What to Expect from Cataract Surgery in Abbotsford, BC

If your family doctor or optometrist has recently raised the possibility of cataract surgery, you probably have many questions. What exactly is done? Will it hurt? How long does recovery take? And — one of the most common questions from Fraser Valley patients — is it covered by MSP? This guide answers all of those questions in plain language, drawing on current ophthalmological practice in British Columbia. It is intended to complement, not replace, the personalised advice you'll receive from Dr. Sundaram at your consultation.

What Is Cataract Surgery?

The lens of the eye sits just behind the pupil and is responsible for focusing light onto the retina. In a healthy eye, it is clear. As we age — and sometimes due to diabetes, certain medications, or previous eye injury — proteins within the lens begin to clump together and lose their transparency. This clouding is called a cataract. The result is progressively blurred, hazy, or dim vision that cannot be corrected with glasses or contact lenses.

Cataract surgery involves removing the clouded natural lens and replacing it with an artificial intraocular lens (IOL) that restores clear vision. It is the most commonly performed surgical procedure in Canada and has an excellent safety record. The technique used today — called phacoemulsification — uses ultrasound energy to gently break up the cataract into tiny fragments, which are then aspirated from the eye through a very small incision. An artificial lens is then folded and inserted through the same opening, where it unfolds and settles into position. No stitches are typically required.

Am I a Candidate?

The decision to proceed with cataract surgery is not based solely on how a cataract looks on examination — it depends on how much it is affecting your vision and daily life. Common symptoms that indicate cataract surgery may be appropriate include:

• Blurred or hazy vision that cannot be corrected with new glasses
• Difficulty reading, driving (especially at night), or watching television
• Increased sensitivity to bright lights or glare — particularly from oncoming headlights
• Faded or yellowed colour perception
• Frequent changes to your glasses prescription without lasting improvement
• "Second sight" — a temporary improvement in near vision due to the lens swelling, which is often a sign of a progressing cataract

MSP covers cataract surgery when the cataract is clinically significant and impairing your ability to perform daily activities. Your ophthalmologist will document visual acuity, contrast sensitivity, and your reported functional impairment as part of the pre-approval process.

Getting a Referral in BC

In British Columbia, ophthalmologists are specialist physicians and require a referral from a family doctor (GP) or optometrist before you can be seen. This is true for all publicly funded specialist consultations in the province.

If you suspect you have cataracts, the most straightforward path is to:

1. Describe your visual symptoms specifically to your GP or optometrist — blurred vision, difficulty with night driving, glare sensitivity
2. Ask them to perform or review visual acuity testing and, if relevant, a dilated eye exam
3. Request a referral to an ophthalmologist if they confirm a visually significant cataract

Your GP can refer you to Dr. Sundaram's practice in Abbotsford or Chilliwack by fax or through the Ocean Health eReferral platform. The referral should include your visual acuity, a brief clinical history, current medications (especially blood thinners), and any other ocular conditions. Clear, complete referrals are prioritised and help ensure you're seen in a timely manner. For information on what to include, see our For Physicians page.

Your Pre-Operative Assessment

Before surgery is scheduled, you will attend a pre-operative assessment appointment with Dr. Sundaram's team. This is one of the most important appointments in the process — it determines the exact measurements needed to select the correct power of intraocular lens for your eye.

During this visit, you can expect:

• Biometry: Precise measurements of the length of your eye (axial length), curvature of the cornea, and anterior chamber depth are taken using a laser-based device. These measurements are used to calculate the IOL power that will give you the best possible post-operative vision.
• Visual acuity testing: Both uncorrected and best corrected vision will be formally documented.
• Slit-lamp examination: Dr. Sundaram will examine the front and back of your eye under high magnification to assess the density of the cataract and check for any other ocular conditions (such as macular degeneration or glaucoma) that may affect your vision outcome after surgery.
• IOL discussion: You will discuss the different types of intraocular lenses available and which may be best suited to your visual goals and lifestyle. This is the appropriate time to ask whether a premium lens upgrade is right for you.
• Health review: Your general health history and current medications will be reviewed. If you take blood thinners, you will receive specific guidance on whether and when to hold them.

Surgery Day: Step by Step

Knowing exactly what to expect on the day of your surgery reduces anxiety and helps the procedure go smoothly. Here is a step-by-step walkthrough:

1. Arrival and check-in: Arrive at the surgical facility at the scheduled time, usually 60–90 minutes before your procedure. Bring a responsible adult who can drive you home — you will not be permitted to drive on the day of surgery.
2. Eye drop preparation: A nurse will instil a series of dilating drops into your eye. These widen the pupil and are necessary for the surgeon to access the lens. This process takes 20–30 minutes and your vision will be blurry while the drops are working.
3. Anesthesia: Cataract surgery is performed under local anaesthesia — you do not require general anaesthesia. Anaesthetic drops numb the surface of the eye, and in some cases a small injection of local anaesthetic is given around the eye. You will be awake throughout the procedure but should feel no pain. Mild sedation is available if anxiety is a concern.
4. The surgery: You will lie on an operating table and Dr. Sundaram will work under a microscope. A speculum gently holds the eyelid open. The phacoemulsification probe is inserted through a small incision (approximately 2.4–2.8 mm). The cataract is emulsified and removed, and the IOL is inserted and positioned. The incision is self-sealing — no sutures are typically needed. The procedure takes approximately 15–20 minutes.
5. Recovery and discharge: After a brief rest period in the recovery area, you will receive a protective shield for your eye and written post-operative instructions, including your eye drop schedule. Most patients go home the same day within a few hours of arriving.

Choosing Your Lens

The intraocular lens (IOL) that replaces your natural lens is a permanent implant, so understanding your options before surgery is important. Lenses fall into three broad categories:

Monofocal IOL (MSP-Covered)

The standard monofocal lens corrects vision at a single focal distance — typically distance vision. Most patients still require reading glasses for near tasks. This lens is fully covered by BC MSP and is the lens used in the vast majority of cataract surgeries. For many patients with mild pre-existing astigmatism, this lens provides excellent distance vision with glasses for reading.

Toric IOL (Premium Upgrade)

For patients with significant corneal astigmatism, a toric IOL corrects astigmatism at the same time as the cataract. This results in sharper distance vision without the distortion that astigmatism causes. Toric lenses carry an additional cost, typically in the range of several hundred to over a thousand dollars per eye, paid privately. The precise amount varies and will be discussed at your consultation.

Multifocal / Extended-Depth-of-Focus (EDOF) IOL (Premium Upgrade)

These advanced lenses are designed to provide useful vision at multiple distances — distance, intermediate (computer), and sometimes near — reducing dependence on glasses. They involve an additional private fee and are not appropriate for every patient. Suitability depends on your corneal health, pupil characteristics, and visual expectations. Some patients experience increased halos or glare with multifocal lenses, which typically diminish over months as the brain adapts.

Recovery: The First Week and Beyond

Cataract surgery recovery is generally straightforward, but careful attention to your post-operative instructions makes a significant difference to your outcome.

The First 24–48 Hours

It is normal for vision to be blurry, watery, or slightly hazy in the first day or two after surgery. You may notice the eye appears red or feels gritty or mildly uncomfortable — this is expected. Wear the protective shield as instructed, especially while sleeping. You will be prescribed antibiotic and anti-inflammatory eye drops; administer these exactly as directed.

The First Week

Most patients notice significant improvement in vision within the first week. Activities to avoid in the early recovery period include:

• Swimming and hot tubs (avoid for at least four weeks post-surgery)
• Rubbing or pressing on the eye
• Strenuous exercise or heavy lifting for one to two weeks
• Dusty or dirty environments
• Driving until cleared by your surgeon at your post-operative visit

Follow-Up Appointments

You will typically have a follow-up appointment the day after surgery, and again at one week and four to six weeks post-operatively. These visits allow Dr. Sundaram to confirm the eye is healing well, check pressure, and assess your visual outcome. If you experience sudden vision loss, increasing pain, or significant redness at any point after surgery, contact our office immediately or go to an emergency department.

When to Expect Final Vision

Most patients reach their final visual outcome within four to six weeks of surgery. A new glasses prescription should not be written until vision has stabilised, typically at the six-week post-operative visit.