Pre-Op Checklist for Cataract Surgery
What Your Eye Doctor Measures Before Surgery
About one week before surgery, your eye doctor takes precise measurements of your eye to select the right intraocular lens (IOL) power. These measurements include the length of your eye and the curvature of your cornea (the clear front surface of the eye). A device called an optical biometer captures these numbers in seconds without touching your eye. Your doctor uses the results to calculate which lens strength will give you the sharpest focus after surgery.
Accurate biometry depends on a stable corneal surface. If you have dry eyes or blepharitis (inflamed eyelids), your doctor may treat those conditions first. Untreated surface problems can skew your measurements and affect how well your new lens performs.
Your doctor may ask you to stop wearing contact lenses before your biometry appointment. Contacts reshape your cornea over time, and those temporary changes can produce inaccurate measurements. Soft lenses require a break of five to seven days before the appointment. Rigid gas-permeable lenses may need two to four weeks.
Wearing contacts up until your measurement day can lead to a lens calculation that misses your ideal prescription. Give your cornea enough time to return to its natural shape so your surgeon can select the most accurate IOL power for your eyes.
Your eye doctor needs every medication, supplement, and vitamin on your list. Blood thinners such as warfarin, clopidogrel, and aspirin require special attention because your surgeon must coordinate with your prescribing physician about whether to continue, adjust, or pause them. Herbal supplements like fish oil, ginkgo biloba, and vitamin E can also affect bleeding.
Bring a written or printed medication list to your preoperative appointment. Your surgeon will review each item and give you specific instructions about what to stop, what to continue, and when to make changes. Do not adjust any medication on your own before talking with both doctors.
The AAO and ASCRS developed a surgical safety checklist for all eye procedures to prevent wrong-site and wrong-patient errors. According to the AAO (2025), your surgical team follows this checklist to verify your identity, confirm which eye receives surgery, and review your lens selection before the procedure begins. You may notice staff asking the same questions more than once. Each time, they follow the safety protocol designed to protect you.
Medical Clearance for Cataract Surgery
Most healthy patients do not need blood work, an EKG, or urinalysis before cataract surgery. According to the AAO (2014), routine preoperative medical testing is not required unless your health history warrants it. The AAO Choosing Wisely initiative identifies these routine tests as unnecessary for patients without active medical problems.
This guidance saves you time and money. If a facility orders routine labs for every cataract patient, ask whether the tests are indicated for your specific health situation.
Your surgeon may ask you to see your primary care doctor if you have uncontrolled diabetes, severe heart disease, or lung conditions that could complicate sedation. In those cases, a clearance letter confirms your condition is stable enough for the procedure. Your primary doctor can also flag recent health changes that your eye surgeon should know about.
Patients with sleep apnea should mention it during their preoperative visit. If deeper sedation is planned, your care team can make adjustments to keep you safe during the procedure.
If you take anticoagulants, your eye surgeon and prescribing doctor will decide together whether to pause them. Many patients continue blood thinners through cataract surgery because the procedure uses topical anesthesia and carries a low bleeding risk. Your surgeon will give you a clear plan based on your medications and health conditions.
Do not stop any blood thinner on your own. Stopping without medical guidance raises your risk of stroke or blood clots, which poses far greater danger than a small chance of minor bleeding during eye surgery.
Preparing Your Eyes and Home
Clean your eyelids and lashes with diluted baby shampoo or a lid scrub the night before and the morning of surgery. This step removes bacteria from the skin around your eyes and lowers your infection risk. Use a clean washcloth, apply the diluted solution, and scrub along the lash line of both eyes for about 30 seconds each.
Avoid eye makeup, face lotions, and perfume on the day of surgery. These products can introduce particles near the surgical area. Remove false eyelashes or eyelash extensions before your procedure if your surgeon asks.
Your surgeon may prescribe antibiotic drops to start one to three days before surgery. These drops reduce bacteria on the surface of your eye and help prevent infection. Follow the dosing schedule as prescribed. Some surgeons also prescribe anti-inflammatory drops before the procedure to reduce swelling during and after surgery.
Wash your hands before applying any drops. Tilt your head back, pull down your lower eyelid, and place one drop into the pouch without touching the dropper to your eye. Wait at least five minutes between different drop types if you use more than one.
Prepare a comfortable area at home before you leave for surgery. Place your prescribed eye drops, clean tissues, and protective eye shield within easy reach. Stock the refrigerator with simple meals or snacks, since bending over to cook can feel uncomfortable during the first day of recovery.
Make sure your home has good lighting and clear pathways. Your depth perception may be off for the first day or two, and removing tripping hazards reduces your fall risk. Keep a pair of dark sunglasses near your recovery area for sensitivity to light.
A companion must drive you to and from surgery. Your vision will be blurry from dilating drops and the procedure itself, and you cannot drive until your surgeon clears you at your follow-up visit. Ask your companion to stay at the surgery center so they can help you get settled at home afterward.
If you live alone, consider asking a friend or family member to check on you the evening of surgery. While most patients recover without issues, having someone available offers support during the first few hours after your procedure.
What to Expect on Surgery Day
If your surgeon plans to use sedation, stop eating solid food at least six hours before your procedure and stop drinking clear liquids at least two hours before. These guidelines follow standard anesthesia safety protocols. If your surgery uses numbing eye drops without sedation, your fasting requirements may be lighter. Follow the specific instructions your surgical team provides.
You can take your regular morning medications with a small sip of water in most cases. Confirm which medications to take during your preoperative appointment so you have a clear plan for surgery morning.
Bring your insurance card, photo identification, and your medication list. Wear comfortable, loose clothing with a button-front or zip-front top so you do not need to pull anything over your head after surgery. Leave jewelry, watches, and valuables at home.
Bring sunglasses for the ride home. Your eyes will be sensitive to light from the dilating drops, and sunglasses make the trip more comfortable. You can also bring a book, phone, or headphones for the waiting period before your procedure.
Arrive at the time your surgery center specifies. Staff will verify your identity, review your health history, and confirm which eye receives surgery. You will receive dilating drops to widen your pupil and numbing drops to prepare your eye for the procedure.
Your surgical team performs a final timeout before beginning. They confirm your name, procedure, lens selection, and the correct eye one last time. The procedure itself takes about 10 to 20 minutes. You will stay awake, may see bright lights, and should feel no pain.
Common Questions About Cataract Surgery Preparation
Most surgeons allow patients to continue aspirin because cataract surgery carries a low bleeding risk. Your surgeon and prescribing doctor will make this decision together based on your health needs. Do not stop aspirin on your own without their guidance.
Your glasses prescription will change after surgery. Your doctor will wait four to six weeks for your vision to stabilize before writing a new prescription. During this time, your old glasses may not feel right, but you can remove the lens on the operated side if needed.
Showering the morning of surgery is fine. Avoid getting soap, shampoo, or water in your eyes. Some surgeons ask you to use the diluted baby shampoo lid scrub after your shower as the last step before leaving for the surgery center.
Call your surgeon office right away. A mild cold without fever does not delay surgery in most cases, but coughing during the procedure can affect the surgeon work. Your doctor will decide whether to proceed or reschedule based on your symptoms.
Tilt your head back and pull down your lower eyelid to create a small pouch. Look up and squeeze one drop into the pouch without touching the tip to your eye. Close your eye for one to two minutes and press on the inner corner near your nose. Your doctor staff can demonstrate this technique at your preoperative visit.
Your surgeon may allow your existing anxiety medication or prescribe a mild sedative for the morning of surgery. Discuss this at your preoperative appointment. If approved, take it with a small sip of water as directed by your care team.
Schedule Your Preoperative Appointment
Contact your eye doctor to schedule your preoperative measurements and medication review. Starting early gives you time to treat any surface issues, arrange support for surgery day, and feel prepared walking into the procedure room.