Purpose of review: This review summarizes the recent literature of the impact of cataract surgery from the patient's perspective, with a focus on second-generation patient reported outcome (PRO) measures that used Rasch analysis to explore their data. Recent findings: Irrespective of the instrument utilized, the overriding conclusion is that cataract surgery unequivocally improves vision-specific functioning and several aspects of visionspecific quality of life. The benefit of cataract surgery, however, on generic health is less clear, due to limited vision-related items. Evidence suggests that cataract surgery also improves visual functioning in comorbid eye disease, especially in the early stages. Similarly, second eye cataract surgery appears to improve visual ability beyond that achieved with first eye surgery. Recently, there has been a shift toward secondgeneration, Rasch-validated PROs to assess cataract surgery outcomes and large gains in visual function have been demonstrated. Importantly, measurement precision is dramatically improved compared with the original first-generation instruments. Summary: Cataract surgery-induced improvements in visual acuity are translated by considerable gains in real life activities, emotional and social life components. The utilization of second-generation instruments and modern psychometric methods, however, appears to be the best current strategy to optimize the impact of cataract surgery on healthrelated quality of life.