Our Readers Want to Know: When Should I Have Cataract Surgery?

Editor’s note: One of the many benefits associated with an online information center and website, such as VisionAware, is the ability to track readers’ search terms [i.e., information readers are seeking as they search the Internet]. Since the earliest days of VisionAware.org, the following questions about cataract surgery consistently rank within the five most popular searches:

  • When should an individual have cataract surgery?
  • How long is the recovery time after cataract surgery?

An Answer from Tina D. Turner, M.D.

Tina D. Turner, MD

This week, our answer comes from Tina D. Turner, M.D., a staff comprehensive ophthalmologist at Henry Ford Health System’s Grosse Pointe Ophthalmology and author of An Introduction to Cataracts and Cataract Surgery on the VisionAware website. She lectures widely on many topics in ophthalmology to ophthalmology residents, family medicine residents, emergency medicine residents, ophthalmic technicians, surgical technicians, and patients.

When Should an Individual Have Cataract Surgery?

To date, no medication or eye drop has been proven to prevent or reverse cataract formation. If a cataract is causing nearsightedness or a change in an individual’s prescription, new prescription eyeglasses can help improve blurred vision. The only treatment for a cataract, however, is surgical removal of the natural lens.

When to Remove? Sooner or Later?

A cataract should not be removed simply because it is present. Many people have cataracts that do not cause blurred vision, interfere with activities of daily living, or otherwise prevent them from leading active and productive lives. In such cases, these individuals should not undergo unnecessary surgery to remove their cataracts.

However, if an individual has blurred vision that makes it difficult to read print or read signs while driving; has disabling glare while driving at night; or has difficulty engaging in hobbies such as knitting, crocheting, or card games, it is time to consider cataract surgery.

In short, if an individual has a cataract and resultant blurred vision that makes it difficult to do anything he or she wants and needs to do, it is time to consider cataract surgery.

If there are cataracts in both eyes that require surgery, the surgeries are usually performed several weeks apart. Cataract surgery on both eyes at the same time is not recommended because there is a possibility of complications affecting both eyes; the most worrisome is infection.

How Much Should the Cataract Develop Before Having Surgery?

A cataract does not have to become “ripe” before it can be removed. In the past, the lens could not be extracted safely from the eye unless it was at a relatively advanced stage of development. With modern advances in cataract surgery, the lens can now be removed from the eye at any stage of development.

It is true that the longer a cataract develops, the more it hardens. At advanced stages, a firmer or more developed cataract can be difficult to remove. In certain situations, it is safer to remove a cataract sooner rather than later; in most cases, however, an individual should not undergo cataract surgery unless he or she is experiencing blurred vision caused by the cataract.

It is also true that if cataracts are allowed to develop for long periods of time, they can cause inflammation or increased intraocular (within the eye) pressure that can lead to glaucoma.

In these situations, it is extremely important to remove the cataract to prevent loss of vision from the resultant inflammation or glaucoma. This scenario rarely occurs in the United States, however, due to regular access to most types of health care.

The Patient’s Decision

It’s important to understand that it is the patient who should – and must – make the decision to undergo cataract surgery. It is the doctor’s responsibility to educate patients and give them the knowledge they need to make an independent and well-informed decision regarding cataract treatment.

You can read Dr. Turner’s cataract surgery response in its entirety at VisionAware.org.

How Long Is the Recovery Time After Cataract Surgery?

Some patients see very well the day after cataract surgery. Other patients see well a few days after surgery, and still others may need a full month to reach their maximum vision improvement.

The First Week after Surgery

During the first week after surgery, it generally is recommended that the patient keep his or her eye covered at all times, either with eyeglasses or an eye shield, to protect it from being bumped or rubbed. A small amount of pressure can easily open the incision, and protecting the eye prevents this.

Also, it is recommended that the patient refrain from (a) bending with the head below the waist, (b) lifting more than 10 pounds, and (c) straining (on the toilet, for example) to the point of holding one’s breath. All of these activities increase the pressure inside the eye and can open the incision.

Antibiotic and anti-inflammatory eye drops are used in the weeks after cataract surgery to help prevent infection and control inflammation.

A Few Weeks after Surgery

A few weeks after the surgery, the patient is checked for eyeglasses and given a final prescription.

Artificial lenses last for a lifetime, and with newer types of lenses, it is very rare to experience a lens-associated complication. Occasionally, an artificial lens can dislocate (move out of its intended position) and result in blurred vision. This usually occurs as a result of trauma to the eye and the doctor should be contacted immediately.

You can read Dr. Turner’s recovery time response in its entirety at VisionAware.org.

Additional Information about Cataracts