Cataract Surgery: Indications

May 20, 2023
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Indications for Cataract Surgery

Cataract surgery is a very commonly performed surgery in the United States. In the greater Orlando area, cataracts are one of the most common eye problems that I see. 

I often get asked by patients: how do I know if I'm ready for cataract surgery?

My framework for answering this question has two parts: 

1) The patient's perspective

2) The eye surgeon's perspective

In my practice in the Orlando/Oviedo area, I treat the patient first and foremost. The patient is always the number one focus in my practice. So to that end, I like to ask my patient: how is your eye condition affecting your "activities of daily living"? Such as reading, driving, watching television, playing golf, playing with children or grandchildren, shopping, and so on. 

I also like to ask about glare, especially at night time. In fact, one of the most common complaints that I hear about cataracts is that a patient is having issues driving at night time, specifically related to glare caused by oncoming headlights. When I hear this complaint, I immediately think that cataracts could potentially be the culprit. 

After I've spoken to the patient and heard their perspective, I typically check a few different tests. First we want to see how poorly the patient is seeing, even with glasses or contacts. Sometimes we will even test their vision with a glare test, to see how glare can affect the vision. 

Then I like to measure other "eye vitals" such as peripheral vision, pupils, and eye pressure. 

Finally, I like to physically look at the cataracts (ideally with the eyes dilated). Having seen tens of thousands of cataracts and done thousands of cataract surgeries in my career, I can get a really good idea of the nature of the cataracts by actually looking at them. 

The fact is: Cataracts have different patterns. Without going into too much detail, some cataracts are dense in the middle, some are dense in the rear, some are light and fluffy, some are like red bricks, and some are like white cream puffs. Each of these different appearances of cataracts has a very different behavior in the operating room, so it's best for me to know ahead of time. 

I also like to see how a wide the patient's pupils dilate with dilating eye drops (the red cap drops). This is very important for cataract surgery because if pupil dilation is poor, that could indicate potential issues with the iris, which may make the cataract surgery more complex. 

After the exam, I have a discussion with the patient regarding the risks and benefits of cataract surgery, as well as the alternatives

I will cover more information in subsequent blog posts. 

If you are a patient seeking cataract surgery or other medical eye care needs, my practice is now open and I'm accepting new patients. 

I'm located in Oviedo, also servicing Orlando, Winter Park, Winter Springs, Castleberry, and other nearby areas. 

Until next time,