Cataract Surgery In Cape Town & The West Coast
Dr Zoran Aleksic consults on cataract patients at his rooms in Sea Point, Cape Town, and Vredenburg on the West Coast, with surgery itself either performed at Life Peninsula Eye Hospital in Claremont or Life Peninsula West Coast Private Hospital.
What is a Cataract?
The lens inside your eye is normally clear, allowing light to pass through and focus on the retina. A cataract develops when proteins in the lens begin to clump together, clouding part of the lens and scattering light instead of focusing it. This clouding tends to develop gradually with age, though it can also be linked to factors such as diabetes or smoking. It's the most common cause of reduced vision in older adults, and most people will develop some degree of cataract if they live long enough. A cataract doesn't spread from one eye to the other, but many people develop cataracts in both eyes over time.
Common signs include blurred or cloudy vision, glare or halos around lights (especially at night), colours appearing faded, and needing brighter light to read. In the early stages, stronger lighting or an updated glasses prescription may be enough to manage symptoms; surgery becomes an option once cataracts start to interfere meaningfully with daily activities such as reading or driving.
What Cataract Surgery Involves
Cataract surgery — also known as lens extraction, lens replacement surgery, phacoemulsification, or intra-ocular lens (IOL) surgery — involves removing the eye's clouded natural lens and replacing it with a clear artificial lens implant. Through a small incision at the edge of the cornea, the surgeon breaks up the cataract using ultrasound energy (phacoemulsification) and removes it, then places a folded lens implant into the same capsule that held your natural lens, where it unfolds and stays permanently. It's a day-case procedure performed under local anaesthetic — usually eye drops or an injection around the eye, sometimes with a mild sedative if you'd like to feel more relaxed — so you're awake but the eye is numbed, and you don't need to stay in hospital overnight.
Types of lens implants
Almost everyone having cataract surgery receives a lens implant. A few different types are available, each suited to different visual needs and lifestyles:
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Monofocal lenses — a single, fixed focusing strength, usually set for distance vision; reading glasses are generally still needed for near tasks.
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Extended depth of field (EDOF) lenses — offer a wider range of clear focus than a monofocal lens, though not quite as much range as a multifocal lens.
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Multifocal lenses — different zones of the lens focus at different distances, aiming to reduce dependence on glasses for near, intermediate, and distance vision. Multifocal lenses can increase visual disturbances such as glare or halos, particularly in low light, and some patients still need reading glasses depending on their prescription and eye health. Learn more about multifocal lens surgery.
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Toric lenses — correct significant astigmatism as part of the same procedure.
There's no single lens that suits everyone — the right choice depends on your eyes, lifestyle, and preferences, and your surgeon will talk through the options, benefits, and trade-offs with you before surgery.
What Happens on the Day
You'll need to arrive at the hospital around 1.5 hours before your scheduled surgery time to allow the preoperative dilating drops to take effect. The surgery itself is quick, and most patients are ready to go home about an hour afterwards. You won't be able to drive yourself, so please arrange for someone to bring you home. An anaesthesiologist is present for all cataract procedures, even though most are done under local anaesthetic rather than general anaesthetic.
Recovery After Cataract Surgery
It's common to experience mild discomfort, light sensitivity, watery eyes, or a gritty feeling in the eye on the day of surgery — this typically settles over the following hours to days. Vision is often blurry at first and improves steadily; some double vision on the day of surgery is normal and related to the anaesthetic. You'll wear a protective eye shield, particularly while sleeping, for the first night or two to prevent accidentally rubbing or bumping the eye. A course of prescribed eye drops is used over the following weeks to support healing and reduce the risk of infection or inflammation. Most patients avoid swimming, eye makeup, and strenuous exercise for a short period after surgery while the eye heals. Many people also notice colours appearing brighter than before, simply because the natural lens was clouding them beforehand — this can take a few days to get used to, and sunglasses can help in the meantime.
Follow-Up Care and When to Seek Help
The first follow-up appointment at our rooms is included as part of your surgery. Healing varies from person to person, so if you experience pain, a sudden change in vision, or symptoms such as significant redness, discharge, or flashing lights, please contact us straight away rather than waiting for your next scheduled visit.
Considering Cataract Surgery
In the earlier stages, an updated glasses prescription may still help, but once a cataract is advanced enough, glasses can no longer fully compensate and surgery becomes the only way to restore clear vision. Cataracts typically progress slowly, and delaying surgery doesn't put your vision at sudden risk — but as the cataract develops further, vision will keep declining until surgery is done. Cataract surgery itself is one of the most commonly performed and well-established eye procedures, but as with any surgery, it carries some risk, and your surgeon will talk you through the expected benefits, possible complications, and your options as part of your consultation, so you can make an informed decision together. Before surgery, it also helps your surgeon to know about any previous eye surgery, all medications and supplements you're taking, any allergies, and anything that might make lying still for the procedure difficult.
Medical Aid and Cost
Cataract surgery is not automatically covered in full by medical aid, and cover varies from scheme to scheme. We recommend confirming your benefits, any waiting periods, and your expected reimbursement rate with your scheme ahead of time. Our rooms can provide a cost estimate for you to submit for pre-authorisation, and full details of our billing terms are available on request.
Frequently Asked Questions
Is cataract surgery painful?
No. The procedure is done under local anaesthetic, so the eye is numbed throughout. Most patients feel little more than mild pressure, and any discomfort afterwards is usually minor and manageable with simple painkillers.
How long does cataract surgery take, and how long is the recovery?
The operation itself takes about 25 minutes per eye. Vision often starts to clear within a day, though it can take a little longer in some cases, and most people are back to normal daily activities within a few days while continuing their prescribed eye drops.
Will I still need glasses after cataract surgery?
It depends on the type of lens implant chosen and your eyes beforehand. Monofocal lenses typically still require reading glasses, while multifocal or extended depth of field lenses aim to reduce — though not always fully remove — the need for glasses at different distances. Your surgeon will discuss what to expect based on your chosen lens.
Is cataract surgery covered by medical aid?
Medical aid schemes differ in how they cover cataract surgery, and having medical aid doesn't guarantee full cover. It's best to confirm your specific benefits, any shortfall, and pre-authorisation requirements with your scheme before your procedure. Our rooms can assist you with this.
What happens if I choose not to have surgery?
Cataracts usually progress slowly, so a delay doesn't put your vision at sudden risk. However, vision will continue to decline gradually as the cataract develops, and surgery remains the only way to restore it once glasses can no longer help.
Are cataracts only found in older people?
Most cataracts develop slowly with age and are most common in people over 50. Congenital cataracts in infants do occur but are rare, and are usually linked to infections during pregnancy or an inherited condition.
Will cataract surgery always give me perfect vision?
Cataract surgery is generally safe and effective, but even without any surgical complications, a small degree of residual refractive error is possible, and no outcome can be guaranteed. Other age-related conditions, such as macular degeneration or diabetic retinopathy, can also affect your final vision independently of the cataract surgery itself.
Can I reduce my need for glasses at the same time as having cataract surgery?
For suitable candidates, multifocal or extended depth of field lens implants can meaningfully reduce dependence on glasses for near, intermediate, and distance vision, though they don't remove the need for glasses entirely in every case. Whether this option suits you depends on your eyes and lifestyle, and can be assessed during a consultation.
What is a "secondary cataract," and can it happen after surgery?
Months or years after cataract surgery, the part of the lens capsule left in place to support the implant can sometimes become hazy, causing vision to blur again — this is known as posterior capsular opacification, or a "secondary cataract." It's usually treated quickly and effectively with a short outpatient procedure called YAG laser capsulotomy. We perform YAG laser at our laser clinic in Claremont.
How long should I stay in Cape Town after my cataract surgery?
Because eye surgery requires close monitoring during the healing process, Dr Zoran Aleksic asks that all patients remain within the Cape Metro area for at least two weeks following each procedure. This allows for timely access to the follow-up appointments needed to check on healing, monitor eye pressure, and catch any early signs of complications before they become serious. Follow-up visits are typically scheduled within the first 24 to 48 hours after surgery, with further checks over the following one to two weeks depending on the procedure performed and how the eye is healing. Patients who live outside the Cape Metro area, or who are visiting from elsewhere in South Africa or abroad, should plan their travel accordingly and arrange local accommodation for this period. This precaution is a standard part of safe surgical aftercare, ensuring that any issues can be identified and treated promptly, rather than a general restriction on travel. Patients are welcome to discuss their specific travel plans with the practice ahead of surgery so that a suitable follow-up schedule can be arranged.
