Cataract Surgery Recovery Week by Week: What's Normal

You're home, the shield's taped on, and you're sitting very still — because nobody really told you what you're actually allowed to do. You've read the do's and don'ts after cataract surgery, and some of them contradict each other. So here's the thing that makes sense of all of it, before I explain anything else.

There are no stitches in your eye. The cut we make seals itself, held shut by the pressure inside your own eye. Almost every rule you've been given exists to protect that seal while it knits — and once you know that, you can work out any rule you're unsure about, including the ones nobody thought to tell you.

I'm Mr Dilraj Sahota, a consultant eye surgeon, with training from Oxford University and Moorfields Eye Hospital in London. If you'd like a consultant-led conversation about your surgery or recovery, you can book a consultation.

Ring your team the same day for:

1. Severe or worsening pain that painkillers don't touch.
2. A curtain or shadow across your vision with new floaters or flashes.
3. Increasing redness with sticky discharge, and vision that goes backwards rather than forwards.

And one that isn't an emergency but needs saying, because I've read people planning it: do not drive yourself home, and don't plan a long drive the next day either. Between the blurring, the drops and possible sedation, you are not the person to judge whether you're safe. (When you can legally drive again has a proper answer with specific DVLA standards — I cover that in the week-by-week recovery guide.) For the day of surgery, the rule is simply: not yet, and not home from surgery.

You've been handed a list, and you're probably wondering: is this a real medical list, or is it the hospital covering itself? It's real. Here's what it's protecting.

To take your cataract out, we make a small cut in the cornea — the clear window at the front of your eye. The clinical term is a corneal incision; in plain English, a tiny tunnel. And here's the clever part, because this is genuinely how it works: the tunnel is cut on a slant, like a flap. So the normal pressure of fluid inside your eye presses the inner lip of that flap up against the outer lip and holds it shut from the inside. The eye seals its own wound — which is why, most of the time, there are no stitches at all.

That elegance tells you exactly what the wound is vulnerable to. It isn't really brute force from outside — it's the seal being lost from the inside. If the pressure in the eye drops suddenly, or is forced to spike and swing, the lips of that tunnel can momentarily part. And a tunnel that parts, even for a moment, can let surface fluid — and the bugs in it — be drawn inside.

So hold those two ideas, because every rule on every list is one of them:

• Don't make the pressure spike and swing.
• Don't put dirty water where the healing seal is.

That's the whole key. Two questions: would what I'm doing spike the pressure? and would this put something dirty near the eye? Ask those, and you'll usually land on the right answer yourself.

This is the group where people are either far too cautious or not cautious enough.

Bending and lifting. Bending forward puts your head below your heart and raises the pressure in the eye. Lifting something heavy makes you brace and hold your breath, which does the same thing harder. So for the first week or two: reach down rather than folding over, and let someone else carry things. As a rough guide, keep below around 10 kg.

Straining is the same thing from a less obvious source — so if you're prone to constipation, sort it before your operation rather than after.

Sneezing and coughing raise the pressure briefly, but they're unavoidable and short, so they aren't what these rules are aimed at. One tip: sneeze with your mouth open rather than clamping it shut — stifling a sneeze raises the pressure more than the sneeze itself.

Exercise. Walking is fine and good for you. What we're avoiding is straining and impact — the gym, running, anything where you're braced or bent. Racquet sports like tennis and badminton get listed to avoid, and it's really about the swing: there's a well-known account of a patient who played golf two days after surgery and the pressure spike pushed tissue out of the incision. That's rare — but it's exactly the mechanism above.

For the first week or two: reach, don't bend. Ask, don't lift. Walk, don't strain.

One patient of mine arrived at her week-one check having barely left her chair for six days, because she'd been given a list and no explanation and decided the safest thing was to do nothing at all. She protected the eye perfectly — and had a thoroughly miserable week she didn't need to have. Over-restriction has its own cost.

Everything here is about not introducing anything into an unstitched wound. Water is the main one — tap water isn't sterile, and the eye is a bad place to test that.

• Showering: shower from the neck down, keep your face out of the stream, and wash your face with a clean, damp cloth rather than splashing.
• Hair washing is what people struggle with: tilt your head back, not forward, and get help if you can.
• Swimming, hot tubs and saunas come later than you'd expect, because of shared water — I'd recommend waiting four weeks.
• Dust and airborne debris — building work, strimming, sanding, emptying a cat litter tray — avoid, and wear protection if you really must do it.
• Eye make-up: mascara and eyeliner sit exactly where we don't want anything sitting. Give it four weeks, and start with a fresh mascara rather than the one that's been in your bag for months.

Water off the face, dust away from the eye, make-up on hold for a few weeks.

Two rules, and they're the ones I'd defend hardest: don't rub the eye, and don't press on it.

This is also why the shield exists — the thing you resent, and I understand why. It's uncomfortable, it's taped to your face, and you sleep badly in it. But its single job is to stop you rubbing your eye in your sleep, when you have no say in the matter. Someone in a comment described being given no shield, having an itch in the night, scratching the eye, and it doing lasting damage. Protocols genuinely vary and have changed — some UK units have moved away from shields, so if yours didn't give you one, that isn't an oversight. But if it did, please wear it.

Someone actually commented that under a do's-and-don'ts video, and nobody replied — so let me. If you bent down yesterday, or lifted the kettle, or rubbed the eye before you thought about it, the overwhelming likelihood is that nothing has happened. These are precautions across a whole population, not trip-wires. One bend is not the same as a fortnight of gardening.

But do something with it rather than nothing for the next day or two: watch three things — is the vision going backwards, is there new pain, is the eye getting redder? If any of those, phone your team and tell them exactly what you did — not because you're in trouble, but because it's useful information and they'd rather have it.

And one thing genuinely not to do: someone once said the drop stung, so they stopped taking it. Please don't. There's almost always an alternative or a preservative-free version — and quietly stopping a drop is one of the few things here that really does cause problems.

• A swimming-style mask — the sort sold to protect eyelash extensions — for hair washing. About fifteen pounds, and it works far better than trying to be careful.
• A long-handled reacher. It sounds like an old person's aid; it's the single best way to stop yourself bending twenty times a day.
• If the shield tape pulls at your skin, use a fabric plaster instead.
• Leave five minutes between drops — one of the most useful things patients learn, and often not mentioned.
• After a drop, press gently on the inner corner of your eye, against the bone by your nose (not the eye itself) for a minute. It keeps the drop where it belongs, and less drains into your throat as that bitter taste.

Following this list perfectly does not make your surgery risk-free, and breaking a rule is very unlikely to be what harms you. The largest study of what actually causes infection after cataract surgery — pulling together millions of operations — found the risks that matter are surgical: how the wound was built, and whether you had antibiotic given during the operation. Bending, swimming and hair-washing don't appear in the evidence. So if something does go wrong, it is almost certainly not something you did — and I don't want anyone lying awake blaming a sneeze.

And here's why four videos give four different answers. A national survey of UK cataract units found they agree on drops, but vary markedly on shield duration, lifting and driving. That isn't sloppiness — those particular numbers were never built on strong trial evidence. The mechanism is solid; the exact number of days often isn't. Which is exactly why your own surgeon's instructions override everything I've said here.

So the one thing that genuinely is evidence-based isn't a restriction at all. The two things that most reduce your infection risk are the antibiotic put in at surgery and the drops you faithfully take at home — not whether you bent to feed the cat. If you take one instruction seriously, let it be the drops.

One myth to retire while we're here: some advice online says that if you bend your head, your artificial lens may move. A modern lens settles securely inside the natural capsule that held your own lens. I won't say it can never happen, but it's uncommon, and it's not what bending does — so don't spend three weeks afraid to look down.

And who this can't help: if you live alone, "ask a family member to help with your drops" is useless advice, and I've read people saying exactly that in real distress. If that's you, say so before your operation rather than after — there are usually options, and they work far better arranged in advance.

I promised one rule that matters more than all the others put together. Here it is — and I'm giving you my reasoning, not quoting a study, because there isn't one that ranks these.

Every rule on the list protects the seal from one of two things: pressure, or dirt. Rubbing your eye is the only thing I can think of that does both at once. It presses on a wound that's held shut by pressure, and it does it with your own hand — which is where the bugs are. Nothing else on the list manages both in a single movement. That's my reasoning for treating it as the one I'd never bend — and it's why the shield you resent exists. Not because we think you'd rub your eye on purpose, but because at three in the morning, you don't get a vote.

Everything else is sensible precaution. That one, on rubbing, I'd hold to.

• There are no stitches — the wound is a self-sealing tunnel held shut by the eye's own pressure, and the rules protect it for a couple of weeks
• Two questions answer almost any rule: would this spike the pressure, and would it put something dirty near the eye?
• Pressure group: reach don't bend, walk don't strain, keep lifting under ~10 kg, sneeze with your mouth open
• Water/dirt group: face out of the shower stream, tilt back to wash hair, wait ~4 weeks for swimming and eye make-up
• The drops matter more than any restriction — never quietly stop one; ask for a preservative-free version instead
• The one rule never to bend is don't rub the eye — which is exactly what the night-time shield is for

How long after cataract surgery do the restrictions last?

Most of the precautions apply for the first week or two, while the self-sealing wound knits. A few — swimming, hot tubs, saunas and eye make-up — are best left for around four weeks because of infection risk. Your own surgeon's specific instructions always override general advice, as protocols vary between units.

Can I bend down after cataract surgery?

Brief, occasional bending is very unlikely to cause harm — these are population-level precautions, not trip-wires. But for the first week or two it's sensible to reach down rather than fold forward, avoid heavy lifting (roughly under 10 kg), and not strain, because all of these raise the pressure inside the eye. A long-handled reacher helps you avoid bending repeatedly.

When can I wash my hair after cataract surgery?

You can wash your hair in the first days as long as you keep tap water out of the eye — tilt your head back rather than forward, and get help if you can. Many patients find a swimming-style mask (the kind sold to protect eyelash extensions) makes this much easier.

Do I really have to wear the eye shield at night?

If your unit gave you one, yes — please wear it. Its single job is to stop you rubbing or pressing the eye in your sleep, when you have no control over it, and rubbing is the one action that both spikes the pressure and introduces dirt at the same time. Some UK units have moved away from shields, so if you weren't given one, that isn't an oversight.

What actually causes infection after cataract surgery?

The largest studies, covering millions of operations, show the risks that matter most are surgical — how the wound was constructed and the antibiotic given during the operation — together with faithfully taking your prescribed drops at home. Everyday activities like bending, swimming or hair-washing don't appear in the evidence, so if a problem occurs it is almost certainly not something you did.

Most people find these first couple of weeks straightforward once they understand what the rules are actually for. If you'd like a fuller conversation — before surgery, or because something in your recovery is worrying you — Mr Dilraj Sahota offers consultant-led cataract assessment and private cataract surgery in Edgbaston, serving Birmingham and the wider West Midlands. Book a consultation, or arrange a free 10-minute video call. And for what happens next — the fog, the odd sensations, and when to worry — see my week-by-week recovery guide.

This article is for general information and patient education. It is not a substitute for a personal consultation, diagnosis or treatment from a qualified clinician, and your own surgeon's instructions always take precedence. If you have had cataract surgery and are concerned, contact your surgical team, and seek urgent advice for severe pain, a sudden drop in vision, a shadow or curtain across your vision, or increasing redness with discharge.

Last updated: September 2026.