Monday, February, 13, 2012

Cataracts - Treatment

Table of Contents

Indications for Surgery

In general, surgery is indicated for people with cataracts under the following circumstances:

  • The Snellen eye test reports 20/40 or worse, with a cataract being responsible for vision loss that cannot be corrected by glasses.
  • Performing everyday activities has become difficult to perform to the point that independence is threatened, or the patient is at risk for accident or injury.

These guidelines are general, however. Whether surgery is appropriate or not further depends on the cataract patient's specific condition and needs. Some examples include:

  • Even if the criteria for surgery are met, a very sick, elderly person in a nursing home may have less need for sharp vision than an active younger adult. Among very elderly patients (85 years and older), especially those with serious health problems, there are also higher risks for complications during surgery and poorer outcomes afterward. Nevertheless, advanced age alone should not prevent someone from having this procedure; vision improvement rates are still over 85%.
  • Even if the criteria for surgery are not met, some people with eye tests of 20/40 or better might want surgery because of problems with glare, double vision, or the need to have an unrestricted driver's license.
  • Even if the criteria for surgery are not met, if retinal disease is also suspected (usually a complication of diabetes), the doctor may perform cataract surgery in order to have a clear view of the eye.

Because of the risks, albeit small ones, of poorer vision or blindness, no one should be forced to have cataract surgery if they don't want it or are not strong enough to have the procedure. If there are any doubts about whether or not to have cataract surgery, consider a second opinion.

Questions for the Ophthalmologist

The patient should ask the ophthalmologist the following questions before agreeing to cataract surgery:

  • Is my cataract surgery an emergency?
  • Are the cataracts the only cause of my poor vision?
  • How much experience do you have with this procedure?
  • Do I have other eye diseases that might complicate surgery or reduce my benefit?
  • Do I have other health problems that might further complicate eye surgery?
  • What type of lens will you implant?
  • What type of procedure will you use?
  • Afterwards, what are my chances of having poorer vision or becoming totally blind in that eye?
  • How well should I ultimately be able to see out of the operated eye?
  • How long will it take to heal?
  • What precautions should I take during the healing process?
  • How long will it take to achieve my best eyesight?
  • Will I have to wear glasses or contact lenses after surgery?
  • When will I get my final eyeglass prescription?
  • How soon after surgery will I be able to see well enough to go back to work? Drive a car? Return to full activity?

Treatment for Patients with Accompanying Eye Conditions

Review Date: 06/23/2010
Reviewed By: Harvey Simon, MD, Editor-in-Chief, Associate Professor of Medicine, Harvard Medical School; Physician, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org)