How To Know When to Have Cataract Surgery

If you’ve just been told you have cataracts, one of the foremost questions on your mind might be about how do you know when to have cataract surgery. While your cataract surgeon or optometrist will be able to provide you with a good deal of guidance, the ideal timing of when to have cataract surgery is largely dependent on factors that you yourself are best placed to assess. 

5 Factors to Consider for When to Have Cataract Surgery

Cataract surgery is considered to be a safe and effective procedure. For the time being, it is also the only way that we can treat cataracts. However, there is typically no need to rush into cataract surgery as soon as the diagnosis is made. In consultation with your optometrist or cataract surgeon, you may want to consider a few factors to help guide your decision on when to have cataract surgery. 

What are the visual requirements of your occupation and lifestyle?

Everyone has different expectations of their sight. A lot of your visual demand is based on the requirements of your occupation or your hobbies. For example, a person who observes wildlife will likely require better visual acuity and contrast sensitivity compared to a person who spends their time on computers. Alternatively, a person who drives trucks long distances overnight will be more affected by the glare from their cataracts compared to a taxi driver who only works daytime shifts. If you find the symptoms of your cataracts are beginning to interfere with activities you do often, you may want to consider cataract surgery.

What is your tolerance for your cataract symptoms?

This is highly variable from one person to the next. A lot of people are unaware that their sight has deteriorated from cataracts. In fact, many people don’t know they even have a cataract until they attend a routine eye test. Even once realising that the clarity of their sight is not as sharp as it used to be, many are still content with what they can see, particularly if it’s still adequate for their daily tasks. However, some people are constantly aware of a blur or haze to their sight, which they find bothersome, even if they can still see what they need to. This might be more bothersome if you notice that one eye is much better than the other due to an asymmetry in your cataracts. Conversely, you may be entirely unaware that there’s a difference between the eyes.  

Does your current sight meet the legal vision requirements for driving in your state?

Although there is some flexibility for your cataract surgeon to recommend you be provided with a conditional licence based on their assessment, there are sight requirements to hold an unconditional driver’s licence.

For private vehicles, this is usually a visual acuity no worse than 6/12 with the two eyes working together.

For commercial vehicles such as bus drivers or truck drivers, the visual acuity requirements are more stringent, including assessing each eye individually.

If your sight through a cataract precludes you from attaining the minimum visual acuity standards to hold your driver’s licence, your cataract surgeon may recommend you proceed with cataract surgery even if you don’t feel you have a problem. 

Can your sight be improved through other means?

In the early to moderate stages of a cataract, you may actually still be able to achieve a quite reasonable sight. Your eye care professional may recommend other strategies to maximise your visual function before considering cataract surgery. Many people find that reading in poor lighting becomes increasingly challenging as their cataracts progress. Although the lighting in your home or workplace may not feel particularly dim, using a focal lamp or task lighting can increase the contrast of the detail against the background, making it easier to see. Problems with glare sensitivity can be alleviated through the use of sunglasses or even lightly tinted lenses to wear indoors. You may also find that simply updating your contact lens or spectacle prescription is enough to buy you a couple more years of sharp sight before needing to consider cataract surgery. In the end, if all these workaround solutions are unable to address the concerns you have with your eyes or vision, then your cataract surgeon may suggest you proceed with cataract surgery.

Do you have another vision problem that could be treated at the same time as cataract surgery?

Occasionally, cataract surgery may be performed to help manage another condition. In most of these cases, removing cataracts can be part of managing glaucoma, a disease of the optic nerve inside the eye. Extracting a cataract can improve fluid outflow from the eye, thereby helping to lower the pressure inside the eyeball and protect the optic nerve. During cataract surgery, a glaucoma patient may also benefit from having the insertion of a stent into their fluid drainage channels to aid fluid outflow. This stent is almost always combined with a cataract procedure. Some people may also seek the attention of a cataract surgeon simply for a procedure to reduce their need for glasses. Part of a cataract operation is to replace the natural lens with an artificial implant, which has been calculated to correct the eye’s prescription. This means that after successful cataract surgery, you may no longer be dependent on glasses for distance and/or near sight. 

Ultimately the decision on the optimal timing for cataract surgery is best discussed with you and your cataract surgeon. Other pre-existing health concerns or your financial situation may also play a part in dictating when you should go for a cataract operation.

Note: Any surgical or invasive procedure carries risks. Before proceeding, you should seek a second opinion from an appropriately qualified health practitioner

References

Cataract surgery.

https://www.mayoclinic.org/tests-procedures/cataract-surgery/about/pac-20384765#:~:text=Normal%20vision%20(left)%20becomes%20blurred,doctor%20may%20suggest%20cataract%20surgery.

Do I Really Need Cataract Surgery?

https://www.dukehealth.org/blog/do-i-really-need-cataract-surgery