Cataract surgery is a frequently performed and generally successful procedure designed to restore clear vision by replacing a cloudy natural lens with an artificial one. While many patients experience a significant improvement in their eyesight, it is common to notice unusual sensations during the recovery period. One such sensation is the feeling that something is present in the eye, which can be a source of concern. This article explains the common physiological reasons behind this sensation and provides guidance on how to manage it.
Causes of the Sensation
The sensation of something in the eye after cataract surgery often results from physiological changes and healing. A common cause is temporary dry eye syndrome, as surgical incisions can disrupt small nerves on the eye’s surface responsible for tear production. This can reduce tear production, leading to dryness that often feels sandy or gritty. This dryness may persist for several months until the nerves heal and tear film normalizes.
Corneal swelling or irritation is another reason for this sensation. The cornea, the transparent front layer of the eye, can become temporarily swollen, known as corneal edema, or irritated during surgery. This swelling is common in the initial days and can cause a scratchy feeling, blurry vision, and increased light sensitivity. It generally subsides within a few days to a couple of weeks as the eye recovers.
Inflammation is a natural response to surgery, and the eye undergoes an inflammatory process after cataract surgery. This inflammation contributes to discomfort, making the eye feel irritated or as if something is present. Anti-inflammatory eye drops are prescribed to manage this response, reducing swelling and associated sensations.
In some cases, small, dissolvable sutures may be used to close the surgical incision. These threads, designed to be temporary and eventually absorbed by the body, can cause irritation or grittiness as they heal or dissolve. Even without sutures, microscopic incisions made during the procedure can lead to a sensation similar to having a grain of sand or an eyelash. This feeling typically fades as the incision site heals and ocular surfaces smooth, often within a week or two.
Alleviating Discomfort
Managing post-operative discomfort is an important part of recovery. Using lubricating eye drops as prescribed is a primary method to combat dryness and soothe irritation. These artificial tears help keep the eye moist and comfortable, providing relief from gritty sensations.
Adhering to the prescribed medication regimen is crucial. This typically includes antibiotic eye drops to prevent infection and anti-inflammatory eye drops to reduce swelling and inflammation. These medications promote healing and minimize discomfort.
Avoiding eye rubbing is paramount during the healing period. Rubbing can worsen irritation, disrupt delicate healing incisions, and increase the risk of infection. If the eye feels itchy, using lubricating drops or a clean, damp cold compress can provide relief without rubbing.
Protective measures are essential. Patients are instructed to wear a protective eye shield to prevent accidental rubbing or pressure on the eye. Wearing sunglasses outdoors helps shield the sensitive eye from environmental irritants and bright sunlight.
Allowing adequate rest and avoiding strenuous activities is important. Resting helps minimize strain on the eye and reduces discomfort. Avoiding heavy lifting, bending over, or activities that significantly raise blood pressure helps prevent undue pressure on the healing incision.
When to Contact Your Doctor
While some discomfort is normal after cataract surgery, certain symptoms warrant immediate medical attention. Severe or worsening eye pain that does not respond to over-the-counter medication requires evaluation. This pain may indicate increased eye pressure, infection, or serious inflammation.
A sudden or progressive decrease in vision is another serious concern. While some blurriness is expected initially, a dramatic decline in visual acuity after improvement could signal complications. These include retinal detachment, macular edema, or a severe internal eye infection.
Increased redness of the eye, especially if accompanied by pain or vision changes, should be promptly evaluated. While mild redness is typical, worsening redness or any yellow or green discharge suggests infection or inflammation.
Other warning signs include new flashes of light or a significant increase in floaters, which could indicate a retinal issue like detachment. Severe sensitivity to light or new swelling around the eye or eyelid also requires professional assessment.