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CATARACTS: When is the right time to fix them?

Cataracts some might say start from the day we are […]

By Published On: 22 November 20113.2 min read

Cataracts some might say start from the day we are born.  If we live long enough they will eventually impede vision enough to significantly affect our vision and thus our lifestyle.

If you would like to find out more about what cataracts are CLICK HERE.

At The Eye Practice, a day does not go by that we do not have to advise a patient about cataracts.

A very common question is: “When will I know that I need to have cataract surgery?”

Even though cataract surgery is very sophisticated and very successful, most Eye Doctors will tell you that you should wait until you are having some form of trouble.  This could be any of the following symptoms:

  • Blurry Vision
  • Frequent changes in spectacle prescriptions
  • Ghosting or distortion
  • Colour perception difference between eyes
  • Glare sensitivity and vision disturbance

Even though cataracts are more common as we get older, occasionally even someone in their 30’s can develop cataracts to the point that surgery is required, as their vision deteriorates to a point that it affects their occupation or hobbies.

 There is no correct best time to do cataract surgery but at The Eye Practice, Dr Jim Kokkinakis tends to follow these principles:

  • On average when cataract is developing, one eye is usually more  advanced than the other.
  • When the more advanced eye has deteriorated to not passing a driver’s license it is time to consider fixing this eye.
  • This is even though with the better eye it is still possible to pass the license test.
  • The logic here is that the worse eye will be rehabilitated by the time the second eye finally fails a drivers license.

Sometimes visual demand is very high and cataract surgery will be performed early.  The perfect example is a pilot.  In these circumstances a pilot might be referred for cataract surgery even though the vision is still 20/20.  This is because that glare can often cause significant vision issues and a pilot cannot take the risk.

On the other hand a person might be incapacitated and does not perceive that there vision is compromised to the point of interfering with whatever reading or TV they need to watch.  In this case it is reasonable to wait until the patient perceives a need.

Is there a time that it is too late to do cataract surgery?

Yes there is. There are a few circumstances:

  • If a patient has an retina disease like Macular Degeneration or Diabetic Retinopathy (these have been described in previous posts)
  • Retinal disease needs to be monitored carefully so that timely treatment can be offered.
  • If the cataracts are interfering with the view of the retina, in these circumstances doing cataract surgery later can prove to be too late.
  • If the cataract is allowed to progress too far, the lens in the eye tends to become hard. In these circumstances it is important to remove the cataract as if it is allowed to progress too far, it becomes very difficult to remove the lens and the procedure risks causing complications.
  • In some cases as cataracts progress, the lens in the eye swells and it can raise the pressure in the eye.  In severe cases this can even block the drainage system totally and cause angle closure glaucoma, which is a medical emergency.

In most cases cataract monitoring and referral is quite simple.  It is important though that careful monitoring still occurs as concurrent eye disease needs to be looked for. Dr Jim Kokkinakis follows all cataracts closely and makes timely referrals to expert and experienced cataract surgeons.

Once the procedure has been performed he will do the after care and prescribe new glasses as required.  Remember everyone will develop cataract at some point, so start getting your eyes checked for cataracts from now.  Call 9290 1899 or make an appointment ONLINE now.


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