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At what point do I need cataract surgery?
There is no single objective test to determine the need for
cataract surgery. The final decision for cataract surgery is made
by the patient and depends on how much the decreased vision
from the cataract is bothersome. My patients are highly
intelligent and informed patients, and I prefer to explain their
current status in plain English, and have them make their own
decisions. Doing cataract surgery at an earlier stage makes for
a quicker recovery and a technically easier surgery. Waiting
until the vision is very poor can often make the surgery and the
recovery more involved. Cataract surgery is an elective surgery
and it’s up to the patient to decide when to undergo surgery.
Similarly, refractive lens surgery is scheduled when the patient
would like better vision and less dependence on glasses.
The California Department of Motor Vehicles requires that
drivers have 20/40 vision (with or without glasses) in their
better eye to qualify for a license. Some patients choose to wait
until their vision is approximately at this 20/40 level. However,
many active patients who still work, drive, and use computers
have higher demands for their vision. These patients tend to
choose surgery at an earlier stage.
Some patients choose to have surgery even before they
develop vision-blocking cataracts. For these patients, who are
typically in their 50s, refractive lens surgery is performed in
order to eliminate or reduce the need for glasses and to regain
their near vision. With their astigmatism managed and a
premium lens implanted, the vast majority (92% in the official
FDA study of one premium lens) of these patients saw well at
distance, intermediate, and near, and they never or just
occasionally use glasses. The remaining 8% also saw quite well,
but they used glasses more than just occasionally.
The bottom line is: If you’re happy with your vision and it
doesn’t cause difficulties with reading, computer use, driving,
working, or your active lifestyle, then you should postpone the
surgery. If you want and need better vision for your activities
right now, and would like to see more clearly, then schedule
the surgery. They’re your eyes, and you decide what’s best.
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