After the Cataracts
Insider tips for a smooth recovery from surgery
Heidi Godman
Harvard Health Publishing
Replacing a clouded lens inside the eye (a cataract) with an artificial lens is a routine procedure with a low risk for complications. That doesn’t mean you can be complacent about recovery; you need to follow the postsurgical plan your doctor prescribes. Here are some extra tips:
Review post-procedure instructions
The day of your procedure isn’t the time to become familiar with complicated postsurgical instructions. For example, you’ll need to use several types of prescription eye drops.
“There’s an antibiotic eye drop you’ll use for a week to prevent infection,” says Dr. Nandini Venkateswaran, a cataract surgeon at Harvard-affiliated Massachusetts Eye and Ear. “And for four weeks, you’ll use a steroid drop to reduce inflammation and a nonsteroidal anti-inflammatory [NSAID] drop to help with pain and prevent swelling. Some of the drops will have to be tapered off, according to a precise schedule.”
Ask about post-procedure instructions well in advance. If possible, pick up medications before the procedure, or arrange for someone to get them afterward and help you use them if necessary.
Ask about a simpler drug regimen
If a complex eye drop regimen sounds challenging, ask your doctor well before the procedure if you can get a compounded eye drop.
“It must be made at a special pharmacy that can combine all three eye medications into one. It might cost more money, and your insurance might not cover everything. So you need time to do some legwork,” Venkateswaran says.
Learn the right way to use eye drops
Some people have a hard time using eye drops: when they squeeze the little plastic container, the drops don’t get into their eyes.
“Learn how to use eye drops before the procedure. Practice with artificial tears in front of a mirror,” Venkateswaran says. “Pull down the lower eyelid, look up, and place the drop in the little pocket that’s created when you pull down the eyelid. Don’t touch the eye or eyelid with the tip of the dropper; the tip should be just above the eye. If you have trouble doing it, teach a loved one to do it for you. Also, store the drops in a clean environment to reduce infection risk.”
Adjust your eyeglasses
If you wear eyeglasses, removing cataracts will change your prescription in the affected eye. That eye might not even need a prescription lens anymore (you’ll know once your eye heals). If the other eye still needs correction, you can get a clear lens installed on the side of the glasses where the cataract was removed. Ask your doctor whether and when this should be done.
Protect your eye
After the procedure, you’ll wear a clear plastic shield over the eye for 24 hours (and then at night only, for a week), to protect it from things that can poke into it (like your pillow). When the shield comes off, avoid exposing your eye to elements that can cause infection, such as pool or ocean water, or outdoor environments with dust and debris in the air. Don’t hike, bike or swim for a week.
Pause certain activities
To keep your eye incision from reopening, avoid putting pressure on your eye in the days after surgery. Venkateswaran says that means no bending over, lifting objects that are 10 pounds or heavier, cleaning, vacuuming or doing laundry. “It’s OK to do gentle walking, but don’t jump around and get sweat in your eye, which could cause infection. Wait at least a week before resuming normal activities.”
Put your eyes to work
Venkateswaran finds that some people are scared to strain their eyes after the procedure. That’s not a problem; for example, it’s fine to read or work on a computer as long as you choose. Your depth perception might be off initially, so don’t drive unless you’re sure your vision is at least as good as before the procedure.
Don’t stress over differences
If you get a cataract removed from each eye, a few weeks apart, don’t worry if you have vision differences. “You had natural differences in your eyes before surgery, and you may have some afterward,” Venkateswaran says. “Give your eyes time to work together and adjust, and enjoy your new vision.”
New guidelines open door for blood donation
Manuel Valdes and Claire Rush
Associated Press
VANCOUVER, Wash. — Over the last six years, blood center employee Dylan Smith was often asked how frequently he gave blood himself. His answer was always the same: As a gay man, he couldn’t.
That changed this month.
Thanks to new federal guidelines finalized in May, gay and bisexual men in monogamous relationships can now donate at many blood centers around the country without abstaining from sex.
Bloodworks Northwest, where Smith works as a donor services supervisor, adopted the change on Dec. 6. He and his partner gave blood for the first time the next day.
“It’s been really emotionally difficult just to explain every single time the reason why,” said Smith, 28. “To be able to finally step up and support the mission that I really have just believed in since I started here just makes my heart feel so happy.”
The new U.S. Food and Drug Administration guidelines are the latest step in a yearslong effort to reverse restrictions that were designed to protect the blood supply from HIV, but which were increasingly criticized as discriminatory following scientific advances that allowed better detection of the virus.
In 2015, the FDA dropped the lifetime ban on donations from men who have sex with men and replaced it with a one-year abstinence requirement. The agency shortened the abstinence period to three months in 2020 after donations plummeted during the COVID-19 pandemic.
The American Red Cross, which accounts for about 40% of blood and blood component donations in the U.S., began implementing the new guidance in August.
About half of the 16 independent blood bank organizations that are members of the Alliance for Community Transfusion Services have rolled out the new guidelines, with more expected next year, the organization said.
“It is going to take time,” said Benjamin Prijatel, president of Shepeard Community Blood Center in Augusta, Georgia. “Blood centers and health professionals are going to have to put forth the effort to engage and educate this community in order to overcome years of distrust. That’s the only way this rule change will translate into additional donations.”
The change puts the emphasis on sexual activity rather than on sexual orientation. All potential donors are screened with a new questionnaire evaluating their HIV risk based on sexual behavior, partners and other factors that can contribute to the spread of blood-borne infections, such as intravenous drug use or recent tattoos or piercings.
Potential donors who report having anal sex with new partners in the last three months are barred from giving until a later date, and anyone who has ever tested positive for HIV will continue to be ineligible.
Those taking pills to prevent HIV through sexual contact are still barred until three months after their last dose; the medications, known as PrEP, can delay the detection of the virus, the FDA said.
Donated blood is then tested for HIV, hepatitis C, syphilis and other infectious diseases.
Bloodworks Northwest, which supplies blood to more than 90 hospitals in the region, isn’t keeping track of how many newly eligible donors are coming in, said Dr. Kirsten Alcorn, the nonprofit’s co-chief medical officer. But workers have heard plenty of stories from people excited to give.
“It feels very meaningful to many of them to now be able to contribute to somebody’s survival,” Alcorn said.
Bloodworks executive Aaron Posey, whose own life was saved by a transfusion when he fell down a set of stairs and broken glass sliced an artery, welcomed the new guidance. He said hospitals and patients need access to a new pool of donors.
“Having always witnessed a shortage in the blood supply, it has at times been very frustrating,” said Posey, who first donated blood during the pandemic when the abstinence period was cut to three months.
Smith learned of the restrictions on gay men giving blood when he was screened while trying to donate his freshman year of college in 2013. The rules blindsided him, he said. It was a long time to wait before he could finally donate with his partner and other friends.
“Just being able to see them donating next to me, smiling next to me … meant so much,” Smith said.
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