Infections, vision loss, and high eye pressure are among the many complications that can arise from untreated cataracts and cataract surgery. Regular eye checks and prompt medical assistance may reduce or prevent some of these risks.

Complications may arise if a cataract is left untreated, especially in advanced stages. That’s why many people treat cataracts with surgery, which replaces a cloudy lens with a clear artificial one. And although cataract surgery is generally considered safe, complications from it can also occur.

In other words, risks exist both from cataract surgery and from letting the cataract progress unchecked.

A healing journey can look many ways, so risks and complications may vary. Here are some potential complications of untreated cataracts, as well as those that may arise from the recovery process following cataract surgery.

9 Surgery-related complications

These complications may develop in the context of cataract removal or after surgery:

  • Posterior capsule opacification (PCO): This is when a membrane behind the new lens becomes cloudy over time, making vision blurry again, even with the new clear lens.
  • Cystoid macular edema (CME): The central retina (macula) may become swollen, which could impact central detail vision. This may happen right after surgery or weeks later.
  • Endophthalmitis: This is a serious infection that develops inside the eye, causing severe pain, redness, and worsening vision.
  • Retinal detachment: The retina (back layer of the eye) may pull away or tear after surgery, which may lead to flashes, floaters, or a curtain effect.
  • High eye pressure: Immediately after surgery, the pressure inside your eye may rise, causing hazy vision or damage to the optic nerve. It’s also possible that the cornea (clear layer in the front eye) gets swollen, causing the same symptoms.
  • Lens dislocation: The new lens may shift out of its intended position, resulting in blurry vision.
  • Uveitis: This refers to recurrent inflammation inside the eye, which may involve swelling or high pressure and pain.
  • Capsule or zonule tears: Zonules are the fibers that support the eye lens. These may tear during surgery, and the vitreous (gel-like substance inside the eye) may enter other areas.
  • UGH syndrome: When a mispositioned lens rubs against other eye structures, it may cause inflammation (uveitis), bleeding, and increased internal pressure (glaucoma).

Factors that may increase the risk of postsurgery complications

Research from 2021 suggests that major postoperative complications of cataract surgery are associated with:

7 Complications of untreated cataracts

These are risks associated with advanced cataracts:

  • Phacomorphic glaucoma: This refers to increased pressure inside the eye that results from a thickened lens that pushes eye structures and may block the natural drainage of the eye ducts.
  • Phacolytic glaucoma: This type of glaucoma comes from lens proteins leaking into nearby structures and clogging drainage ducts.
  • Lens dislocation: The natural lens can also shift out when its supportive structure becomes weak. This can damage nearby eye structures.
  • Corneal damage: Dense cataracts can affect the cornea, leading to swelling or scarring over time.
  • Severe vision loss: When cataracts worsen over time, light cannot reach the retina, and you may lose vision. This vision loss may be reversible with surgery.
  • Other complications: Decreased vision can significantly impact quality of life, especially for older adults, affecting aspects such as mobility, balance, independence, mood, and brain health.

Complications and risks may be reduced to some extent by preparation, careful technique, and ongoing care.

For surgery-related complications:

  • Ensure you monitor inflammation closely ahead of your surgery, especially if you have a history of uveitis or other eye conditions. You may want to ask the healthcare team for signs to watch out and report.
  • An eye doctor may use povidone-iodine and intraocular antibiotics at the end of surgery to reduce postsurgery infection risks. Consider asking them about the potential side effects of antibiotics and the cleaning methods you need to follow.
  • Techniques for cataract surgery may vary. Consider a surgeon who uses modern surgical techniques, such as small incisions and advanced lens designs. This can help reduce trauma to the eye and avoid zonular tears.
  • Ensure you understand and follow all post-operative care steps, including eye drop regimens. These should be discussed with the doctor before the surgery day.
  • Avoid rubbing, contaminants, or early exposure to irritants (dusty environments, eye contact, swimming).
  • Wear glasses or goggles when spending time outdoors, especially in windy conditions.
  • Attend all scheduled follow-ups, even if your vision appears to be fine. This is important to check eye pressure, scars, lens position, and retina health.

For untreated cataract risks:

  • Try not to wait too long to get a professional opinion. It’s important to monitor the cataract’s progression regularly.
  • Monitor and report any new symptoms promptly, including pain, halos, vision shifts, and flashes.
  • Maintain general eye health. Manage conditions like diabetes, which can affect the eyes.
  • Avoid smoking.
  • Try to eat foods rich in antioxidants and limit your intake of processed foods.
  • Always wear UV protection when outdoors.

When to seek care

Seek emergency care if you experience:

  • worsening eye pain
  • sudden vision changes
  • new flashes and floaters
  • persistent eye redness
  • halos or curtain vision

Cataract surgery is a safe and effective procedure for restoring vision, but certain risks are associated with it. On the other hand, allowing cataracts to become advanced can lead to serious eye problems, including permanent vision loss.

It’s important to remain proactive in cataract management. Track vision changes, don’t delay care, understand the risks, and seek immediate care if warning symptoms arise. Early cataract intervention can make a difference.