Eye pain one month after cataract surgery: what to do?

One month after cataract surgery, some discomfort is still common: a gritty feeling, prickling, dry eye, glare. It most often comes from the surface of the eye. A deep pain that is getting worse, or that comes with redness or a drop in vision, should on the other hand be examined without waiting for the scheduled check-up. A red, painful eye with worsening vision: the consultation takes place the same day.

KEY POINTS

AT A GLANCE

Discomfort or pain: telling the difference

• Discomfort is superficial: grittiness, prickling, burning, a watering eye, especially at the end of the day or in front of a screen. It varies from one hour to the next, and an artificial tear eases it.
• Pain is deep, in the eye or around it. It sets in, gets worse, can wake you at night, and is sometimes accompanied by redness, marked discomfort in light or blurred vision.

What is still usual, and what no longer is

A gritty feeling on waking, eyes watering in the wind, tiredness after an hour at a screen, glare in the sun, a few floaters: these sensations are common at one month. The French national health insurance (Assurance Maladie) lists increased sensitivity to light, dryness and floaters among the temporary functional disturbances that can follow the operation. They fluctuate, ease in part with artificial tears, and vision stays as it was in the previous days.

What is no longer part of the usual course: a pain that sets in instead of becoming less frequent, redness that comes back after it had gone, vision that worsens again after it had improved. The expected course is described in recovery after cataract surgery.

MOST OFTEN

The common causes of discomfort that lingers

Post-operative dry eye

This is the first explanation: the operation and the eye drops disturb the tear film. A systematic review of twenty studies concludes that dryness can persist for up to three months after surgery Ta 2025. Hence the artificial tears prescribed for about three months, or as needed.

The pattern gives a lead: slight discomfort on waking, stronger at the end of the day, made worse by a screen or by air conditioning, and receding after a drop. It often affects both eyes, including the one that was not operated on: the dryness was already there and has simply become more noticeable. See the gritty feeling and dry eye.

A surface irritated by the eye drops, blepharitis

Several drops a day for a month sometimes irritate the surface of the eye. Blepharitis, a chronic inflammation of the edge of the eyelids, also keeps up burning and a foreign-body sensation: red lid margins, crusts at the base of the lashes, eyelids stuck together on waking. These discomforts should be reported to the ophthalmologist, who adapts the prescription; they are no reason to stop the treatment on your own, or to rub the operated eye (see what not to do after the operation).

An optical correction that is not yet up to date

Not every complaint at one month is a pain. Eye strain, a heavy feeling in the forehead, headaches when reading sometimes come from old glasses that have become unsuitable for the operated eye. Visual acuity is measured at the one-month check-up and the prescription adjusted if needed: see glasses after cataract surgery.

GET IT CHECKED

What needs to be examined without delay

An inflammation that flares up again

The anti-inflammatory eye drops are prescribed for about a month. Sometimes the inflammation inside the eye (anterior uveitis, or iritis) wakes up again when the drops are reduced or stopped: the eye turns red again, a dull pain, marked discomfort in light, slightly veiled vision. The redness is then concentrated around the cornea rather than over the whole white of the eye. These signs call for a prompt examination, never for restarting a bottle that has already been opened.

Intraocular pressure that is too high

Corticosteroid eye drops raise the pressure in the eye in a minority of people. In a series of 1,642 patients operated on for cataract and treated with a corticosteroid eye drop, 39 showed this response; younger patients and those with high myopia were the most exposed Chang 2011. The pressure usually returns to normal once the corticosteroid is stopped Grzybowski 2019, but that decision belongs to the doctor, after a measurement. A dull pain, headaches on the operated side or coloured halos should prompt a pressure check.

Macular oedema

Macular oedema in an eye fitted with an implant (pseudophakic macular oedema, or Irvine-Gass syndrome) is a swelling of the centre of the retina. It generally occurs around the sixth week, and the risk is roughly doubled in the presence of diabetes Fouad 2025. It does not hurt: it blurs or distorts central vision, and is diagnosed by an OCT of the macula. Vision that worsens again, even without pain, should therefore be reported without delay; the causes of late blurring are reviewed in blurred vision after cataract surgery.

EMERGENCY

Red, painful eye, worsening vision: the same day

This combination raises the suspicion of an infection inside the eye, endophthalmitis. It is rare: in the European ESCRS study, 29 cases were recorded among 16,603 patients operated on ESCRS 2007. At one month, it remains possible: the reference trial on its treatment included infections that occurred up to six weeks after surgery EVS 1995. The time taken to start treatment weighs on the visual outcome, hence the same-day consultation.

On the phone, say how long the pain has lasted, whether it is getting worse, and whether your vision has changed since the day before. See also: ophthalmic emergencies.

LIGHT

Glare after cataract surgery: what to do?

The clear implant lets in more light than the clouded lens, which had been filtering the rays for years: brighter whites, a harsher sun, harsher headlights in the first weeks. This is an adaptation, and dryness makes it worse: an irregular tear film scatters the light instead of letting it through cleanly.

What helps day to day

• Filtering sunglasses outdoors, even in overcast weather, and a brimmed hat.
• The prescribed artificial tears, used before dazzling situations rather than afterwards.
• Indirect lighting, and a screen brightness matched to that of the room.
• Putting off night-time journeys for as long as headlights are bothersome, and mentioning it at the check-up.

Sun protection is detailed in sun and holidays after the operation.

Halos, arcs of light and night-time reflections

Some people describe, rather than a diffuse glare, well-defined arcs around light sources, or a crescent-shaped shadow at the side of the visual field: these are dysphotopsias. A review published in Ophthalmology links them to the way oblique light meets the edge of the implant, and points out that their persistence is a significant cause of dissatisfaction Masket 2021. Night-time halos linked to extended depth-of-focus implants have a dedicated article: EDOF implants and night-time halos.

One point to watch: discomfort in light that is recent, that appeared after it had gone away, and that comes with a red or painful eye, is not a matter of adaptation. It suggests inflammation and needs to be seen by an ophthalmologist without delay.

TREATMENT

Eye drops: neither stopped nor extended on your own initiative

Stopping too early risks a rebound of the inflammation; extending a corticosteroid on your own risks a rise in pressure and can mask an early infection. The duration set by the prescription should be followed, and any change goes through the ophthalmologist, notably at the one-month check-up at the practice, in Cachan or in Paris. A drop that stings briefly is not an allergy: what should raise concern is swelling of the eyelids or itching that sets in.

Follow-up consists of a check-up two days after the operation, a check-up at one month, then a check-up at one year, unless otherwise indicated. New discomfort, or discomfort that gets worse between two appointments, does not wait for the scheduled date.

IN PRACTICE

What I feel, what it may be, what to do

The problems felt after a cataract operation fall into three levels of urgency: what concerns the surface of the eye, what needs examining in the coming days, and what must be seen the same day. This table places a sensation; it does not make a diagnosis.

• Gritty feeling, prickling, watering eye, especially in the evening or in front of a screen.
  Often: post-operative dry eye.
  What to do: the prescribed artificial tears; mention it at the one-month check-up.
• Red lid margins, crusts at the base of the lashes, eyelids stuck together on waking.
  Often: blepharitis, or a surface irritated by the eye drops.
  What to do: report it; consultation in the following days if it persists.
• Visual tiredness, headaches when reading.
  Often: an optical correction that is no longer suitable.
  What to do: wait for the measurement of visual acuity at the one-month check-up.
• Eye red again and sensitive to light since the eye drops were reduced.
  Possible: a rebound of the inflammation inside the eye.
  What to do: prompt examination, without restarting a bottle on your own; the same day if vision worsens.
• Dull pain, headaches on the operated side, coloured halos.
  Possible: intraocular pressure that is too high.
  What to do: have the pressure measured promptly; change nothing in the treatment on your own.
• Central vision blurred or distorted, without pain, around the sixth week.
  Possible: macular oedema, more common in the presence of diabetes.
  What to do: consultation with an OCT of the macula, without waiting for the scheduled appointment.
• Glare in the sun, halos around headlights, arc-shaped reflections.
  Often: adaptation to the implant, dryness, or a dysphotopsia.
  What to do: sunglasses and artificial tears; earlier than the check-up if it appeared suddenly.
• Gradual veiling of vision that comes back months or years later.
  Possible: a secondary cataract.
  What to do: make an appointment; this is not an emergency.
• Red, painful eye, worsening vision, thick discharge, fever.
  To watch out for: an infection inside the eye.
  What to do: examination the same day, at the ophthalmic emergency departments outside the practice’s opening hours.

FREQUENTLY ASKED QUESTIONS

Frequently asked questions

SOURCES

Scientific sources

1. Endophthalmitis Study Group, European Society of Cataract & Refractive Surgeons. Prophylaxis of postoperative endophthalmitis following cataract surgery: results of the ESCRS multicenter study and identification of risk factors. J Cataract Refract Surg. 2007;33(6):978-988. PMID: 17531690
2. Endophthalmitis Vitrectomy Study Group. Results of the Endophthalmitis Vitrectomy Study. Arch Ophthalmol. 1995;113(12):1479-1496. PMID: 7487614
3. Ta H, McCann P, Xiao M, et al. Dry eye post-cataract surgery: a systematic review and meta-analysis. BMC Ophthalmol. 2025;25(1):18. PMID: 39806338
4. Chang DF, Tan JJ, Tripodis Y. Risk factors for steroid response among cataract patients. J Cataract Refract Surg. 2011;37(4):675-681. PMID: 21420592
5. Grzybowski A, Kanclerz P. Early postoperative intraocular pressure elevation following cataract surgery. Curr Opin Ophthalmol. 2019;30(1):56-62. PMID: 30489361
6. Fouad YA, Karimaghaei S, Elhusseiny AM, et al. Pseudophakic cystoid macular edema. Curr Opin Ophthalmol. 2025;36(1):62-69. PMID: 39446879
7. Masket S, Fram NR. Pseudophakic dysphotopsia: review of incidence, cause, and treatment of positive and negative dysphotopsia. Ophthalmology. 2021;128(11):e195-e205. PMID: 32800744
8. Assurance Maladie (ameli.fr). Traitement de la cataracte : quand faut-il être opéré ? Updated 5 December 2025. ameli.fr

GOING FURTHER

Further reading

• Recovery after cataract surgery: the course week by week
• Recovery after the operation: how long does it take?
• When to start driving again after the operation

Cachan practice · Tel. +33 1 45 47 08 11

MEDICAL DISCLAIMER

Medical disclaimer

This article is intended as general information and does not replace a medical consultation.

The pointers given here describe common situations, not an individual case, and the time frames indicated may be adapted to yours. Only an examination at the slit lamp, with a measurement of intraocular pressure and sometimes an OCT of the macula, can establish the cause of pain after cataract surgery. In case of severe pain, a red eye or a drop in vision, consult without delay.