People can compensate for early-stage cataracts by using stronger contact lenses or glasses, anti-glare sunglasses, magnifying glasses and brighter lights. If these steps do not help, the only treatment for cataracts is surgical removal.

The ophthalmologist may recommend waiting a period of time before undergoing cataract surgery. The National Eye Institute (NEI) suggests that surgery may not be necessary unless the loss of vision disrupts daily activities. Studies have shown that delaying surgery rarely causes long-term damage to the eye. However, some cataracts may need to be removed even if they do not impair vision. This is usually the case if the patient has other eye diseases such as diabetic retinopathy or glaucoma, which may be more easily treated or monitored if cataracts are removed.

Patients need to disclose their medications in advance of the surgery. A recent concern is alpha blockers, a class of antihypertensives. Alpha blockers are often prescribed to treat prostate enlargement (benign prostatic hyperplasia, BPH), a common condition in middle-age and elderly men. Researchers have found that alpha blockers can cause the iris, one of the colored parts of the eye, to become floppy during cataract surgery. This condition, known as intraoperative floppy iris syndrome (IFIS), can constrict the pupil, which needs to be dilated during the operation. IFIS has been noted in some patients who stopped taking alpha blockers as long as five years before their operation.

Surgical complications can result if the surgeon is not prepared for the possibility of IFIS. However, advance notification that a patient has taken alpha blockers can permit use of modified surgical techniques that have a successful outcome. Alpha blockers are safe and effective treatments for BPH, but patients using them should notify their ophthalmologist before their surgery, according to the American Society of Cataract and Refractive Surgery, the American Academy of Ophthalmology and the American Urological Association.

Cataract removal is one of the most common, safe and effective surgeries. Usually the patient can go home the day of surgery. About 98 percent of patients enjoy better eyesight afterward. If cataracts need to be removed in both eyes, the operations are typically performed apart.

The 15-minute  procedure is performed under local or topical anesthesia in a hospital or ambulatory surgical center. The ophthalmologist makes an incision in the cornea (the clear front of the eye) and removes the lens, after breaking it up with special ultrasound, called phacoemulsification.

Usually the lens is replaced with an artificial lens implant that cannot be felt or seen, requires no care and becomes a permanent part of the eye. Patients who cannot have an artificial lens because of complications such as other eye diseases may instead be prescribed glasses or contact lenses.

Following the surgery, patients may need to wear a patch over the eye to allow it to heal. The physician may also prescribe corticosteroids, nonsteroidal anti-inflammatory drugs (NSAID) and antibiotic eyedrops with directions on their use. After the operation, patients may perform minor activities such as walking and climbing stairs but should avoid activities that may increase pressure in the eye, such as lifting heavy objects. Follow-up physician visits may be scheduled to check the patient’s recovery.

People with diabetes tend to have more complications from surgeries, including cataract surgery. Complications include the possibility of infection and bleeding and a slightly increased chance of a detached retina. These complications may lead to loss of vision if left untreated.

Patients who have an artificial lens implanted sometimes develop an after-cataract. An after-cataract is clouding of the eye tissue that forms around the synthetic lens. This may develop months or years after the implant and is usually resolved with a painless laser treatment.