After Cataract Surgery: What to Expect

Cataract is a common eye disease that can lead to blindness. The only treatment for this condition is cataract surgery. Here’s what to do before and after the surgery.

A woman doctor helping an elderly patient with his glasses

Being diagnosed with cataracts may cause anxiety and uncertainty. While cataract is a common eye disease, it is a major cause of blindness in Malaysia (39%), which leads to the rise in cataract surgery. Data shows an increase of cataract surgery from 12,798 cases performed in 2002 to 44,534 cases performed in 2015.

What Causes Cataracts?

A woman wearing glasses and massaging her eyes
According to TCM, cataracts are caused by pathogenic factors disrupting the qi and blood flow to the eyes.

Cataracts are characterised by the clouding of the eye’s lens. It is also typically associated with ageing. In a report by the Ministry of Health Malaysia, 93.4% of cataract patients have age-related cataracts, while ocular trauma is the most common secondary cause (1.7%).

Apart from ageing, other causes of cataracts include diabetes mellitus, a serious eye injury, radiation treatment, and prolonged intake of steroids. Eye surgery to treat glaucoma or other eye conditions are also causes.

Causes of cataracts from a TCM perspective 

According to Traditional Chinese Medicine (TCM) , cataracts arise from several causatives. These include pathogenic factors like phlegm, fire, and blood clots disrupting the qi (vital life energy) and blood flow to the eyes, which can directly inflict damage to the eyes. Deficiencies of the five vital viscera, especially the liver and kidneys, can also lead to cataracts.

According to the Lingshu (灵枢) segment of the Yellow Emperor’s Canon of Internal Medicine (黄帝内经), there is this saying: “The eyes are infused and powered with the essence of all the vital viscera. The essence of the bones, which are governed by the kidneys, nourish the pupils; the essence of the sinews, which are governed by the liver, nourish the iris; the essence of blood, which is governed by the heart, nourish the blood vessels; the essence of qi, which is governed by the lungs, nourish the sclera; the essence of the muscles, which are governed by the spleen, nourish the eyelids.” 

“Essentially, eye health closely relates with the health of the vital viscera. These causatives are a result of ageing, eye-related injuries, chronic medical conditions, or prolonged consumption of certain medications. Factors like a stressful lifestyle, lack of sleep, and unhealthy eating habits can contribute and accelerate the formation of these causatives,” says Real Health Medical Senior TCM Physician Brandon Yew. 

Cataract Surgery and Treatment 

If left untreated, cataracts can progress into total blindness. Unfortunately, there is no medication for cataracts. Surgery is the only way to treat this eye condition. However, in the early stages, you can still make small changes to cope. Getting new eyeglasses prescriptions, using brighter lights, wearing anti-glare sunglasses, or using magnifying lenses for reading may work.

In addition, TCM can help slow down the progression of the early onset of cataracts effectively through TCM herbal medication, acupuncture, moxibustion, cupping and tuina. A TCM physician would formulate these treatments carefully to address the patients’ specific body constitutions. Hence, it’s best to consult a TCM physician for proper assessment. 

When cataracts begin to interfere with your daily activities, it’s a sign of progression of the disease. At this time, surgery is essential. During cataract surgery, a doctor will replace the clouded lens with an artificial lens called intraocular lens, or IOL. Usually, the surgery takes about an hour and is virtually painless.

“If the cataract is in its very early stage, you can consider conservative TCM treatments. These may help slow down its progression or even improve it,” Physician Yew adds. “If the condition is of moderate and greater severity, surgery would be the ideal option. Thanks to advancements in medical technology, cataract surgery is a safe and highly effective option.”

Recovering from Cataract Surgery

A patient using eye drops on her eye
After cataract surgery, eye drops are prescribed to help relieve the eyes. 

After cataract surgery, it’s important to take care of your eyes. Doctors would usually prescribe eye drops to help with healing as well as special eye shield or glasses. Refrain from touching your eyes and avoid activities that strain eye muscles. Your eyes may also be sensitive to light and feel itchy or uncomfortable. It will take up to eight weeks for your eyes to completely heal. However, consult your doctor immediately if you have symptoms like vision loss, intense, persisting pain, severely red eyes, floaters, light flashes or dark spots in your vision.

TCM Remedies

Consuming TCM remedies can also effectively support your cataract surgery. Physician Yew explains further: “Before surgery, TCM can help improve body constitution. This is so the patient can tolerate the post-operative side effects. After surgery, herbal formulas can assist with healing and recovery of the surgical wounds. They can also relieve side effects, and help one regain overall well-being.” 

Some of the herbal formulations usually prescribed for this condition include: 

  • Qi Ju Di Huang Wan (杞菊地黄丸) 
  • Tong Qiao Huo Xue Tang (通窍活血汤) 
  • Chuan Xiong Cha Tiao San (川芎茶调散) 
  • Di Tan Tang (涤痰汤) 
  • Chrysanthemum (菊花) 
  • Mint leaf (薄荷叶) 
  • Prunella selfheal spike (夏枯草) 
  • Mulberry leaf (桑叶) 
  • Pale butterfly bush flower (密蒙花) 
  • Cassia seed (决明子) 
  • Dandelion (蒲公英) 
  • Dendrobi (石斛) 
  • Flastem milkvetch seed (沙苑子) 
  • Dodder seed (菟丝子) 
  • Gastrodia tuber (天麻) 
  • Puncturevine caltrop fruit (蒺藜) 
  • Glossy privet fruit (女贞子) 
  • Goji berry (枸杞子) 

“The herbs and formulas provided above are for mild cataracts and post-surgical conditions. Not all people may benefit from them; others may not – the herbs can even worsen existing conditions or cause new problems. Therefore, you must not purchase any of them or self-medicate without getting a proper assessment and professional guidance by a TCM practitioner,” Physician Yew cautions.

Acupuncture and Acupressure After Cataract Surgery 

Research shows that acupuncture and tuina could significantly relieve pain and improve visual acuity in patients who have undergone phacoemulsification (surgical removal of cataracts using an ultrasonic device).

“Acupuncture improves qi and blood circulation to the eye. It also enhances the functions of the vital viscera, which leads to better eye health,” remarks Physician Yew. 

In addition, acupressure is an easy self-help remedy to speed up recovery or alleviate discomfort after surgery. Place your fingers or use a blunt object like a massage stick at specific acupoints. Use an appropriate amount of pressure to stimulate a sore or aching sensation or numbness. At the same time, massage the area in both clockwise and anti-clockwise circular motions (20 times each). Repeat for at least three minutes per acupoint.

The acupoints include:  

  • Fengchi GB20: In the depression between the origins of the sternocleidomastoid and trapezius muscles, at the junction of the occipital and nuchal regions. 
  • Hegu LI4: On the dorsum of the hand, between the first and second metacarpal bones. 
  • Taichong LR3: On the dorsum of the foot, in the depression proximal to the first metatarsal space. 
  • Taiyang EX-HN5: In the temples region, located in the depression about one finger-breadth posterior to the midpoint between the lateral end of the eyebrow and the outer canthus. 
  • Jingming BL1: On the face, in the depression superior to the inner canthus. 
  • Yifeng SJ17: Posterior to the lobule of the ear in the depression between the mandible and the mastoid process. 
  • Chengqi ST1: Directly below the pupil between the eyeball and the infraorbital ridge. 
  • Taixi KI3: In the depression midway between the tip of the medial malleolus and the attachment of the Achilles tendon level with the tip of the medial malleolus. 
  • Sanyinjiao SP6: On the inner lower leg, four-fingers-breadth above the tip of the inner ankle bone, just behind the shin bone. 

It’s important to note that acupressure is suitable for mild cases of post-surgery side effects. Physician Yew strongly recommends seeking medical treatment and comprehensive professional TCM help. Patients with a more severe condition should consult an ophthalmologist first. 

While cataracts can happen to anyone, most people recover from this eye condition after a successful surgery. Fortunately, patients can effectively support the healing process after surgery through TCM methodologies. Always consult a healthcare professional and TCM practitioner to get the right diagnosis and treatment plan. 

References

  1. Asia-Pacific Journal of Ophthalmology. 2015. The Malaysian Cataract Surgery Registry: Profile of Patients Presenting for Cataract Surgery. [Accessed 14 Jan 2022] 
  2. US National Library of Medicine. 2018. The Malaysian cataract surgery registry: incidence and risk factors of postoperative infectious endophthalmitis over a 7-year period. [Accessed 14 Jan 2022] 
  3. National Eye Institute. 2019. Cataracts. [Accessed 14 Jan 2022] 
  4. National Eye Institute. 2019. Causes of Cataracts. [Accessed 14 Jan 2022] 
  5. National Eye Institute. 2019. Cataract Surgery. [Accessed 14 Jan 2022] 
  6. Cochrane Library. 2019. Effects of acupuncture, tuina combined with phacoemulsification for cataract with glaucoma. [Accessed 14 Jan 2022]
  7. HealthCMi. 2019. Acupuncture Improves Cataract Surgery Outcomes.  [Accessed 14 Jan 2022] 

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