What could be causing a headache and burning sensation in my left eye after cataract surgery?

Immediate Ophthalmology Evaluation Required for Possible Postoperative Endophthalmitis or Severe Inflammation

You need urgent same-day evaluation by your ophthalmologist because severe unilateral headache with eye burning after cataract surgery can indicate serious complications including endophthalmitis (infection inside the eye), toxic anterior segment syndrome, or severe postoperative inflammation—all of which require immediate diagnosis and treatment to prevent permanent vision loss. 1, 2

Most Likely Serious Causes Requiring Urgent Evaluation

Postoperative Endophthalmitis (Infection)

• Pain and redness are the hallmark symptoms of endophthalmitis, often accompanied by decreased vision and sometimes purulent discharge 1
• This is a rare but vision-threatening complication that typically presents with pain, photophobia, and inflammatory cells in the vitreous fluid 1, 2
• Early detection through immediate follow-up is critical because delayed treatment leads to serious complications including permanent vision loss 2
• The infection usually results from bacterial invasion (Staphylococcus, Streptococcus, or gram-negative organisms) during or after surgery 1

Severe Postoperative Inflammation

• Early onset postoperative inflammation affects approximately 8% of cataract patients and causes pain, burning, and decreased vision 3
• While most cases respond well to topical steroids, the symptoms you describe warrant immediate evaluation to rule out more serious causes 3
• Acute complications can include elevated intraocular pressure (which causes headache), posterior synechia, and pupillary block 3

Elevated Intraocular Pressure (IOP)

• Increased pressure inside the eye is a known complication of postoperative steroid drops (prednisolone) and manifests as headache and eye pain 4
• The FDA label for prednisolone specifically warns about IOP elevation with possible glaucoma development and optic nerve damage 4
• This requires immediate measurement of your eye pressure 5

What Your Ophthalmologist Will Evaluate

Critical Assessment Points

• Visual acuity testing to determine if vision has decreased 5
• Intraocular pressure measurement to detect elevated pressure causing your headache 5, 4
• Slit lamp examination to look for inflammatory cells in the anterior chamber and vitreous 1, 3
• Assessment for infection signs including corneal infiltrates, hypopyon, or purulent discharge 1, 2
• Evaluation of the ocular surface for dry eye or surface toxicity from postoperative drops 6

Why This Cannot Wait

Time-Sensitive Complications

• Endophthalmitis requires immediate treatment with intravitreal antibiotics to prevent permanent vision loss 1, 2
• Severe inflammation unresponsive to standard therapy needs aggressive management to prevent complications like cystoid macular edema or posterior capsular opacity 3
• Acute IOP elevation can cause optic nerve damage if not promptly treated 4

Expected Postoperative Course vs. Your Symptoms

• Normal postoperative pain affects only 34% of patients during the first hours and approximately 10% during the first six weeks 7
• Burning and foreign body sensation are common (affecting 38-52% of patients), but when combined with severe unilateral headache, this pattern suggests a complication rather than normal recovery 7
• The American Academy of Ophthalmology recommends postoperative follow-up on day 1 and during weeks 1-2 specifically to check for infection and inflammation 8, 5

Common Pitfall to Avoid

Do not assume this is "normal" postoperative discomfort. The combination of severe unilateral headache localized to the surgical side plus burning eye pain is not typical recovery and requires same-day ophthalmology evaluation 1, 2, 3. Contact your surgical center immediately, as they instruct patients to do for sudden vision changes, increasing pain or redness, or discharge from the eye 5.