Should I take the risk or suffer

48 year old male.  Retinal detachments in both eyes repaired at age 29.  Right eye damaged to optic nerve during surgery at 29 and cataract removed from it at 47, finger count only remaining in that eye due to optic nerve damage docs think.  Left eye now has cateract and is constantly changing and getting worse.  Currently -9.0 uncorrected.  Glasses changing monthly (for last 6 months) and only get me to between 20/50 and 20/80 depending on the month.  It is dangourous to drive, I can not see the television from more than 4 feet away with glasses on.  I am going to see doctor about removing the other cataract in my good eye, but know by my last conversation with him that he is reluctant to operate because I only have one eye remaining, which I understand, but what are my chances of going blind and should I insist on the surgery or see other doctors?

[John C Hagan III, MD, FACS, FAAO]

This is what I've advised patients with that problem to consider:

1. See a retina surgeon, the best one you can find in your area, ask around. Also check on www.aao.org   most will allow appointments without referral by another Eye MD.

2. Have the Retina Eye MD check your retina to see if there are any holes, tears, thin areas that might need treatment before the cataract operation. If so they should be treated.

3. Retina Eye MDs know who the best surgeons are in the area. Ask the Eye MD to recommend two different cataract surgeons then go see them for their opinion. I think you are going to need cataract surgery.

4. Finally discuss with the retina Eye MD post operative observation for retina detachment. I usually have my high risk cataract patients see the retina MD a week after surgery, then a month after surgery, then 3 months, then every 6 months for another year. Then I see them once/year and the retina MD sees them once/year and we schedulce such that the patient is seen by one or the other of us twice/year.

That has proved to be a very effective way of indentifiying retina problems post operative.

One last thought. At the stage you are waiting for the cataract to get bigger harder may increase the risk of cataract surgery.

JCH III MD