What Is a Cataract?
A cataract is a clouding of the eye's natural lens, which sits just behind the iris and pupil. The lens is normally clear, focusing light precisely onto the retina so you can see sharp images. With age — or as a result of certain medications, medical conditions, or eye injuries — proteins in the lens begin to clump together, causing the lens to become progressively opaque.
Cataracts are extremely common. By age 80, more than 90% of Canadians have a cataract of some degree. They are the leading cause of reversible visual impairment worldwide, and cataract surgery is the most frequently performed elective surgical procedure in Canada.
Cataracts typically develop gradually over months to years, and early changes may be managed simply by updating your glasses prescription. However, once visual impairment begins to affect daily function, surgery becomes the only effective treatment — there are no drops, medications, or dietary interventions that can reverse an established cataract.
Symptoms: When Should You Consider Surgery?
Many patients with early cataracts are unaware of any problem. As the cataract matures, you may notice one or more of the following:
- Blurry, hazy, or dim vision that glasses cannot fully correct
- Difficulty driving at night due to glare, halos, or starbursts around lights
- Fading or yellowing of colours
- Double vision in one eye
- Frequent changes in your glasses or contact lens prescription
- Increased sensitivity to bright light and glare
- Difficulty reading fine print, even with reading glasses
Surgery is generally recommended when cataracts interfere with your quality of life or ability to carry out routine activities safely — for example, when you can no longer pass the visual acuity standard for driving, or when reading, recognizing faces, or watching television has become significantly impaired.
How Cataract Surgery Works
Modern cataract surgery is a minimally invasive, highly predictable procedure. Dr. Sundaram uses phacoemulsification — the current gold standard — in which a small ultrasonic probe is inserted through a self-sealing micro-incision of approximately 2.2–2.4 mm. The probe emits ultrasonic energy that breaks up the cloudy lens into tiny fragments, which are then gently suctioned out of the eye.
Once the natural lens is removed, a clear artificial intraocular lens (IOL) is folded and inserted through the same small incision, where it unfolds and positions itself permanently inside the eye's natural lens capsule. No sutures are typically required because the incision is self-sealing.
Pre-Operative Assessment
Biometry, keratometry, and optical coherence measurements are performed to select the correct IOL power for your eye, aiming to optimize your post-operative refraction.
Day of Surgery
The procedure takes 15–20 minutes per eye and is performed under topical (eye drop) anesthesia as day surgery. You will be awake but relaxed. Most patients feel little to no discomfort.
Discharge & Eye Drops
You go home the same day, typically 1–2 hours after surgery. Prescription anti-inflammatory and antibiotic eye drops are used for 4–6 weeks post-operatively.
Follow-Up Visits
A post-operative check occurs the next day, at one week, and at one month. Once fully healed, your optometrist will update your glasses prescription if needed.
MSP Coverage & Premium Lens Options
BC's Medical Services Plan covers the surgeon's fee, anesthesia, and a standard monofocal IOL for patients with visually significant cataracts. A monofocal lens corrects vision at one focal point — typically distance — meaning most patients still require reading glasses for near work after surgery. There are no out-of-pocket costs for the standard procedure.
For patients who wish to reduce their dependence on glasses, Dr. Sundaram offers several premium lens options. These are patient-paid upgrades above the MSP standard:
| Lens Type | Best For | Coverage |
|---|---|---|
| Monofocal IOL | Distance vision; reading glasses still needed | MSP Covered |
| Toric IOL | Patients with pre-existing astigmatism | Patient-Paid Upgrade |
| Multifocal IOL | Distance and near vision; reduce glasses dependence | Patient-Paid Upgrade |
| Extended Depth of Focus (EDOF) | Extended range of vision; fewer halos than multifocal | Patient-Paid Upgrade |
Not all premium lenses are appropriate for every eye. Dr. Sundaram will review your pre-operative measurements, lifestyle, and visual goals to help you make an informed choice. Patients with significant pre-existing retinal disease, irregular corneas, or extreme refractive errors may have a limited range of suitable options.
Recovery: What to Expect After Surgery
Most patients are pleasantly surprised by how quickly their vision improves. Here is a general timeline:
- 24–48 hours: Many patients notice noticeably brighter, clearer vision. Some initial blurring, mild grittiness, or light sensitivity is normal.
- First week: Avoid rubbing the eye, swimming, hot tubs, and dusty environments. Wear the provided eye shield while sleeping. Use your prescribed eye drops as directed.
- 2–4 weeks: Strenuous exercise, heavy lifting, and activities that increase eye pressure should be avoided. Vision typically stabilizes within this window.
- 4–6 weeks: Most activity restrictions are lifted. Your optometrist can update your glasses prescription once the eye has fully healed.
Posterior Capsule Opacification (PCO): Months to years after surgery, some patients develop a haze on the membrane behind the IOL. This is treated quickly and painlessly in the office with a YAG laser capsulotomy — a five-minute procedure covered by MSP.
Why Choose Dr. Sundaram
Dr. Aish Sundaram is a fellowship-trained ophthalmologist with specialized expertise in cataract surgery and anterior segment disease. She completed her ophthalmology residency at Dalhousie University and holds the designation of Fellow of the Royal College of Surgeons of Canada (FRCSC). She serves as a Clinical Instructor in the UBC Department of Ophthalmology, contributing to the education of the next generation of Canadian ophthalmologists.
Dr. Sundaram is known for her patient-first approach — she takes the time to explain the surgery, the lens options, and what to expect, so that patients feel confident and prepared. Her practice serves Abbotsford, Chilliwack, Mission, Langley, Hope, and surrounding Fraser Valley communities.
Referrals are accepted from family physicians, general practitioners, internists, and optometrists. Most patients are seen within clinically appropriate timeframes.
Frequently Asked Questions — Cataract Surgery
Yes. Standard cataract surgery using a monofocal intraocular lens is fully covered by BC's Medical Services Plan when the surgery is medically indicated. There are no out-of-pocket costs for the standard procedure. Premium lens upgrades — toric, multifocal, or extended depth-of-focus IOLs — involve an additional patient-paid fee above the MSP standard.
The surgical procedure itself takes approximately 15 to 20 minutes per eye. However, you should plan to be at the day-surgery facility for 2 to 3 hours to account for pre-operative preparation, sedation checks, and post-operative monitoring before discharge.
Your family physician or optometrist can send a referral directly to Dr. Sundaram's office. Once received, our team will contact you to schedule a pre-operative consultation. If your optometrist has confirmed visually significant cataracts, please ask them to include their clinical records and biometry measurements with the referral.
Yes. Beyond the MSP-covered monofocal lens, Dr. Sundaram offers toric, multifocal, and extended depth-of-focus (EDOF) IOLs. These are patient-paid upgrades. Dr. Sundaram will review which options suit your eye anatomy, lifestyle, and visual goals during your pre-operative consultation and help you make an informed decision.
Most patients notice improved vision within 24 to 48 hours. You will use prescription eye drops for 4 to 6 weeks. Avoid rubbing the eye, swimming, and strenuous activity for the first two weeks. Driving is typically permitted once your vision meets the legal standard. A follow-up appointment is scheduled the next day, at one week, and at one month.
Surgery is generally recommended when cataracts cause functional difficulty — problems with driving, reading, recognizing faces, or performing daily activities — and when glasses can no longer adequately correct your vision. During your consultation, Dr. Sundaram will assess your cataract density and your functional visual needs to determine whether surgery is appropriate and timely.
With a standard monofocal IOL targeted for distance, most patients still need reading glasses. Premium multifocal or EDOF lenses aim to reduce this dependence, though some patients may still require low-power glasses for fine print in dim lighting. Your lens choice and expected visual outcome are discussed in detail during your pre-operative consultation.
Cataract surgery is one of the safest and most frequently performed surgical procedures in Canada. The vast majority of patients achieve improved vision with no serious complications. Small risks include infection, inflammation, retinal detachment, and posterior capsule opacification — a common, treatable cloudiness that can develop later and is easily corrected with a quick in-office YAG laser treatment. Dr. Sundaram reviews all risks and benefits with you before surgery.