Your Cataract Surgery Exam
What to expect during your exam

The examination will start with a discussion of your symptoms. Cataracts can cause a variety of problems, such as difficulty reading fine print, difficulty seeing road signs while driving, or trouble with viewing the television. Cataract patients often give up driving at night because of glare symptoms. Hobbies such as handwork and crocheting can become difficult. We no longer wait until your cataract is ripe. The word ripe dates to a time when cataract surgery was done by an older technique. Nowadays cataract surgery is indicated when you can no longer see well enough to participate in the activities you enjoy.

After measuring your visual acuity, a careful refraction (measurement for glasses) will be done. Even if you have cataracts, your vision may be improved adequately just by updating your glasses. It is often possible to put off cataract surgery for years by periodically changing glasses prescription. Eventually, however, a cataract can progress to the point where new glasses will no longer provide adequate clarity of vision. At this point generally cataract surgery is considered.

Next, your pupils will be dilated so that your eyes can be examined inside and out. A cataract is a clouding of your natural lens. The lens is located behind the iris (colored part of your eye). With your pupil dilated the lens can be seen in its entirety. Your doctor will judge the degree of clouding of the lens and whether it would help to replace it with an intraocular lens implant.

Cataract EvaluationAll other parts of the eye are closely examined as well. Diseases of the cornea (the clear window in front of the eye), retina, and optic nerve can also cause blurred vision. In particular, detection of diseases such as macular degeneration and glaucoma are critical before considering cataract surgery. It is particularly disappointing to the doctor and patient alike when a perfectly performed cataract surgery does not result in the expected visual improvement because of a pre-existing problem like macular degeneration. A skilled eye care professional can often predict whether or not in a given patient cataract surgery will lead to a significant improvement in visual acuity.

Finally, a cataract evaluation will include a discussion of treatment options. Of course, there is always the option of doing nothing. Cataract surgery is almost always elective and the timing of surgery is generally up to the patient. Other medical problems may need to be attended to first. A risk-to-benefit analysis will help in the decision of whether to proceed with cataract surgery. Fortunately, modern cataract surgery has a success rate in excess of 95%.