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This page explains what causes cataracts, the symptoms people with cataracts might experience and how cataracts are treated. Readers can find information about the different procedures and replacement lens options and the factors that contribute to variability in the cost of treatment. This information is provided to help people who have cataracts understand what their treatment options are with Vision Eye Institute.

A cataract is not a growth, but rather a clouding of the normally transparent and flexible lens of the eye. This condition usually develops over some time and interferes with light entering the eye, which affects a person’s ability to see clearly. If left untreated, people with cataracts may eventually go blind. Both eyes may be affected, although not usually to the same extent.

Cataracts are mainly diagnosed in people over 60 but can occur at any age (some babies may even be born with congenital cataracts). Age is the major risk factor for developing cataracts. However, a cataract can also be associated with eye trauma, prolonged use of steroids, sun exposure or previous inflammation and infection in the eye.

Early cataracts are often managed with a change in your glasses or contact lens prescription. When this stops working and/or you can’t perform your daily tasks, then it could be time to consider cataract surgery. This involves replacing the dysfunctional lens with an artificial one. The same procedure can also be used as an alternative to laser eye surgery to correct vision, regardless of whether cataracts are present. If the person does not have cataracts, it is referred to as refractive lens exchange or clear lens surgery.

We perform cataract surgery and lens surgery in Melbourne, Sydney, Brisbane, Townsville, Mackay and Adelaide.

Cataracts are not painful and often don’t cause noticeable changes in the early stages.

As the condition progresses, symptoms can include:

  • Blurred, cloudy or dim vision
  • Difficulty seeing at night or in low-light situations
  • Being sensitive to bright lights and glare
  • Seeing halos
  • Needing stronger glasses and more frequently
  • Colours appearing faded or yellow
  • Double vision in the affected eye
  • A whiteness through the pupil (late stage).

The Fred Hollows Foundation, which some of our doctors have worked with, has developed a sight simulator to demonstrate the visual impairment a person with cataracts may experience.

Your ophthalmologist will perform a thorough assessment of your eyes and will help you determine which replacement lens option best matches your needs and lifestyle. These lenses vary in design and offer clear vision at either one, two or three distances. They can be customised to correct short-sightedness, long-sightedness and/or astigmatism, even allowing some people to have normal vision without the need for glasses after the surgery.

Some, but not all, of the costs of cataract surgery are covered by Medicare and also by private health insurance (depending on the type of cover you have). The gap payment, or out-of-pocket cost, will depend on several factors, including your level of private health cover and the replacement lens option you choose.

Unfortunately, due to the variability in patient private health cover and replacement lens selection, it isn’t possible to provide an accurate cost for cataract surgery online. Your ophthalmologist will be able to provide you with the full cost during your consultation, once you have chosen your preferred lens option. You will need to contact your private health insurer directly to find out whether your cover includes cataract surgery and if there is any excess.

When will I need cataract surgery?

In the early stages, some cataracts can be left untreated. When your sight deteriorates to a point where it interferes with your ability to carry out daily tasks (including seeing in low-light situations such as at night), it could be time to consider surgery.

What is the success rate?

Traditional or manual cataract surgery is considered one of the safest surgical procedures in the world today, with a very high success rate. Laser cataract surgery may reduce the risk of complications even further. Serious complications are rare with cataract surgery but may include endophthalmitis (infection of the eye), bleeding, retinal detachment, macular swelling and posterior capsular rupture.

How long does cataract surgery take?

A typical procedure takes less than 30 minutes. Allowing for admission, preparation and recovery time, you’ll be in the day surgery for around 3 hours.

Will it hurt?

No. We will administer a local anaesthetic (numbing drops) to your eye and you may also be given a sedative to help you relax.

What if I blink?

Your surgeon will ensure that your eyelid is gently held open throughout the procedure so that you cannot blink.

Will I be awake?

Probably, but not necessarily – some people even fall asleep during the surgery. You are not required to be awake for the operation.

What will I see during surgery?

You may see a bit of light and some vague movement or you may see nothing at all. You will not be able to see what the surgeon is doing to your eye.

Will my eye hurt afterwards?

You may feel a bit of discomfort a few hours after surgery but no pain.

How long does it take to recover from cataract surgery?

Your sight will usually recover within days but typically fluctuates for about a month before stabilising. If you notice any significant reduction in your vision, tell your surgeon immediately. The protective shield is usually worn for the first day and your surgeon may also recommend the shield be used for the first few nights after the operation – this is usually the case if you can’t stop rubbing your eyes. Cataract surgery does not usually involve stitches.

Normal daily activities such as light housework can be resumed within a couple of days. With routine and successful surgery, patients are usually fit for all physical activities and contact sports one month after cataract surgery – this includes sparring in martial arts.

How long before I can drive a car?

Driving is not recommended for the first few days after surgery to allow your eye to settle.

Can both eyes be operated on at the same time?

It is generally preferable to give the first eye a chance to settle before planning surgery and lens requirements for the second eye. Even though cataract surgery is quite safe, operating on both eyes at the same time may increase the risk of serious complications and visual impairment (e.g. if both eyes were to get infected at the same time). However, there are some rare situations where your surgeon may recommend having both eyes done at one.

When will I get the second eye done?

Your doctor will be able to help you determine when the second eye can be operated on. Although it varies, most surgery is around two weeks apart. In the case of multifocal implants, early second eye surgery hastens the recovery. Patients who are very short- or long-sighted also benefit from both eyes being operated on in quick succession, as it is common that their eyes are now significantly unbalanced. During the period between surgeries, a contact lens may be used to balance the eye that has not yet been operated on.

Will I still need glasses after cataract surgery or lens exchange?

Today’s replacement lenses can also be used to correct pre-existing vision problems due to short-sightedness, longsightedness, presbyopia and/or astigmatism. There are different lens options available, and some may allow you to achieve clear vision without glasses. For example, trifocal lenses provide focus at near, intermediate and far distances. These are typically the best option for achieving clear vision without glasses, although there are no guarantees. The most suitable candidates are over 55 years, rely heavily on glasses/contact lenses and are long-sighted. If you are quick to notice visual imperfections, then glasses may remain your best choice.

Speak with your ophthalmologist to find out the best lens option for you. This will depend on your lifestyle, expectations and eye health, and your surgeon will help you understand what you can realistically expect to achieve.

What are the risks?

Cataract surgery is one of the most successful procedures in medicine, so the risk factor is relatively minimal. However, as with any surgery, complications can occur and are related to the procedure itself or to the anaesthesia. Most of the complications from cataract surgery are minor and can be corrected. The success rate is high, with around a 1 in 1000 risk of permanently impaired eyesight.

Your doctor will discuss the risks and benefits of cataract surgery so that you can make a fully informed decision.

What are the potential complications of cataract and lens surgery?

Posterior capsule opacification (PCO) is the most common potential complication of cataract and lens surgery. PCO can occur when the back of the capsule (housing the lens) thickens. This can cause your vision to appear cloudy but can be treated quickly using a YAG laser outpatient procedure and eye drops.

Also refer to the section ‘Potential complications’ at the bottom of this page.

Does laser cataract surgery cost more?

As with any new technology, laser cataract surgery costs more than traditional cataract surgery. This is due to the operating cost of the laser. We offer laser cataract surgery in Sydney, Melbourne, Brisbane, Townsville and Mackay.

Is everyone suitable for laser cataract surgery?

No, there are certain patients that are not suitable. Your surgeon will be able to advise if you are suitable after completing a thorough examination of your eyes.

How is the gap payment for cataract surgery determined?

Some, but not all, of the costs of cataract surgery are covered by Medicare and also by private health insurance (depending on the type of cover you have). The gap payment will depend on several factors, including your level of private health cover and the replacement lens option you choose.

What are the different types of lenses available for cataract surgery?

Artificial intraocular lenses (IOLs) are composed of pliable and flexible plastic materials and serve as replacements for the natural lens in your eyes. They not only provide a substitute for your eye’s original lens but can also address existing refractive errors like myopia, hyperopia, and astigmatism. Available lenses include:

– Monofocal lenses
– Multifocal lenses
– Bifocal lenses
– Trifocal lenses
– Extended-depth-of-focus (EDOF) lenses
– Toric lenses

References

For a full list of references, visit the cataract & lens surgery FAQ page.

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Cataract surgery

This is one of the most frequently performed surgical procedures in the world. The surgery involves:

  1. Administering a local anaesthetic to the eye(s)
  2. Making a tiny 2–3 mm incision in the outermost layer of the eye (the cornea)
  3. Making an evenly round incision in the ‘bag’ (capsule) containing the affected lens
  4. Breaking up the affected lens into smaller pieces with an ultrasound
  5. Removing these pieces with a vacuum and flushing the lens capsule to clean it
  6. Inserting and accurately positioning a clear artificial replacement lens (known as an intraocular lens or IOL).

The new lens can’t be felt once placed inside the eye. When a lens is replaced, it is not possible to develop another cataract.

The operation itself takes less than 30 minutes and can be performed in a day surgery or in hospital. At Vision Eye Institute, your procedure will be performed in one of our fully equipped, accredited, state-of-the-art day surgeries.

Laser cataract surgery

Laser-assisted cataract surgery using the femtosecond laser is offered by some of our surgeons as their preferred method of cataract surgery. Visual outcomes are similar with all methods of cataract surgery and are rarely dependent upon surgical technique.

Refractive lens exchange

This is also known as clear lens extraction or lens replacement surgery. Using the same technique as for cataract surgery, the dysfunctional natural lens (with no cataract present) is removed and replaced with an artificial intraocular lens (IOL) to correct vision. Most surgeons recommend using a laser when performing refractive lens exchange.

People under 45 are usually not suitable candidates for this type of procedure. This is because the body’s natural lenses are better than any of the replacement lens options that are currently available. A laser eye surgery procedure is usually the better option in these cases. Your ophthalmologist will discuss the vision correction options best for you.

Replacement lens options

Artificial intraocular lenses (IOLs) are made of soft, flexible plastic and are used to replace your body’s natural lens. They can also be used to correct pre-existing refractive errors, such as short-sightedness, long-sightedness and/or astigmatism (blurry vision due to an abnormally shaped cornea or lens).

There are a number of replacement lens options available – the lens you choose will influence whether you still require glasses for certain activities following surgery.

  • Monofocal lenses allow clear vision at a single distance (i.e. near/reading or far). Following surgery, glasses will still be required for certain tasks.
  • Multifocal lenses allow clear focus at more than one distance but have a higher risk of visual side-effects (e.g. glare and halos around lights).
    – Bifocal lenses allow clear focus at two distances (near/reading and far), but glasses are likely to be required for intermediate distances (e.g. computer work).
    – Trifocal lenses allow clear vision at three distances (near/reading, intermediate and far). Glasses are often not required for standard day-to-day activities following surgery.
  • Extended-depth-of-focus (EDOF) lenses represent the latest in lens technology. In these lenses, a single focal point is stretched to increase the range of clear vision. After surgery, patients will typically have good unaided distance and intermediate vision, with functional near vision. Glasses may still be required for some near tasks. EDOF lenses have less issues with unwanted visual side-effects.
  • Toric lenses are used to correct astigmatism, where an abnormally shaped cornea or lens causes blurry or distorted vision.

A premium lens refers to the more sophisticated lenses that offer greater flexibility and individual customisation. Trifocal and EDOF lenses are good examples of premium lenses. Patients should note that bifocal and trifocal lenses involve some visual compromise, meaning that they aren’t ideal for everybody. If you are quick to notice visual imperfections or don’t mind wearing glasses, monofocal lenses are usually a better choice.

Your ophthalmologist will discuss the advantages and disadvantages of each lens type and help you select the right one for your needs. They will provide you with the full cost during your consultation, once you have chosen your preferred lens option.

Implantable (phakic) lenses

Implantable lenses (sometimes called implantable contact lenses) are tiny, flexible lenses designed to be placed semi-permanently within the eye. The lens is inserted via a tiny incision in the cornea – once inside it unravels and sits in front of the natural crystalline lens. Sutures are not required and the eye heals in a few weeks.

This procedure is reversible – the implantable lens can be removed at a later stage should another lens procedure (such as cataract surgery) be required. People who have a high degree of short- or long-sightedness may not be suitable for laser eye surgery. But, if their eyes are otherwise healthy and they are between 18 and 50 years old, implantable lenses may be an option.

These lenses cannot be felt, require no maintenance and can achieve good quality vision. Yearly check-ups are required to ensure that the lens stays in position, the pressure inside your eye remains normal and your natural lens is healthy. The surgery to fit implantable lenses is more involved than that for laser eye surgery so the benefits/risks must be considered carefully before proceeding.

Monovision/blended vision

This involves correcting one (usually the dominant) eye for distance vision and the other eye for reading/near vision. When looking into the distance, your brain pays more attention to the eye that is focussed for distance and vice versa when looking at close objects (i.e. your brain relies more on the eye that is focussed for near distance). Overall, the images from both eyes are processed by your brain as one blended image.

Many people who have monovision find that they adjust within a matter of days and many can get rid of their glasses. Before proceeding with surgery, your ophthalmologist will usually get you to trial a set of contact lenses to make sure you can adapt to the change.

Monovision can be achieved using laser eye surgery (e.g. LASIK or ASLA/PRK) or artificial lenses (e.g. replacement lenses or implantable phakic lenses).

What to expect on the day of surgery

Cataract and lens surgeries are performed as day procedures at one of our dedicated day surgery facilities. You will receive detailed instructions about fasting and taking medications prior to your surgery.

On the day of your surgery, your pupil will be dilated using eye drops and your eye will be prepped for surgery. You may also be given a mild sedative. A local anaesthetic will be applied to your eye and you will be operated on in the laser suite and/or operating theatre. Once the surgery is complete, a protective cover will be placed over your eye.

You will then be moved to the recovery area and offered something to eat and drink. After resting, you will be able to go home – you will not allowed to drive home or take public transport so remember to arrange for someone to pick you up. You will be discharged with eye drops and instructions on how to use them and also how to clean around your eye. It’s normal to experience some discomfort, including itching, sensitivity to light and a slight discharge. If you have had a previous allergic reaction to eye drops, let your surgeon know.

A follow-up appointment is normally scheduled within 48 hours of the operation to make sure your eye is healing properly.

See our post-cataract surgery guide to find out what to expect after surgery.

When should I have cataract surgery?

A person with cataracts does not have to have surgery. However, left untreated, cataracts will eventually cause significant visual impairment that may interfere with your ability to perform everyday activities, which can reduce your quality of life. This may include an inability to perform tasks that require fine-detail vision or drive (especially at night). A recent Australian study has also shown that living with cataracts increases your risk of having a fall.6

If you choose to have cataract surgery, the timing will depend on the type and stage of your cataracts, as well as your personal circumstances and quality of life.

In the past, people could only have cataract surgery once their cataracts were mature and causing significant vision impairment. Advances in technology mean that cataract surgery can now be performed much earlier, when cataracts are causing subtle vision changes or affecting a person’s quality of life.

Your cataract surgeon will give you all the information you need to help you decide if/when to have treatment.

Potential complications

Once the affected lens is replaced, it is not possible to develop another cataract. However, a further enhancement procedure may sometimes be recommended to achieve even clearer vision.

The most common potential complication of cataract and lens surgery is posterior capsule opacification (PCO), a thickening of the back of the capsule that the lens sits in. This can also cause cloudy vision but is easily treated as an outpatient using a YAG laser and eye drops. The YAG laser removes the cloudy part of the lens capsule to allow light to pass through.

Other complications include dislocation of the replacement lens, inflammation of the eye, sensitivity to light, droopy eyelid (ptosis), swelling of the cornea, bleeding in the front of the eye and swelling of the part of the retina responsible for central vision (macular oedema). Most of these are minor/temporary and can be treated with no long-term effect on vision. Serious complications from cataract surgery are possible but unlikely.

Your doctor will discuss the benefits and risks with you so that you can make an informed decision about surgery.

Why choose Vision Eye Institute?

Our mission is to remain at the forefront of technology and clinical research to ensure the best outcomes for our patients. As one of the largest providers of ophthalmic services in Australia, we are able to ensure that our clinics are equipped with the latest state-of-the-art technology. The Vision Eye Institute research unit is overseen by a full-time research coordinator. Our ophthalmologists are regularly invited to participate in international trials and present at international conferences.

Vision Eye Institute surgeons were the first in the Southern Hemisphere to use the state-of-the-art LenSx laser to perform laser cataract surgery. Within the first six months of installing this laser, our surgeons had performed the most laser cataract surgeries in the world. They have also published numerous peer-reviewed articles in this area.

Our ophthalmologists perform cataract surgery and lens surgery in Sydney, Melbourne, Brisbane, Townsville and Mackay.

References/further reading

  1. healthdirect. Cataract surgery. Haymarket, NSW: healthdirect, 2020. Available at www.healthdirect.gov.au/cataract-surgery [Accessed 7 July 2021].↩︎
  2. The Royal Australian and New Zealand College of Ophthalmologists (RANZCO). Preferred practice patterns: cataract and intraocular lens surgery. Surry Hills, NSW: RANZCO, 2016. Available at ranzco.edu/wp-content/uploads/2018/11/RANZCO-Cataract-PPP-2016.pdf [Accessed 7 July 2021]↩︎
  3. American Academy of Ophthalmology. Traditional Cataract Surgery vs. Laser-Assisted Cataract Surgery. USA 5 April 2022. Available at: https://www.aao.org/eye-health/diseases/traditional-vs-laser-assisted-cataract-surgery [Accessed 5 April 2022].↩︎
  4. Assam JH, Bernhisel A, Lin A. Intraoperative and postoperative pain in cataract surgery. Surv Ophthalmol 2018;63(1):75-85. doi: https://doi.org/10.1016/j.survophthal.2017.07.002↩︎
  5. Porela-Tiihonen S, Kaarniranta K, Kokki M  et al. A prospective study on postoperative pain after cataract surgery. Clin Ophthalmol 2013;7:1429–1435. https://dx.doi.org/10.2147%2FOPTH.S47576↩︎
  6. Clark A, Morlet N, Ng JQ et al. Whole population trends in complications of cataract surgery over 22 years in Western Australia. Ophthalmology 2011 Jun;118(6):1055-61. https://doi.org/10.1016/j.ophtha.2010.11.001↩︎
  7. National Health Service (NHS). Overview: Cataract surgery. UK: Crown, 2021. Available at www.nhs.uk/conditions/cataract-surgery [Accessed 7 July 2021]↩︎
  8. 1. Lawless et al. Femtosecond laser-assisted cataract surgery. US Ophthalmic Rev, 2014;7(2):82-88. Doi: https://doi.org/10.17925/USOR.2014.07.02.82 Available from: https://www.touchophthalmology.com/articles/femtosecond-laser-assisted-cataract-surgery↩︎
  9. Clark et al. Whole population trends in complications of cataract surgery over 22 years in Western Australia. Ophthalmology. 2011 Jun;118(6):1055-61. doi: 10.1016/j.ophtha.2010.11.001.↩︎
  10. Keay et al. Falls and cataract: Investigating risk and predictors in older adults during their wait for surgery. (Poster) Agency for Clinical Innovation Ophthalmology Network Eye Forum: Eyes on the Future, 9 June 2017. Available from: https://aci.health.nsw.gov.au/__data/assets/pdf_file/0004/365224/The-FOCUS-Study-Poster.pdf↩︎

VIC

Resources

The information on this page is general in nature. All medical and surgical procedures have potential benefits and risks. Consult your ophthalmologist for specific medical advice.

Date last reviewed: 2024-01-19 | Date for next review: 2026-01-19

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