When is the right time to have cataract surgery?
One of the questions I am often asked by my patients is “are my cataracts ready or ripe enough to need surgery?” Before embarking on this important topic, let’s take a moment to briefly define cataracts.
What are cataracts?
Cataracts are opacities in the crystalline lens, the lens inside the eye. These opacities prevent light from optimally passing through the eye resulting in changes in vision.
The changes in vision associated with cataracts may be gradual or more sudden.
Some of the symptoms of cataracts include:
- decrease in vision
- poor night vision.
- faded colours
- increase in glare
What your doctor sees
When your doctor examines you, she can actually see the cataracts (via special equipment) in your eye and can assess how dense or important the cataracts are and compare from one visit to the next.
Does everybody get cataracts?
If we all lived to be 110, we would all have cataracts or need cataract surgery by then. Most cataracts are age-related, but it is possible to have cataracts in younger patients as well.
Factors associated with the earlier development of cataracts:
- Pale eyes
- UV ray exposure
So what is the treatment for cataracts?
The treatment for cataracts is surgical.
It was once believed that we need to wait until the cataracts are mature or ripe enough before surgery. But waiting too long can actually complicate the surgery. During cataract surgery, the surgeon inserts an instrument in the eye that breaks up the crystalline lens into smaller pieces and then sucks up the pieces like a vacuum. A more mature or advanced cataract is actually thicker, more dense requiring more time and energy to break up the cataract during surgery. The greater the energy required during the surgery, the greater the heat that is released in the eye. The surgeon uses water to cool the eye from this increase in heat. If more water is required, then the cornea, the surface of the eye may not be able to pump out the water as quickly as it comes in causing the cornea to swell. This swelling of the cornea results in blurred vision and an increase in recovery time. Sometimes, the swelling is too great and the corneal tissues develop folds or even scarring, thus resulting in a decreased visual outcome following the surgery.
Another potential complication: During surgical removal of an advanced cataract, the eye may actually be open longer resulting in greater risk for infection.
Don’t panic, the cataracts are not going to evolve overnight. The important thing is to have regular eye exams which measure the vision and allow your doctor to assess the level of cataracts. (how the cataracts are evolving.) For patients whose cataracts appear to be evolving at a more rapid pace,