Cataract surgery will lead to remarkable improvements in the eyes. But sometimes not immediately. While a lot will happen right away, there is still a decent chunk of vision that requires adjusting to. Vision can initially appear somewhat worse after cataract surgery! 

After replacing the cataract with an artificial lens, the brain receives a different picture. Although that picture may be clearer, the brain still has to adjust to the new vision. This adjustment process, called visual neuroadaptation. This allows for continued improvement in vision months out after cataract surgery. All that is required is continuous exposure or training of our eyes after surgery.

Initial Recovery After Cataract Surgery

Don’t expect your vision to be 100% immediately after cataract surgery as it takes time for the vision to heal. Your vision can be blurry the first day or two after cataract surgery from dilation of the eyes, swelling and generalized irritation from the surgery. After that, your vision can be blurry from residual prescription error, dryness and other causes. Once all those other causes of blurred vision are addressed, it is still possible to initially have vision that doesn’t feel quite as sharp as it is supposed to. This is what requires adjusting to. The full and complete recovery time, however, may last anywhere from 4-to-8 weeks. This is not to discourage you from getting this operation. We’re just being honest about how long it will take before the results from cataract surgery fully take effect. (And while we may be biased, we believe the full effect of improved eyesight is worth the wait!)

Change In Vision

Ever get a change in a pair of glasses and your vision doesn’t feel quite as sharp initially; and then gradually over the course of a few weeks, things settle down? You’re experiencing changes in how the brain processes your vision. This is magnified after cataract surgery.

Leading up to cataract surgery, the brain has adjusted to quite a bit. It has reduced the subtle distortions in your cornea and lens and also tried to adjust to the cataract. It automatically applies these corrections to your vision without you realizing it.

But after surgery, the cataract is removed and replaced with a new artificial lens. Not only is this lens perfectly clear, in many cases it will also actually cancel out the subtle distortions from the cornea.

After cataract surgery, the image that makes its way to the retina can be clearer than ever before!

The problem is that the brain is still automatically processing out distortions that don’t exist anymore. This takes the clear image on the retina and makes us interpret it not quite as sharp. Although the cataract is gone, everything is brighter and more colorful and in many cases much clearer, things can still appear a little blurry because the brain hasn’t adjusted.

Fortunately, the brain gradually adapts. This is called visual neuroadaptation.

How Visual Neuroadaptation Works

After cataract surgery you have a brand new vision transmitted to the brain. But initially the brain may have some trouble processing and interpreting the vision due to the reasons described above. And of course, this is further complicated by the extra halos and glare with advanced lenses or monovision.

This can make things harder to see.

In fact, we are more acutely aware that things are difficult to see. The parts of our brain involved with attention are very active with this new visual information. We must focus harder to try to make out details that came easily before cataract surgery.

As we work to do a task, it becomes easier and easier. This is the same way with vision. As we work to see things, we begin to see them clearer over time until eventually we no longer have to work to see those things. 

By 6 months out after surgery, patients were able to see things that initially the glare from the lens prevented them from seeing. These patients adapted to the halos and glare and their vision improved. As these patients adapted, the parts of the brain involved in attention became less active as these patients no longer had to work to be able to see things.

Fine Tuning Vision after Cataract Surgery

Our own environment provides the definitive training ground for our eyes. After-all, the primary goal is to see things clearly in our own environment. The subtle difficulties you have seeing in your own environment are continuously working your brain and your vision. Simply using your eyes throughout the day provides enough exposure for our brain to learn. Having trouble with halos around light at nighttime? Forcing yourself to see through these halos works the brain to sharpen up the vision over time. Using your eyes in your own environment tailors the training to exactly what you need to see.

Whether you work out your eyes just by living, by focusing on certain environments or by using a training program, the more the eyes are worked after cataract surgery, the more your vision can improve.

Improving Near Vision After Cataract Surgery

To improve near vision after cataract surgery, patients can consider multifocal or extended depth of focus (EDOF) intraocular lenses (IOLs), which provide better near and intermediate vision. Monovision correction, where one eye is optimized for distance and the other for near vision, is another effective strategy. Additionally, reading glasses remain a simple and effective solution for those with monofocal IOLs. Discussing these options with your ophthalmologist can help tailor a plan to enhance your near vision and reduce dependency on glasses.

What to avoid after Cataract Surgery

This would also be an opportune time to point out activities you should avoid during the first few days of post-cataract surgery:

• Driving
• Heavy lifting
• Bending over (which puts pressure on the eye)
• Swimming
• Rubbing your eyes

Additionally, it might be a good idea to where a protective shield over your eyes for a few days when you go to sleep, as this will help prevent any pressure.

Halos After Cataract Surgery

Experiencing halos around lights is a common and normal occurrence after cataract surgery, often due to the adjustment period with the new intraocular lens (IOL). Typically, halos diminish within a few weeks to months as the eyes adapt to the new lenses. While many patients find that halos gradually fade and eventually disappear, in some cases, they may persist. If halos remain bothersome or significantly impact your vision, it is important to discuss this with your ophthalmologist, as there are options to manage and reduce these visual disturbances.

Next Steps

Training your eyes really can improve your vision after cataract surgery. You don’t realize that you are constantly training your eyes all the time in your own environment. As you work to see things, your brain becomes stronger at processing your vision and vision becomes more natural. This process continues to occur months out from cataract surgery.