Pre-Surgery Instructions for Cataract Surgery
Medication Changes Before Surgery
Most surgeons prescribe antibiotic eye drops to start two to three days before your procedure. These drops reduce the bacteria on your eye surface and lower the risk of infection during surgery. Your surgeon may also prescribe anti-inflammatory drops (a steroid or NSAID) to reduce existing inflammation before the operation and lower your risk of swelling after. Follow the exact timing your surgeon provides for each drop, because proper dosing ensures your eye has adequate protection when surgery begins.
Supplements like fish oil, vitamin E, ginkgo biloba, garlic, ginseng, and turmeric can increase bleeding during surgery. According to the London Cataract Centre, you may need to stop these supplements 7 to 10 days before your procedure. Your surgeon coordinates with the doctor who prescribed any blood-thinning medications like warfarin or direct oral anticoagulants to decide whether to pause, reduce, or continue them. Never stop a prescribed blood thinner on your own without medical guidance, as doing so can increase your risk of stroke or heart attack.
If you take insulin or oral diabetes medications, your surgeon and primary care doctor create a plan for the morning of surgery. Because you will be fasting, you may need to skip or reduce your diabetes medications to avoid low blood sugar. Your doctors give you specific instructions based on which medications you take and how well your blood sugar is controlled. Bring your glucose monitor to the surgical center so the staff can check your levels before the procedure. Stable blood sugar helps your eye heal well and reduces your risk of infection after surgery.
Continue your heart and blood pressure medications as usual unless your surgeon gives you different instructions. According to standard clinical practice, you should take these medications on the morning of surgery with a small sip of water, even if you are fasting. Stopping blood pressure medications abruptly can cause a dangerous rebound spike in pressure. If you take a diuretic (water pill), your surgeon may ask you to skip it on surgery day to avoid dehydration while you are fasting.
Continue your glaucoma drops as prescribed through the morning of surgery unless your surgeon tells you otherwise. According to the London Cataract Centre, maintaining your glaucoma medication schedule protects your optic nerve and keeps your eye pressure stable throughout the surgical process. Your surgeon adjusts your postoperative drop regimen to work alongside your glaucoma medications without conflicts or interactions that could affect your eye pressure.
Fasting and Day-Before Preparation
Your surgical center gives you specific fasting instructions. The standard guideline is nothing to eat for at least six hours before your procedure. Many facilities tell you to have nothing by mouth after midnight the night before surgery. Clear liquids such as water, apple juice, or black coffee may be allowed up to two hours before the procedure at some centers, following the American Society of Anesthesiologists guidelines. Your surgeon may let you take essential morning medications with a small sip of water, but confirm this with your surgical team beforehand.
Wash your face and scrub your eyelids and lashes with diluted baby shampoo or an antiseptic eyelid wipe the night before surgery. Repeat this cleaning on the morning of surgery. According to the NEI, this step reduces the bacterial load around your eye and lowers your infection risk. Do not apply eye makeup, facial creams, lotions, moisturizers, or perfume on the day of surgery, as these products can introduce particles and bacteria into the surgical field. Residues from cosmetics are difficult to remove completely once applied, so skipping them entirely is safer than trying to clean them off before surgery.
Set up a comfortable recovery area before you leave for surgery. Place your prescribed eye drops, a clean washcloth, and your eye shield within easy reach. Stock your kitchen with meals and snacks that require minimal preparation. Move tripping hazards like loose rugs or cords away from your path, since your depth perception may be different for the first day or two. Having everything ready means you can rest when you get home without scrambling for supplies. Consider preparing meals in advance and placing a nightlight in your hallway and bathroom so you can move safely if you wake during the night.
Morning of Surgery
Wear comfortable, loose-fitting clothes that button or zip in the front. Avoid pullover shirts that go over your head, because you will want to avoid bumping your eye when you change clothes later. Skip jewelry, watches, and hair accessories. Wear flat, closed-toe shoes with good grip so you feel steady walking into and out of the surgical center.
Bring your insurance card, photo ID, a list of your current medications, and your prescribed eye drops. Your surgeon may ask you to bring your glasses. Leave valuables, large amounts of cash, and electronics at home or with your companion. Some facilities provide a storage bag for personal items during the procedure. Arrive at the time your surgical center specifies, which is usually 30 to 60 minutes before your scheduled surgery.
You must have a responsible adult drive you to and from the surgical center. Your vision will be blurry from dilating drops and you may feel drowsy from sedation. According to standard practice, driving is not permitted on the day of cataract surgery. Your companion should plan to stay at the facility during the procedure and be available to drive you home when you are discharged, usually about an hour after you arrive.
Remove your contact lenses before arriving at the surgical center. You should have already stopped wearing contacts days or weeks earlier for your preoperative measurements, so this is a final confirmation. Wear your glasses to the appointment instead. Contact lens material left on the eye can interfere with the surgical environment and increase infection risk. If you are unsure whether you should still be wearing contacts at this point in your preparation timeline, call your surgeon's office to confirm.
What Happens When You Arrive
The surgical team confirms your identity, the eye being operated on, and your medical information. A nurse reviews your medication list, allergies, and health history one more time. This verification process follows an ophthalmic surgical safety checklist recommended by the AAO and ASCRS to prevent wrong-site and wrong-patient errors. You may be asked the same questions multiple times by different team members. This repetition is intentional and follows an ophthalmic safety protocol endorsed by both the AAO and ASCRS (2025) to prevent errors.
A nurse or technician places dilating drops in your surgical eye to widen the pupil, giving your surgeon a clear view of the cataract. According to the AAO, antibiotic drops are given as a final series of doses: one drop every 15 minutes for a minimum of four drops in the two hours before surgery. You may also receive anti-inflammatory drops during this time. The dilation process takes about 20 to 30 minutes.
Most cataract surgery uses topical anesthesia (numbing eye drops) so you stay awake during the procedure. If you feel anxious, your surgeon may offer a mild oral sedative or light IV sedation to help you relax. A nurse monitors your blood pressure and heart rate throughout the procedure. The surgical team keeps you comfortable and tells you what to expect at each step. You may see lights and colors during the operation, but you will not see the surgical instruments. The procedure itself typically takes 10 to 20 minutes per eye.
Answers to Common Pre-Surgery Questions
Tell your surgical team right away. If you ate or drank within the fasting window, your surgeon may need to delay your procedure. Fasting protects you from the risk of aspiration (inhaling stomach contents) if your doctor uses sedation. Your surgeon decides whether it is safe to proceed based on what you consumed and how long ago.
Most surgeons allow you to take essential medications like blood pressure pills with a small sip of water on the morning of surgery. Diabetes medications and diuretics are the most common exceptions. Your surgeon gives you a specific list of which medications to take and which to hold. If you are unsure about any medication, call your surgeon's office the day before surgery to confirm.
Call your surgeon's office if you develop a cold, cough, fever, or any new illness before your scheduled surgery date. Active infections, especially respiratory infections, can increase your surgical risk and may lead your surgeon to postpone the procedure until you recover. It is safer to delay surgery by a week or two than to operate while your immune system is fighting an infection, because illness increases your risk of complications during and after the procedure.
Your companion needs to drive you home and help you settle in. Most people do not need someone to stay overnight unless they have difficulty with mobility or live alone and feel unsteady. You should be able to manage your eye drops and basic care on your own after the first few hours. Your surgeon gives you a phone number to call if you have concerns during the first night.
Plan to arrive 30 to 60 minutes before your scheduled surgery time. This allows time for check-in paperwork, identity verification, pupil dilation, and any final eye drops. The total time at the facility, from arrival to discharge, is usually about one to two hours for uncomplicated cataract surgery.
Yes, most patients are awake during cataract surgery. Your eye is numbed with drops so you do not feel the procedure, and you may receive a mild sedative to help you relax. You may see lights and colors during the surgery but will not see the instruments. The surgical team talks you through what to expect, and the procedure typically takes 10 to 20 minutes per eye.
Get Ready for Clearer Vision
Follow your surgeon's instructions carefully in the days and hours before your procedure. Proper preparation reduces your surgical risk and sets the stage for the best possible outcome with your new lens. If you have any questions about your instructions or are unsure about a medication, call your surgeon's office before the day of surgery so you feel confident and ready.