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February 10, 2012

Cataract Surgery (cont.)

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How are cataracts diagnosed?

Cataracts are detected by the finding of lens opacification during a medical eye examination by an eye-care professional. The abnormal lens can be seen using a variety of specialized viewing instruments. Using a variety of tests, your doctor is able to tell how much a cataract may be affecting your vision. Usual eye tests include testing visual acuity, glare sensitivity, color vision, contrast sensitivity, and a thorough examination of all other parts of the eye. Your doctor will make sure vision loss is not due to other common eye problems, including diabetes, glaucoma, or macular degeneration.

Most cataracts associated with aging develop slowly, and many patients may not notice visual loss until it is fairly advanced. Despite being told that you have cataracts, it is not imperative to have surgery to remove them until they begin to affect your vision. The development of cataracts is unpredictable; some cataracts remain less dense and never progress to the point where they cause cloudy vision and require treatment, while others progress more quickly. Thus, the decision and timing to proceed with cataract surgery is individualized for each patient. Your doctor will be able to tell you how much of your vision loss is due to cataracts and the type of visual recovery that may be expected if surgery is chosen.

Who is a candidate for cataract surgery?

Eye-care professionals may mention during a routine eye exam that you have early cataract development even if you are not yet experiencing visual symptoms. Although your doctor will be able to tell when you first begin to develop cataracts, you will generally be the first person to notice changes in your vision that may require cataract surgery. Clouding of the lens may start to be seen at any age, but it is uncommon before the age of 40. However, a large majority of people will not begin to have symptoms from their cataracts until many years after they begin to develop. Cataracts can be safely observed without treatment until you notice changes in your vision.

Surgery is recommended for most individuals who have significant vision loss and are symptomatic secondary to cataract. If you have significant other eye disease unrelated to cataracts that limits your vision, your ophthalmologist may not recommend surgery. Sometimes after trauma to the eye or previous eye surgery, a cataract may make it difficult for your eye-care professional to see the retina at the back of the eye; in these cases, it may still be appropriate to remove the cataract so that further retinal or optic nerve evaluation and treatment can occur. The mode of surgery can be tailored to individuals based on coexisting medical problems. Cataract surgery is generally performed with minimal sedation and typically takes less than 30 minutes. Therefore the surgery does not put significant strain on the heart or the lungs.

Prior refractive surgery such as LASIK is not a contraindication to cataract surgery.

A cataract is a medical condition, and insurance companies usually cover part or all of the cost of cataract surgery, including pre- and postoperative care. Ask your physician any questions you may have about the cost involved.


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