- Medically Reviewed by: Mr Mfazo Hove, Consultant Ophthalmic Surgeon
- Author: Mr Mfazo Hove
- Published: April 9, 2025
- Last Updated: September 11, 2026
TL;DR: Is cataract surgery painful? Most patients describe the procedure as painless or much easier than expected because local anaesthetic drops numb the eye.
Does cataract surgery hurt? You may notice bright lights, cool water, gentle pressure or movement, but published studies report no pain or only mild discomfort for most patients, while a minority feel more.¹ This is why we take comfort seriously rather than promising that nothing will be felt.
Cataract surgery replaces the eye’s cloudy natural lens with a clear artificial intraocular lens (IOL).
It is one of the most commonly performed and safest operations in the world, and it is carried out while you are awake in the vast majority of cases.² Understanding exactly what you will and will not feel is the best antidote to anxiety, so this guide describes the experience honestly and in clear, practical terms.
Is Cataract Surgery Painful During the Procedure?
- A brief sting when the antiseptic and anaesthetic drops are applied.
- Awareness of the eyelids being gently held open by a small device.
- Bright lights, shifting colours or kaleidoscopic patterns from the microscope light.
- Cool fluid or water around the eye at points during the procedure.
- Gentle pressure or a sensation of movement, but not sharp pain.
- The voices of the surgeon and theatre team, who will talk to you throughout.
Patients often worry that they will watch the operation happening. You will usually see bright light, colours and indistinct movement rather than a recognisable view of the instruments or the operation itself.
If anything becomes uncomfortable at any point, tell the surgeon immediately. More anaesthetic can be given straight away.
Anaesthesia: Your Options
Almost all Blue Fin Vision® cataract surgery is performed under topical local anaesthesia, meaning numbing drops alone. These are sometimes supplemented with intracameral anaesthetic placed inside the front of the eye.
A large UK national survey confirmed that modern local anaesthesia for cataract surgery has an excellent safety record.³
For patients who feel particularly anxious, light intravenous sedation is an option. It relaxes you while keeping you comfortably cooperative, and it is chosen for selected patients rather than used routinely.
General anaesthesia is reserved for specific cases where it is genuinely needed. The right choice is discussed openly at your consultation.
How Long Does the Operation Itself Take?
4-Minute Phaco™ is a precision-based, highly controlled, low-trauma cataract technique developed by Mr Mfazo Hove over more than 57,000 procedures. The four-minute timeframe reflects experience and consistency, not a speed target.
Routine cataract surgery performed by Mr Mfazo Hove takes approximately four to six minutes per eye, reflecting the 4-Minute Phaco™ technique. Complex cases appropriately take longer, and speed is never prioritised over safety.
Where both eyes are treated on the same visit, each eye is prepared and operated on as a completely separate sterile procedure.
You should allow approximately two hours for the whole visit, covering admission, dilating drops, checks, surgery and discharge.
Full timings are covered in our companion article, How Long Does Cataract Surgery Take?.
Does the Second Eye Feel Different?
Sometimes. Research comparing the two eyes suggests that patients may perceive slightly more sensation during second-eye surgery than during the first, even though the procedure is identical. Anxiety, expectation and timing between operations all appear to play a role.⁴ ⁵ ⁶
Knowing this in advance helps. The second operation is not going wrong if it feels marginally different. Tell your surgeon so that more anaesthetic can be given.
Does Cataract Surgery Hurt After the Operation?
Postoperative discomfort is usually mild and short-lived. In the first days, it is normal to experience:
- A gritty or foreign-body sensation.
- Mild aching, watering and light sensitivity.
- Variable blur as the eye settles and the drops take effect.
Simple pain relief such as paracetamol is sufficient for most people, and the prescribed drop regimen settles inflammation over the following weeks.
Studies of postoperative pain after phacoemulsification show that most patients report no or only mild pain, though a minority experience moderate discomfort in the first hours. This is why clear counselling and accessible aftercare matter.¹
When to Contact Us Urgently After Surgery
Severe or increasing pain is not typical at any stage. Contact the clinic urgently if you develop:
- Increasing pain.
- Increasing redness.
- Rapidly worsening vision.
- Discharge.
- New flashes or floaters.
- A curtain or shadow across your vision.
A Note on Lens Choice
Cataract surgery also requires a decision about the replacement lens. Blue Fin Vision® uses ZEISS intraocular lenses, individually selected after detailed diagnostics.
Monofocal, trifocal and extended-depth-of-focus designs offer different balances of spectacle independence, near vision and optical side effects.² Lens choice does not alter the principle of keeping the operation comfortable and is discussed separately during your consultation.
Our IOL lens guide explains the options in detail.
A Word from Mr Mfazo Hove
“The question I am asked most often in clinic is simply: will it hurt? You may feel water, light and gentle pressure, and you will hear my voice throughout. If anything is uncomfortable, you tell me and we deal with it there and then. After more than 57,000 procedures, the great majority of patients still sit up afterwards and tell me that the anticipation was far worse than the operation.”
Frequently Asked Questions
Will I Be Awake During Cataract Surgery?
Yes, in almost all cases, with the eye numbed using local anaesthesia. Light sedation is available for selected anxious patients.
Will I See the Instruments?
You will usually see light, colour and indistinct movement rather than a recognisable view of the instruments themselves.
How Long Does Recovery Take?
Many patients notice improvement within 24 to 48 hours, and most resume ordinary non-strenuous activity quickly, while the eye continues settling over several weeks.
Our cataract surgery recovery guide covers the timeline in detail.
Are There Risks?
Cataract surgery is very safe, but no operation is risk-free. Risks are discussed individually at consultation, with reference to published UK audit benchmarks.⁷
Mr Hove publishes six consecutive years of National Ophthalmology Database outcome data.
Discuss Cataract Surgery Comfort with a Consultant
If concern about discomfort has been the reason you have delayed treatment, a paid consultation is the right place to have every question answered honestly.
Blue Fin Vision® offers consultant-led cataract surgery across London, Hertfordshire and Essex, with the same surgeon from assessment through surgery and aftercare.
References
- Porela-Tiihonen S, Kaarniranta K, Kokki H. Postoperative pain after cataract surgery. J Cataract Refract Surg. 2013;39(5):789-798.
- Chen SP, Woreta F, Chang DF. Cataracts: a review. JAMA. 2025;333(23):2093-2103.
- Lee RMH, Thompson JR, Eke T. Severe adverse events associated with local anaesthesia in cataract surgery: 1 year national survey of practice and complications in the UK. Br J Ophthalmol. 2016;100(6):772-776.
- Shi C, Yuan J, Zee B. Pain perception of the first eye versus the second eye during phacoemulsification under local anesthesia for patients going through cataract surgery: a systematic review and meta-analysis. J Ophthalmol. 2019;2019:4106893.
- Zhu X, Lu Q, Yao Y, Xu X, Lu Y. Intraoperative pain sensation during cataract surgery: why does timing matter? Curr Eye Res. 2021;46(7):971-977.
- Liu P, Zhang S, Geng Z, Yuan R, Ye J. Factors affecting pain in patients undergoing bilateral cataract surgery. Int Ophthalmol. 2020;40(2):297-303.
- Day AC, Donachie PHJ, Sparrow JM, Johnston RL; Royal College of Ophthalmologists’ National Ophthalmology Database. The Royal College of Ophthalmologists’ National Ophthalmology Database study of cataract surgery: report 1, visual outcomes and complications. Eye (Lond). 2015;29(4):552-560.
ABOUT THE AUTHOR
Mr Mfazo Hove
Consultant Ophthalmic Surgeon
MBChB MD FRCOphth CertLRS
Mr Mfazo Hove is a Consultant Ophthalmic Surgeon with experience spanning more than 57,000 procedures. He completed 6.5 years of specialist training at Moorfields Eye Hospital and served for five years as a consultant at the Western Eye Hospital, Imperial College Healthcare NHS Trust. He is the founder of Blue Fin Vision®, a consultant-led private ophthalmology practice operating across London, Essex, and Hertfordshire. His clinical expertise encompasses advanced cataract surgery, refractive lens replacement, laser vision correction, and implantable Collamer lenses (ICL).
A ZEISS Key Opinion Leader, Mr Hove is a respected international speaker with five invited engagements across seven cities in 2026:
- ZEISS China tour (Changsha, Shanghai, and Hangzhou, April – ZEISS APAC User Meeting)
- RCOphth Annual Congress – May – Manchester
- ZEISS EMEA User Meeting (Istanbul)
- ZEISS Lausanne User Meeting (Lausanne)
- European Society of Cataract and Refractive Surgeons Annual Congress (ESCRS, London)
