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When do I need cataract surgery?

This is a very commonly asked question in eye clinics. Most of us have come across friends or family with cataracts, or who have already had cataract surgery. In fact, cataract surgery is one of the most commonly-performed operations throughout all branches of medicine.

A cataract is the clouding which occurs in the eye’s natural lens, and most commonly happens because of age, although it can also develop due to trauma to the eye and medications, amongst other causes.

In general, a cataract is not harmful to the eye, but it can interfere with vision in several different ways, ranging from a constant blur to haloes around bright lights, glare, and “ghosting” or shadowing around the edge of objects. Because cataracts tend to develop gradually, many people are unaware that cataracts are developing in their eyes. They will often be spotted by an optometrist (optician) on a routine sight test for glasses, and many patients find themselves being referred for consideration of cataract surgery on that basis.

The first question I ask when a patient is referred with cataracts is: “Are you aware of the cataracts in your eyes?” and then more specifically “Do the cataracts stop you from doing the things you need to do, or the things you like to do?”.

The reason it is important to establish this at the outset is that whilst cataract surgery is generally a very safe and successful operation, it is not completely risk free. If someone is unaware of the cataracts in their eyes and able to continue with all of their normal daily activities, it is generally not justifiable to put them through the risks of surgery (save for a few exceptions).

In short, whilst for some eye conditions such as glaucoma there is little choice over whether or not to treat, when it comes to cataracts it is often a case of “I’ll be guided by you!”.

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