stronger.

• You have a strong headache that is getting worse, especially if you feel sick or want to vomit.

• Bright light hurts your eye, or light is starting to hurt more than before.

Appearance of the eye Ask someone to look at your eye if you are unsure, or if it is difficult to see clearly. Come back if any of the below are true.

• The white of your eye becomes more red, or the redness is spreading (see photo A, below).

• The clear part at the front of your eye looks cloudy or hazy (photo B).

• There is white or yellow matter inside the front of the eye (photo C).

• You can see blood collecting inside the front of the eye (photo D).

Your eyesight Come back if any of the below are true.

• Your sight is getting worse, or things look more blurry than before.

• You suddenly see a dark shadow, a dark patch, or a curtain coming across your sight.