Is dizziness normal after cataract surgery?

My 70 year old mother had cataract surgery on one eye two days ago.  At first she seemed to be recovering perfectly, but started feeling dizzy and slightly nauseous immediately following the removal of the eye patch 24 hours after surgery.  We took her back to the opthamologist who seemed surprised by her reaction, said her eye seemed to be healing well and suggested she may have an inner-ear infection and that she might try dramamine or another antihistamine.  A cursory internet search suggests this is not a unique problem post-cataract surgery, but I'm not quite sure how to best treat.  Should we just wait and see?  For how long?  Any responsible advice greatly appreciated.  

[Christopher C Shen, MD]

Dizziness is a nonspecific sign that can be caused by various factors.  Not sure if your mother received any anesthesia or sedatives during the surgery but if it is a side effect of the medications given in the operating room, this should start steadily improving with time as the body clears out the medication.  If the patient received any pressure-lowering eyedrops or is taking them chronically for glaucoma (particularly alphagan or the generic name brimonidine) following the procedure, older patients can be especially sensitive to this medication.  Another possibility is that she had a pressure spike in the eye that had surgery although this would have been picked up by measuring the eye pressure in the ophthalmologist's office.  Finally, she may be having trouble adjusting to the vision in the operated eye and balancing it with the fellow eye if there is a large discrepancy in correction since you mentioned it started following removal of the patch.  If this is the case, repatching the eye should clear up her symptoms.  If the nausea/dizziness is not accompanied by any eye discomfort or worsening vision, it should likely begin to clear spontaneously or with the aid of some of the medications suggested.  It is important that her nausea doesn't escalate since vomiting can exert internal pressure that can translate to the eye potentially leading to bleeding within the eye.   I would suggest reevaluation if no improvement is noted within the next day or so after attempting the oral medications if needed.