OPHTHALMOLOGY

Gregory Eippert, MD

Q: My cataracts are beginning to affect my vision. What symptoms qualify me for surgery? Are there any contraindications to having cataract surgery?

A: There are very few cases when cataract surgery is contraindicated or should be avoided. The main consideration when deciding to have cataract surgery is deciding how much you feel your decreased vision is affecting you in your daily life.

Cataracts are a clouding of the lens in your eye that affects your vision. The most common form of cataracts, that which occurs as a natural part of aging, is not preventable. Everyone will develop some degree of cataract as they become older. Visual symptoms of cataracts include blurry vision, difficulty reading in dim light, poor vision at night, and glare or halos around lights. The only treatment for cataracts that significantly impair your vision is surgery. Simply having a cataract however does not always require surgery. Sometimes a change in eyeglasses or contact lens prescription is enough to restore adequate vision. When a cataract becomes visually significant by making it difficult to participate in normal activities of daily living such as reading, driving, working, and other things important to you, may be the time to consider and discuss cataract surgery with your eye doctor.

To qualify for cataract surgery, your doctor will need to document at least two findings: 1) That your visual acuity is 20/40 or worse, and 2) that you are having problems with at least two activities of daily living. An additional consideration for cataract surgery qualification involves glare testing which simulates how much your vision decreases with bright lights, i.e., oncoming headlights at night. Some patients may have vision that is better than 20/40 in normal conditions, but when tested with glare, their vision decreases to 20/40 or worse.

There are also cases where patients have other diseases like glaucoma, macular degeneration, or diabetic retinopathy that may affect the decision/need to have cataract surgery. In these cases, the eye doctor needs to be able to see into the back of the eye to monitor the progress of the disease(s). In patients where the view to the back of the eye is blocked by cataracts, surgery may be necessary to obtain a clear view. Without cataract surgery, as your vision declines, your participation in day-to-day activities may be affected. Keep in mind however that cataracts usually develop slowly so there is generally no need to rush into a decision about surgery. If you are not bothered by the symptoms of cataracts and they don’t interfere with your activities, you may choose to wait for cataract surgery.

If you are concerned about cataracts, contact your eye doctor for a complete, dilated eye exam during which your cataracts and eye health can be assessed. Your eye doctor can also discuss with you all latest cataract surgery options. Modern cataract surgery is one of the safest, most frequent, and most successful procedures done in the world today and can have a profound impact on your life. Gregory Eippert, MD 9485 Mentor Ave., #110, Mentor 44060 440-255-1115 www.opivision.com