Cataract surgery

Cataract surgery is done one eye at a time, under local anaesthetic, and you go home the same day. The surgeon breaks up the clouded lens with ultrasound, removes it, and puts a folded artificial lens in its place through the same small opening.

1. 1

   Measurements first

   Before anything is scheduled, your eye is scanned to work out the exact power of the lens you need. Get these done at the clinic that will operate, or agree in writing which measurements they will accept.
2. 2

   The operation

   It is short and you are awake, with the eye numbed and a drape over your face. You may see light and movement. Most people describe pressure rather than pain.
3. 3

   The same evening

   Vision is blurred and the eye feels gritty. You go back to where you are staying with a shield to sleep in and a schedule of drops.
4. 4

   The day after

   A check the next morning is standard. This is the appointment to fly around, not the operation itself.
5. 5

   The second eye

   If both eyes need doing, the second is usually scheduled days or weeks later rather than at the same sitting.

Four countries come up repeatedly for eye surgery, for different reasons. Distance matters more here than for most procedures, because you have a follow-up appointment the day after and a flight to plan around it.

Turkey

Istanbul and Izmir have a dense cluster of eye hospitals working at high volume, and the country is within a short flight of most of Europe and the Middle East. Accreditation and surgeon volume vary between clinics, so check both on the clinic card rather than assuming.

Mexico

For patients in the United States and Canada, Tijuana, Cancun and Mexico City are close enough to drive or take a short flight, which makes the day-after check straightforward. Many ophthalmologists there trained or are board certified in the US.

Thailand

Bangkok and Phuket handle a large volume of international patients and are set up for people who do not speak the language. The trade-off is the flight: a long haul home shortly after eye surgery needs more planning than a short one.

Colombia

Bogota and Medellin have specialist ophthalmology centres and university hospitals, and are a common choice for patients from North and South America. Altitude in Bogota is worth mentioning to your surgeon if you have other eye conditions.

Price depends on the lens, the clinic and what the quote covers. The starting price and what it is based on are shown in the summary card at the top of this page, drawn from clinic data and updated with it.

• Per eye or both. Check whether the figure is one eye or two. This is the single most common misunderstanding when people compare quotes.
• Which lens is priced. A monofocal quote and a multifocal quote are not comparable. Get the lens named in writing.
• What surrounds the operation. Scans and measurements, the surgeon's fee, the theatre, drops afterwards and the day-after check. Ask which of these are in and which are extra.
• What is never included. Flights, accommodation, and the eye tests you will need at home a few weeks later. Budget for those separately even when the package is described as all inclusive.

Surgery is considered when the cataract has begun to interfere with things you actually do, rather than at a particular point on a scan. An eye examination confirms it and rules out other causes of the same symptoms.

• Vision that is cloudy or dim. Colours look washed out, and reading needs more light than it used to.
• Glare and haloes. Oncoming headlights scatter, and night driving becomes the first thing people give up.
• Glasses that stop helping. A new prescription makes less difference than it used to, or changes more often than it should.
• Other eye conditions to rule out. Glaucoma, macular degeneration and diabetic retinopathy can cause similar symptoms and change what surgery will achieve. A full examination comes before any decision.

Most people notice a difference within a day or two, but the vision keeps settling for weeks. Knowing what is expected saves a lot of worry, and knowing what is not tells you when to call.

1. 1

   The first day

   Blurred, watery, gritty. You wear a shield to sleep and start the drops. Not the day to judge the result.
2. 2

   The first week

   Vision sharpens noticeably. No swimming, no rubbing, no dusty or dirty environments. Most people are reading and watching television normally.
3. 3

   Weeks two to six

   Focus keeps settling. Your final prescription is not measured until this has stopped, which is why you should not order new glasses immediately.
4. 4

   Call, do not wait

   Increasing pain, worsening vision, a sudden shower of floaters or flashes of light are all reasons to contact the clinic the same day, wherever you are.

Many countries let you enter visa free for a short stay or issue a visa on arrival, but some ask for a medical visa when treatment is the reason for the trip. Check the rules for your own passport with the destination's consulate, not with the clinic.

• A passport valid well beyond your trip. Six months of remaining validity is the usual requirement.
• A letter from the clinic. Naming the procedure and the dates, on clinic letterhead.
• Proof of where you are staying and how you are returning. Book flexible return travel, since your date may move by a day.
• Travel insurance that does not exclude planned treatment. Most standard policies do exclude it. Read that clause specifically.