Discomfort, a gritty feeling and a watering eye after cataract surgery

Yes, discomfort, a gritty feeling and a watering eye are usual after cataract surgery. Very noticeable in the first few hours, these sensations ease over the following days; they are mostly due to dryness of the surface of the eye, a dryness that can take a few weeks, sometimes up to three months, to fade. Light seems brighter and the eyes tire more quickly: this is part of the same picture. Severe pain, a sudden drop in vision or a red, painful eye, on the other hand, are not part of it: in that case, call without delay.

KEY POINTS

MECHANISMS

Why does the eye feel gritty and water after the operation?

The discomfort does not come from the implant, which cannot be felt: it comes from the surface of the eye, that is, the tear film and the cornea. Several causes add up Ghazou 2026:

• The antiseptic used in theatre. The eye is disinfected with povidone-iodine (Bétadine): essential, but irritating to the cornea;
• The corneal micro-incision. It cuts a few of the fine nerve fibres in the cornea, which for a time disturbs sensation and tear production Sutu 2016;
• The post-operative eye drops. They are essential and are put in several times a day; some contain a preservative that can make the dryness worse.

These three causes act in the same place: the tear film becomes unstable. This is exactly the mechanism described on the dry eye page, except that here it is triggered by the operation, and is most often reversible.

What is not to blame

The implant itself cannot be felt: it is placed in the capsular bag that held the natural lens, an area with no nerve endings. The incision, for its part, is very small and most often needs no stitch at all: in that case, there is no thread to remove, and nothing hard to “feel” under the eyelid. When a patient describes a foreign body, it is not the implant they are sensing: it is their own eye surface, short of tears.

DURATION

How long does the gritty feeling last?

There is no single duration: it varies from one eye to the other. Nor does the discomfort stop all at once; it fades in stages.

• The first few hours. Blurred vision, stinging, a gritty feeling and watering: this is mostly the effect of the antiseptic;
• The first few days. The discomfort clearly lessens. In studies, post-operative dryness peaks as early as the day after the operation Miura 2022;
• The first few weeks. Intermittent discomfort (at the end of the day, at a screen, in the wind) can persist. According to a meta-analysis, the dryness can last up to three months Ta 2025; improvement follows the regrowth of the corneal nerves, generally within that time Ghazou 2026;
• Beyond three months. Discomfort that persists is not inevitable: established dryness can be treated, and other causes may be added to it. It is reassessed at a consultation rather than waited out.

The phenomenon is common: in a meta-analysis of nine studies, 37.4% of patients with no dryness beforehand developed it after the operation Miura 2022. Pre-existing dryness, age and female sex increase the risk. The general course of recovery is described on the page recovery after cataract surgery.

In practice, check-ups are scheduled on day 2, then at one month, then at one year, unless there is a particular reason to do otherwise. The second eye is operated on one to two weeks after the first, and the discomfort in the first eye has generally already eased well by then. These appointments are an opportunity to describe precisely what you feel: “it itches in the evening”, “it stings when I wake up” and “it hurts all the time” do not call for the same response.

RELIEF

What helps day to day

• The artificial tears on your prescription. The hyaluronic acid gel prescribed (Hylovis or Hylocomfort) is used 3 to 6 times a day depending on the discomfort, for three months or as needed;
• Keep using all the prescribed eye drops, even if one of them stings, leaving 2 to 3 minutes between two eye drops;
• Take as much care over the technique as over the product: hands washed, head tilted back, the drop placed in the pouch of the lower eyelid, the tip of the bottle touching neither the eye nor the eyelashes;
• Do not rub or press on the eye. The shield, worn at night for seven nights, the night of the operation included, protects against movements made in sleep: how it is fitted is detailed on the page protective shield after the operation;
• Sunglasses outdoors, against light, wind and dust;
• Breaks from screens: you blink less when looking at them, and the eye dries out;
• Morning discharge is wiped away with a sterile compress and saline solution, from the inner corner, on the nose side, outwards, never with cotton wool.

What does not help

Rinsing the eye with tap water, adding on your own an eye drop bought without a prescription, in particular a “redness-relief” product that constricts the blood vessels without treating the dryness, putting eye make-up back on before ten to fourteen days, going back to the swimming pool, the sea, the sauna or the hammam before a month: all of these habits keep the discomfort going or expose the eye, and bring nothing in return. The details are on the page what not to do after cataract surgery.

TEARS

“Crying” after cataract surgery: the eye that streams, and tears of emotion

The question can mean two very different things, and both deserve an answer.

The eye that waters on its own

The paradox is a classic one: a dry eye waters. When the tear film becomes unstable, the surface of the eye sends an irritation signal, and the reflex triggers a massive production of tears. These tears arrive all at once, run down the cheek and evaporate quickly: they do not lubricate the cornea. A gritty feeling and a watering eye are therefore two faces of the same phenomenon, and that is why they are put right in the same way, with artificial tears.

This watering is most marked in the first few days, then comes back from time to time: in the wind, in the cold, at the end of the day. If it persists on its own, several weeks after the operation, with no discomfort or redness, the first cause is still dryness, which triggers reflex tearing; next come an inflamed eyelid margin or a tear duct that drains poorly. An examination tells them apart.

Crying from emotion, joy or sorrow

Yes, you can cry. Tears of emotion do not harm the operated eye and do not move the implant, which is held steady in its bag. The only risk lies in the gesture that goes with them: wiping by rubbing the eyelid, or pressing with the back of the hand. Let the tears flow, then dab the cheek with a sterile compress or a clean tissue, without pressing on the eye. The reflex of rubbing is what has to be unlearned in the first few weeks, much more than the tears themselves.

LIGHT

Sensitivity to light: why everything looks so much more vivid

The lens, once clouded by the cataract, used to filter the light and yellow the colours. It has been replaced by a clear implant: the same room suddenly looks brighter, whites whiter, blues truer. On top of that, in the first few hours, the pupil is still dilated by the eye drops given in theatre, which lets in more light than usual.

This glare eases as the brain gets used to it again, and it is all the more striking because the second eye, not yet operated on, still sees “yellow”: the comparison between the two eyes exaggerates the sensation. Until then, sunglasses outdoors are most often enough, as the page sun and holidays after cataract surgery explains. Halos and rings of light around headlights at night are a different question, linked to the type of implant fitted: see night-time halos and implants.

Sensitivity to light that gets worse instead of easing, especially if it comes with pain, redness or a drop in vision, is no longer a matter of adjustment: it should prompt a consultation, according to the guidance given below.

TIREDNESS

Tiredness after cataract surgery

The phrase “I’ve been tired since the operation”, often heard at check-ups, covers two distinct things, which have neither the same cause nor the same duration.

Visual tiredness in the first few weeks

It is common and it can be explained. Your old glasses no longer suit the operated eye. As long as the second eye has not been operated on, the two eyes no longer see the same thing, and the brain has to work to fuse two images of different sharpness and tint. The unstable tear film makes sharpness fluctuate from one blink to the next. Finally, the image is brighter than before, and this new brightness also takes time to get used to.

In practical terms, reading, looking at a screen or working remains possible as soon as it is comfortable, but in shorter stretches than usual, with breaks and adequate lighting. The prescription for new glasses waits until vision has stabilised: the timeline is detailed on the page glasses after cataract surgery. This kind of tiredness fades as the surface of the eye heals and as the correction is brought up to date.

General tiredness on the day of the operation

It is of a different order, and it is real. The day of the operation is not an ordinary day: it is better to end it quietly and not plan anything for the evening. The exact sequence of the day is explained to you before the operation.

No standard duration can be given for this tiredness: it depends on age, on the previous night’s sleep, on apprehension and on how the day went. A sick note can be issued, for a length suited to your work and discussed at the consultation. And if the tiredness settles in beyond a few weeks, or comes with other signs, it deserves to be mentioned: it is then not necessarily related to the eye.

WHEN IT LASTS

When the discomfort sets in: what we look for

Discomfort that goes beyond the first few weeks is not necessarily the same as the discomfort at the start. Several possibilities are looked into at the check-up:

• Pre-existing dryness, often unnoticed before the operation, which the surgery has revealed or made worse: this is the most common situation;
• Inflammation of the eyelid margins, which destabilises the tear film and keeps up the morning stinging;
• A poorly tolerated local treatment: stopping, reducing the frequency of or replacing an eye drop is a decision for the consultation, never something to do on your own initiative;
• Genuine pain, which is no longer discomfort: it has a page of its own, eye pain one month after cataract surgery.

In every case, what to do is decided on an examination, not on a description: the surface of the eye, the pressure and the back of the eye are all examined, and that is what distinguishes persistent dryness from a problem that calls for a different treatment.

WARNING SIGNS

Usual discomfort or warning sign: where is the line?

Usual discomfort feels gritty, stings, fluctuates through the day and improves from one week to the next. A warning sign hurts, gets worse, or affects vision.

FREQUENTLY ASKED QUESTIONS

Frequently asked questions

SOURCES

Scientific sources

1. Ta H, McCann P, Xiao M, Lien T, et al. Dry eye post-cataract surgery: a systematic review and meta-analysis. BMC Ophthalmol. 2025;25(1):18. PMID: 39806338
2. Miura M, Inomata T, Nakamura M, Sung J, et al. Prevalence and Characteristics of Dry Eye Disease After Cataract Surgery: A Systematic Review and Meta-Analysis. Ophthalmol Ther. 2022;11(4):1309-1332. PMID: 35534685
3. Ghazou A, Bowden B, Khalifa YM. Impact of Cataract Surgery Steps on Postoperative Dry Eye Disease: A Narrative Review. Semin Ophthalmol. 2026 (published online). PMID: 42623163
4. Sutu C, Fukuoka H, Afshari NA. Mechanisms and management of dry eye in cataract surgery patients. Curr Opin Ophthalmol. 2016;27(1):24-30. PMID: 26569526

FURTHER READING

Further reading

• Recovery after cataract surgery: the complete guide
• Blurred vision after cataract surgery
• Recovery after cataract surgery: how long does it take?

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 or the instructions given to you after your operation. If you are in doubt about a symptom, contact the practice or an ophthalmic emergency department.

The sensations described here are those most often reported by patients in the aftermath of cataract surgery; they are neither a diagnosis nor a prognosis for any particular eye. The durations given combine published studies, cited above, and the practice’s usual instructions; they describe averages: one eye may recover faster, another more slowly, without that meaning that anything is going wrong. Local treatments, their schedule and when to stop them are governed by the prescription given after the operation and by the scheduled check-ups; they are not to be changed on the basis of an article. Like any surgery, cataract surgery carries risks, rare but real, which are explained before the operation and looked for during follow-up. When a symptom is worrying, an examination by an ophthalmologist remains the only reliable answer.