Cataract surgery is one of the safest and most frequently performed operations in the UK, with thousands of people regaining clear vision every year. Yet, like any surgical procedure, it’s not completely without risk. Sometimes, a complication occurs — and understandably, patients wonder whether what happened was simply one of those unfortunate but recognised risks, or whether it points to medical negligence.
So, when does a complication actually become a claim? The answer lies in understanding how “duty of care” works, what the law considers a reasonable standard of practice, and the crucial difference between an accepted risk and a preventable error. Let’s go through this step by step in plain terms.
Understanding Cataract Surgery and Its Risks
Cataract surgery involves removing the eye’s cloudy natural lens and replacing it with a clear artificial one called an intraocular lens. The entire procedure is usually completed under local anaesthetic in about 15 to 30 minutes, and most patients go home the same day.
The vast majority of surgeries go smoothly and result in dramatically improved vision. However, as with all operations, complications can occur even when the surgeon does everything correctly. These can include swelling at the back of the eye (known as cystoid macular oedema), infection, bleeding inside the eye, or posterior capsule rupture — where the thin membrane behind the lens tears during surgery. There can also be refractive surprises, meaning you might still need glasses after surgery, despite a technically good outcome.
It’s important to remember that such issues don’t necessarily indicate negligence. These are recognised surgical risks that occur in a small percentage of cases, and most are manageable with prompt treatment. Negligence, on the other hand, involves a clear failure to meet the professional standard of care.
What “Duty of Care” Means in Cataract Surgery
In the UK, all healthcare professionals — whether working in the NHS or privately — owe their patients what’s known as a duty of care. This means they must take reasonable steps to provide safe and competent treatment throughout every stage of your care: assessment, surgery, and aftercare.
For cataract surgery, this duty begins from the moment your suitability for surgery is assessed. The surgeon must explain the potential risks, benefits, and alternatives to help you make an informed decision — a process known as informed consent. This duty was clarified in the landmark Montgomery v Lanarkshire Health Board case, which made it clear that doctors must inform patients about any risks that might be significant to them personally, not just those considered significant by medical professionals.
The duty continues during surgery itself, where the surgeon must perform the operation with the skill and care expected of a reasonably competent ophthalmic surgeon. It also extends into the postoperative period, ensuring that appropriate checks are done and any complications are managed promptly and correctly.
When any of these elements are overlooked — for example, if risks aren’t properly discussed, the wrong lens is implanted, or aftercare is neglected — that’s when questions about negligence can arise.
Recognised Risks vs Negligence
The key distinction between a surgical complication and negligence lies in whether the care fell below an acceptable professional standard.
If your surgery was performed correctly, you were fully informed of the potential risks, and you still developed a complication such as swelling or mild infection, that’s usually classed as a recognised surgical risk. These events can happen even with excellent care.
Negligence, on the other hand, involves a breach of duty — meaning something was done (or not done) that a reasonably competent surgeon wouldn’t have done in the same situation. For example, failing to sterilise instruments properly, operating on the wrong eye, implanting an incorrect lens power, or missing early signs of infection that later led to vision loss.
It’s also essential to prove causation. Even if a breach of duty is identified, it must be shown that the breach directly caused harm that otherwise would not have occurred. If the outcome would have been the same even with perfect care, the legal test for negligence isn’t met.
So while it’s natural to feel upset when a complication arises, it’s equally important to understand that not every unfavourable result is due to negligence.
Common Cataract Complications: When to Worry
Complications after cataract surgery range from minor and temporary to rare but serious. Knowing which category yours might fall into helps clarify whether it’s part of the normal risk spectrum or something more concerning.
Typical, accepted risks include mild discomfort, temporary blurred vision, light sensitivity, inflammation, and posterior capsule opacification — where the membrane behind the new lens becomes cloudy months later and needs a quick laser treatment (YAG capsulotomy). These are normal, well-documented occurrences that can usually be managed easily.
However, complications that may point to substandard care include implanting the wrong intraocular lens, failing to act promptly when a patient reports severe pain or vision loss, not diagnosing infection early enough, or neglecting follow-up after a complex surgery.
For example, if signs of infection such as endophthalmitis were present but ignored for several days, resulting in permanent vision loss, that could be considered negligent because timely intervention could have prevented the damage.
What to Do If You Think Something Went Wrong
If you suspect something wasn’t handled properly, it’s best to approach it calmly and methodically. Your goal at this stage isn’t to start a claim — it’s to understand exactly what happened.
Start by requesting your medical records. These will show what was discussed during your consent process, the details of the operation, and the follow-up care. Review whether your risks were properly documented and whether complications were recorded and addressed.
Ask your surgeon or clinic for a clear explanation of the outcome. Many times, misunderstandings or anxiety stem from a lack of communication. A good clinician will be willing to go through the records with you and explain what occurred.
If you still feel unsatisfied, you can raise a formal complaint. For NHS patients, this can be done through the hospital’s Patient Advice and Liaison Service (PALS). For private clinics, contact the patient liaison or management team directly.
If necessary, you can request an independent ophthalmologist to review your case. An expert opinion can clarify whether the care you received fell below the expected standard and whether this caused your outcome.
Finally, be aware of time limits. In the UK, you generally have three years from the date of the alleged negligence or from when you first became aware that negligence may have occurred.
When a Claim Might Be Justified
Pursuing a medical negligence claim is not about seeking revenge or unnecessary litigation — it’s about accountability and fair redress when a patient has suffered avoidable harm.
A claim may be reasonable if, for instance, you were operated on without proper consent, received the wrong lens, or suffered a preventable loss of vision because a complication wasn’t managed correctly. But before any legal process begins, a specialist medical negligence solicitor will usually instruct an independent ophthalmic expert to review the evidence.
That expert will answer three key questions:
– Did the surgeon or healthcare provider breach their duty of care?
– Did that breach directly cause harm?
– What are the extent and consequences of that harm?
Only when those questions can be answered with confidence does a claim typically proceed.
If negligence is proven, compensation may cover both the physical and financial impact — for example, further treatment costs, loss of income, rehabilitation, or psychological distress. However, most patients simply want an honest explanation and reassurance that steps will be taken to prevent similar errors in the future.
The Claims Process Explained
If a claim is pursued, it generally follows a clear structure. It starts with a legal consultation, where your solicitor assesses the facts and your likelihood of success. If your case appears viable, medical experts will prepare detailed reports about your treatment and its outcomes.
The next step is called the “Letter of Claim” — a formal document sent to the healthcare provider outlining the alleged negligence. The provider then has the opportunity to respond. In many cases, matters are settled before court proceedings are ever needed.
If the case does go to court, the focus remains on whether the provider failed to meet the expected standard of care and whether that failure directly caused your harm. Compensation, if awarded, is meant to help you recover and move forward, not to punish the practitioner.
Even if you never wish to take legal action, understanding this process can help you make informed decisions about your next steps and communicate effectively with your healthcare provider.
What You Can Do to Protect Yourself as a Patient
There’s a lot you can do before surgery to ensure you’re protected and well-informed. Ask your surgeon clear, specific questions such as:
– What is your personal complication rate for cataract surgery?
– How many procedures have you performed?
– What type of lens will you implant and why?
– What are the specific risks in my case?
– What is your aftercare plan, and what should I do if I notice problems at home?
Being an informed, proactive patient makes a big difference. It ensures you understand what’s happening at every stage and gives you confidence that your care is being managed responsibly.
What to Expect After Surgery
Even when everything goes smoothly, it’s normal to have a few days of blurred vision, mild irritation, and light sensitivity. Most patients notice improvement within a week or two, and their vision stabilises over the following month.
You’ll be asked to use prescribed eye drops for several weeks to prevent infection and reduce inflammation. It’s also common to be told not to rub your eye, swim, or lift heavy objects until it has fully healed.
A follow-up appointment is normally scheduled within a few days, with another check a few weeks later. Always attend these appointments — they’re designed to catch any problems early.
If your vision suddenly worsens, you experience severe pain, or your eye becomes red and swollen, contact your surgeon or clinic immediately. Swift treatment can make a huge difference in outcomes.
Why Patients Often Hesitate to Raise Concerns
Many people feel reluctant to raise questions about their care, even when they think something might be wrong. They worry about appearing confrontational or fear that complaining will affect their ongoing treatment.
In reality, good clinics welcome feedback. Raising a concern is not an attack — it’s part of maintaining high standards and accountability in healthcare. Most issues are resolved through open discussion long before anything formal needs to happen.
For some, simply receiving an honest explanation and apology is enough to restore trust and peace of mind. The aim isn’t necessarily to pursue a claim; it’s to understand what happened and make sure the right lessons are learned.
Key Takeaways
– Cataract surgery has an excellent safety record, but complications can still happen.
– A complication alone doesn’t equal negligence — negligence requires proof that the care fell below an acceptable standard and directly caused harm.
– You are entitled to full, clear information about risks, benefits, and alternatives before consenting to surgery.
– Always attend your follow-up appointments and report any unusual symptoms immediately.
– If something feels wrong, ask questions, request your records, and, if needed, seek an independent medical opinion.
– You have three years to raise a claim from the date of the negligence or the date you became aware of it.
– Most issues are resolved through open communication, not litigation.
– Understanding your rights helps protect both your health and your peace of mind.
FAQs
Can I claim compensation just because my cataract surgery didn’t go as planned?
Not necessarily. A less-than-perfect outcome doesn’t automatically mean negligence occurred. To qualify as negligence, there must be evidence that your surgeon or clinic provided care below the standard expected of a competent practitioner and that this directly caused your complication or injury. Many postoperative issues are recognised risks, even when your surgeon has done everything correctly.
What if my surgeon didn’t warn me about a specific complication that has now happened?
If the risk that occurred was something a reasonable patient would have wanted to know before consenting, then failing to mention it could amount to inadequate informed consent. This doesn’t guarantee a successful claim, but it could form part of one if the omission caused harm or left you unable to make a truly informed decision about your surgery.
How soon should I raise concerns if I believe something went wrong?
It’s best to act promptly. Start by contacting your surgeon or clinic to request your medical records and an explanation of what happened. The sooner you raise your concerns, the clearer the details will be, and the easier it is for the provider to review and respond. You don’t have to begin a legal claim straight away — often, open discussion brings clarity or resolution on its own.
Is there a time limit for bringing a medical negligence claim after cataract surgery?
Yes. In most cases, you have three years from the date of the alleged negligence, or from the date you first realised that negligence might have taken place. This rule applies across both NHS and private care, though exceptions exist for minors or those lacking mental capacity. Acting sooner ensures your records and recollection are fresh, which helps any future investigation.
Can I still make a claim if I already had other eye problems before surgery?
You can, but it may be more complex. Your surgeon must take pre-existing conditions such as glaucoma, diabetic retinopathy, or macular degeneration into account when planning your surgery. If these conditions were ignored or poorly managed and your vision worsened unnecessarily as a result, that could support a negligence claim. However, if your outcome was simply due to the underlying eye disease, it may not meet the threshold for negligence.
Does it make a difference if my cataract surgery was done privately rather than on the NHS?
No — the legal standard of care is exactly the same. Whether your surgery was private or NHS, you’re entitled to the same level of competence, communication, and aftercare. The only difference is how complaints are handled: NHS concerns usually go through PALS, while private patients raise issues through the clinic’s internal complaints process or regulatory body.
Will complaining affect my ongoing treatment or relationship with the surgeon?
It shouldn’t. Professional clinics and hospitals are required to handle complaints fairly and without prejudice to your continuing care. Raising a concern is your right, and a good surgeon will view it as part of maintaining transparency and improving patient safety — not as a personal attack. If you ever feel your care is being affected because of a complaint, you can escalate the matter to the Care Quality Commission or relevant regulatory authority.
Do I need a solicitor immediately if I think negligence occurred?
Not straight away. Start by understanding what happened — request your records, ask for an explanation, and if needed, seek a second medical opinion. If those steps suggest that the care may have been substandard, you can then approach a solicitor specialising in medical negligence for advice. Many offer an initial consultation free of charge and can help assess whether you have a strong case.
What evidence is needed to support a potential negligence claim?
The most important evidence includes your complete medical records, consent forms, surgical notes, and follow-up correspondence. Independent expert reports from ophthalmologists also play a crucial role, as they assess whether the care you received met professional standards and whether any breach directly caused your outcome. Keeping a diary of symptoms and the impact on your life can also be very helpful.
Can I seek answers even if I don’t want to make a claim?
Absolutely. You can request your records, ask for written explanations, or submit a formal complaint purely for clarification. Many patients simply want reassurance, accountability, or an apology rather than compensation. Open communication often leads to better understanding and, in many cases, improvements in the system that prevent similar issues in the future.
Final Thoughts
When cataract surgery goes well, it can transform vision and quality of life. But when complications arise, it’s only natural to seek answers. Understanding what constitutes medical negligence helps you separate unfortunate but recognised risks from genuine errors in care.
If you’ve had a poor outcome, start by asking questions and requesting your records. Most of the time, this alone brings clarity and resolution. If evidence suggests that your care may have fallen below the expected standard, it’s your right to explore the matter further — calmly, factually, and with proper expert guidance.
At London Cataract Centre, we believe that patient trust is built on openness and accountability. Complications can happen, but patients deserve clear explanations, high-quality aftercare, and support throughout recovery. If you have concerns about your vision after surgery, always speak to your ophthalmologist as soon as possible. The sooner a problem is identified, the better the chances of a good outcome.
References
- Ali, N. (2007) ‘A decade of clinical negligence in ophthalmology’, BMC Ophthalmology, 7(20). Available at: https://bmcophthalmol.biomedcentral.com/articles/10.1186/1471-2415-7-20 (Accessed: 5 November 2025).
- Kirthi, V., Neffendorf, J.E., Navaratnam, A.V., Machin, J.T., Hingorani, M., Briggs, T.W.R., Davis, A., MacEwen, C. and Jackson, T.L. (2021) ‘Litigation in ophthalmology against the National Health Service in England’, Ophthalmology, 128(12), pp. 1752–1760. Available at: https://doi.org/10.1016/j.ophtha.2021.03.028 (Accessed: 5 November 2025).
- Alwitry, A. (2019) ‘Medicolegal principles in ophthalmology’, RCOphth Focus, July issue, Royal College of Ophthalmologists. Available at: https://www.rcophth.ac.uk/wp-content/uploads/2021/01/College-News-FOCUS_July2019.pdf (Accessed: 5 November 2025).
- Kim, J.E. (2012) ‘Medical malpractice claims related to cataract surgery’, International Journal of Ophthalmology, 5(2), pp. 195–199. Available at: https://pmc.ncbi.nlm.nih.gov/articles/PMC3671368/ (Accessed: 5 November 2025).