There’s no question that the COVID-19 pandemic transformed every corner of healthcare—and cataract surgery was no exception. From the way patients were triaged, to the use of personal protective equipment, to the rise of telemedicine, the entire surgical experience was reshaped almost overnight. But now, years on from the height of the crisis, which of those changes have stuck around? And more importantly—have they made things better?
If you’re a patient preparing for cataract surgery or a clinician navigating today’s protocols, understanding these lasting shifts isn’t just useful—it’s essential. So, let’s walk through exactly how the pandemic altered cataract care, what improvements have been retained, and where things might go next.
The Pre-Pandemic Cataract Surgery Landscape
Before COVID-19, cataract surgery in the UK followed a well-established routine. Patients would often have multiple in-person appointments before and after surgery—typically including biometry, pre-assessment clinics, post-op checks, and discussions about intraocular lens options. Waiting rooms were full. Patient pathways were fairly standardised but not particularly streamlined.
Surgeons would usually work with large surgical teams. Patients could bring companions into clinics. And infection prevention was focused primarily on ophthalmic risks—not respiratory ones. It was efficient, but not necessarily agile.
This all changed in 2020 when the NHS (and private centres too) were forced to rethink every step of the cataract care journey.
The Initial Disruption: Lockdowns and Surgery Cancellations
When the UK first went into lockdown in March 2020, all elective surgeries—including cataracts—were put on hold. It wasn’t just about freeing up hospital beds; it was also about minimising unnecessary patient contact. Cataract surgery might not be life-saving, but it’s life-enhancing—and that meant it had to wait.
The backlog that formed during this time was unprecedented. Patients reported rapidly worsening vision, lost independence, and increased fall risk. For clinicians, the need to adapt quickly became urgent.
Hospitals and private clinics responded with protocol overhauls—some temporary, but many now permanent.
Lasting Infection Control Measures
Universal Mask-Wearing and PPE Protocols
Pre-COVID, it wasn’t standard for all patients or staff to wear masks during ophthalmic procedures. That changed rapidly. Now, while community-wide masking may have relaxed, in many surgical settings—particularly ophthalmology—masks remain commonplace for both clinicians and patients.
Why? Close face-to-face proximity is routine in cataract surgery. From slit-lamp exams to biometry, there’s often just centimetres between patient and provider. So, although the risk of COVID transmission has decreased, the mask protocol remains a precaution that many clinics feel is worth maintaining—especially during flu season.
Gloves, gowns, and eye protection for staff have also been normalised. Many theatre teams continue to follow enhanced PPE checklists that were introduced during the pandemic.
Enhanced Cleaning Protocols
Disinfection was always important, but COVID ramped it up. Surfaces in waiting areas, diagnostic rooms, and theatres began to be cleaned more frequently with virucidal agents. These practices are largely still in place, especially in higher-risk zones.
What’s more, clinics now tend to schedule additional time between patients for cleaning—something that’s improved overall infection control but also affects capacity.
Streamlined Pre-Operative Assessments
Reduced In-Person Appointments
One of the major realisations during the pandemic was that not every single appointment had to be in-person. Clinics introduced “one-stop” assessment models, where patients could undergo all pre-op investigations, consent discussions, and measurements in a single visit.
This approach wasn’t just safer—it was more efficient. For elderly patients who might struggle with transport or mobility, cutting down on multiple trips to the clinic made a huge difference.
Today, many clinics have retained this streamlined model. It has shortened the patient journey and improved overall satisfaction—without compromising outcomes.
Remote Consultations for Suitable Cases
COVID also fast-tracked the adoption of telemedicine. While you can’t perform biometry or a slit-lamp exam over the phone, certain parts of the process—like initial consultations or post-op check-ins—have moved online.
Patients appreciate the flexibility, and clinics have noted improvements in time management. Especially for straightforward cases or follow-ups after uncomplicated surgery, virtual appointments now have a lasting role.
Theatre Protocols That Have Persisted
Modified Patient Flow and Theatre Access
To reduce congregation in waiting areas, many cataract services introduced staggered appointment times and separate patient flow zones. Instead of large numbers of patients arriving simultaneously, schedules became more tightly controlled.
This not only limited potential exposure during the pandemic—it’s also made theatre days more predictable. Many operating lists now run with better pacing and fewer bottlenecks. The result? Greater consistency in outcomes, fewer delays, and more pleasant experiences for patients and staff alike.
“See and Treat” Approaches
In certain urgent cataract cases, especially in high-risk patients or those who couldn’t easily travel, a “see and treat” model was adopted. Patients would have their assessment and surgery on the same day.
While this isn’t suitable for everyone, some private centres have continued to offer it selectively. It’s particularly helpful for patients travelling long distances or for those with significant anxiety around multiple appointments.
Cataract Backlogs: A Problem That Still Persists
Despite all the improvements, one major problem triggered by the pandemic still lingers: the backlog. NHS waiting lists for cataract surgery remain long, with many patients facing months of delay.
This has prompted increased interest in private cataract surgery. Clinics like the London Cataract Centre have seen a rise in self-referrals, especially among those struggling to function due to poor vision. For patients who can’t wait, private care offers not just faster access—but also greater choice in lenses and surgical options.
That said, both NHS and private services continue to innovate to address this backlog. Some trusts have introduced weekend operating lists, mobile cataract units, or regional surgical hubs to handle volume more effectively.
The Role of Technology in a Post-COVID Cataract World
Digital Patient Education and Consent
COVID forced clinicians to rethink how they delivered information. In-person seminars or long clinic explanations were replaced with digital consent forms, explainer videos, and email-based patient packs.
Interestingly, many patients preferred this format. It allowed them to digest complex information at their own pace, often with family members present at home.
Many centres have retained this digital-first approach. It improves compliance, reduces appointment duration, and offers a more flexible patient experience.
Online Booking and Pre-Op Questionnaires
Another change that stuck? Digital pre-assessment questionnaires. Rather than filling out paperwork on arrival, patients now complete online forms ahead of time, often via secure portals.
This speeds up the in-clinic process and allows staff to triage patients more effectively before they even arrive.
Lasting Cultural Shifts Among Staff and Patients
Heightened Awareness of Infection Risk
Even as the world moves beyond pandemic mode, the legacy of heightened infection awareness has stayed. Staff are quicker to call in sick. Patients are more likely to notify clinics of symptoms. And flexible rebooking policies—once a rarity—are now routine.
In a surgical setting where the stakes are high, this cultural shift has arguably made cataract services safer overall.
Greater Emphasis on Patient Independence
The pandemic also sparked a broader recognition of just how debilitating untreated cataracts can be. Many older adults who were unable to drive or navigate stairs safely during lockdown came to appreciate the link between vision and independence in a whole new way.
Clinics now take a more holistic view of patient goals—not just aiming for 20/20, but understanding what vision outcomes mean for lifestyle, confidence, and mobility.
What Didn’t Stay: Protocols That Have Faded
Not every pandemic-era change has endured. Universal COVID screening before surgery, for example, has largely been dropped in most cataract settings, unless patients are symptomatic or high-risk.
Likewise, temperature checks at the door and plastic barriers in clinics have mostly disappeared. While these were necessary during peak transmission periods, they’re no longer seen as cost-effective or necessary under current risk levels.
Some clinics have also resumed allowing family members to accompany patients—something that was restricted during the pandemic but plays a big role in patient comfort, especially for older adults.
Rebuilding Trust in Surgical Care After COVID-19
One of the quieter—but no less significant—shifts after the pandemic has been a renewed focus on rebuilding patient trust. During COVID, many people grew wary of hospitals and clinics—not out of scepticism, but due to fear of exposure, uncertainty, or disrupted care. In ophthalmology, where patients are often older and medically vulnerable, that fear ran especially deep.
Now, cataract services are not just about restoring vision—they’re about restoring confidence. Clinics have made concerted efforts to communicate clearly, manage expectations, and provide reassurance around cleanliness, efficiency, and safety. From more user-friendly websites to clearer follow-up instructions, the whole patient experience has become more transparent and supportive.
That shift has had a lasting impact. Patients are more engaged in their care, more aware of their options, and more likely to ask questions. And that engagement leads to better outcomes—not just surgically, but emotionally. After all, cataract surgery isn’t just a procedure. It’s a turning point in a person’s quality of life. And rebuilding that trust means patients can walk into theatre feeling prepared—not just protected.
Frequently Asked Questions (FAQs)
- Do I still need to wear a mask during cataract surgery appointments?
In most clinics, yes—but it depends on the setting. While general public mask mandates have relaxed, many cataract surgery units still ask patients to wear a mask, especially in diagnostic rooms or during close face-to-face procedures like slit-lamp exams. It’s a simple measure that helps protect vulnerable patients and reduces the spread of respiratory infections, particularly during flu season or if COVID-19 cases are rising locally.
That said, if you’re exempt or have difficulty wearing a mask, let the clinic know in advance. Most teams are happy to accommodate individual needs while still maintaining safety for everyone. - Are telemedicine appointments still used for cataract care?
Absolutely, and in fact, they’ve become a really valuable part of cataract care. While some assessments—like eye scans or biometry—must still be done in person, things like initial consultations, consent discussions, and post-op follow-ups can often be done remotely. It saves you time, reduces travel, and keeps clinic visits short and focused.
If you’re unsure whether your appointment can be done remotely, just ask. Clinics are generally keen to offer flexible options where possible. - Has the way cataract surgery is scheduled changed since COVID-19?
Yes, significantly. Many clinics now stagger appointment times to avoid crowding, and the days of overbooked waiting rooms are largely behind us. Some centres have even adopted “see and treat” models, especially in urgent or straightforward cases—meaning you might be assessed and have surgery on the same day.
These changes were brought in for safety during the pandemic, but they’ve actually improved efficiency and patient satisfaction, so many clinics have kept them in place. - Can I bring someone with me to my surgery appointment now?
In most cases, yes. During the height of the pandemic, visitors and companions were often restricted from coming into clinics or surgical centres. But now that infection control measures have evolved, many clinics have relaxed those rules—especially for patients who are anxious, elderly, or have mobility issues.
Just check with your provider in advance. Some hospitals may still have limits depending on space or local guidance, but in general, companion attendance is back on the table. - Are cataract surgery backlogs still an issue?
Unfortunately, yes—especially in the NHS. The pandemic caused widespread cancellations of elective surgeries, and cataracts were high on that list. Although services have resumed and improved in many ways, the backlog built up during COVID is still being cleared.
If you’re waiting a long time and your vision is affecting your quality of life, you might want to consider private cataract surgery for faster access and more choice in treatment. - Is cataract surgery safer now because of the pandemic changes?
In many ways, yes. The enhanced hygiene protocols, streamlined patient pathways, and increased use of pre-assessment tools have all contributed to a cleaner, more efficient process. The changes made during COVID weren’t just temporary fixes—they’ve often become permanent improvements in how surgery is delivered.
Plus, there’s now more awareness about infection risks in general. Patients and staff are more cautious, which helps reduce the spread of all types of illnesses, not just COVID-19. - What happens if I feel unwell before my cataract surgery?
If you have symptoms of a cold, flu, or COVID—even mild ones—it’s best to contact your clinic as soon as possible. Most centres have adopted flexible rebooking policies, so you won’t be penalised for rescheduling if you’re unwell.
The key is early communication. Letting your surgical team know gives them time to adjust schedules, protect other patients, and ensure you receive surgery when you’re feeling your best.
Final Thoughts: A More Streamlined, Patient-Centric Future
So, what has COVID-19 really done to cataract surgery protocols in the long term?
It’s made them sharper. More efficient. More considerate of patient needs.
While the urgency of the pandemic forced rapid changes, the healthcare sector—particularly in ophthalmology—has taken the opportunity to retain what worked and let go of what didn’t. We’re seeing fewer unnecessary visits, faster pathways, and better use of digital tools.
If you’re considering cataract surgery now, you’re stepping into a system that’s arguably more patient-friendly than it’s ever been. One where safety, speed, and satisfaction can coexist—thanks in large part to lessons learned during the most challenging health crisis of our generation.
References
- Alegría, J.P., Vogel, N., Marcus, N. et al. (2022) Impacts of the COVID‑19 pandemic on elective cataract surgeries, PLoS ONE, 17(4), e0266217. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9071257/ (Accessed: 12 June 2025).
- Lin, X., Patel, A., and Wang, S. (2020) ‘The impact of COVID‑19 pandemic on ophthalmology services: triage, backlog and emerging practices’, Frontiers in Medicine, 7, 625482. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7685677/ (Accessed: 12 June 2025).
- Royal College of Ophthalmologists (2020) Restarting and Redesigning Cataract Pathways in response to the COVID-19 pandemic. Available at: https://www.rcophth.ac.uk/resources-listing/restarting-and-redesigning-of-cataract-pathways-in-response-to-the-covid-19-pandemic/ (Accessed: 12 June 2025).