When do you know its time to get cataract surgery?

[provlima]

Last February the optometrist  during an exam for glasses told me I had cataracts, and asked me if I have any problems with vision. I answered that I didn't. Last week I went to my opthalmologist for a checkup and told her what the optometrist had told me last year. She told me I had moderate cataracts in both eyes as well as a macular pucker in my right eye. My right eye is clearly worse than my good eye but the brain seems to compensate for this.
I asked her if I needed cataract surgery and she advised only I can determine that if my vision is bad.
I am somewhat confused as I think my vision is generally good but that I have difficulty driving at night
I am wondering if my vision may be more impaired than I think it is.
I would appreciate hearing your experiences with cataracts.. Did your vision clearly show focus or other problems before you decided to have the cataract surgery??  Thanks for your help

[JohnHaganMD]

Usually its pretty easy to cut to the chase on cataract surgery. I ask these questions:

1. In terms of your vision keeping you from things you need to do or want to do would you say your vision is a small problem? medium problem ? big problem"
2. Are you comfortable driving at night? If so if it were raining would you still feel comfortable driving at night?

If a person says there vision is no problem or a little problem they generally do not need cataract surgery.

If a person is uncomfortable driving at night or their night is very bad and glare is a big problem (in the case of non-drivers) and their vision is better than 20/40 then glare testing is done.   Almost all ophthalmologists do glare testing on complaints of night vision.

JCH MD

[SoftwareDeveloper]

Did the doctor tell you what your best corrected visual acuity is, e.g. 20/30 or 20/40? The usual requirement for driving is 20/40. Insurance and government medical programs usually cover cataracts once best corrected vision falls to 20/50, but you'd need to check yours to confirm. Some now allow more flexibility for a doctor to decide you have a problem even if your visual acuity on the surface appears to be good enough.

Cataracts can cause issues with glare and reduced contrast sensitivity that negatively impact night driving earlier than they impact daytime visual acuity as indicated by a test that may show you  as say 20/30 perhaps. Unfortunately it is hard for people to know if their night vision is as good as it should be.  There are some tests doctors can do to ***** the quality of your night vision, testing things like contrast sensitivity  and glare issues, but most doctors don't tend to do such tests unless asked and not all have the equipment to do the best tests so you might need to hunt around.

Aside from factoring in the  the issue of whether insurance will cover it or not, deciding when to have cataract surgery is mostly subjective, it is based on when you think your visual problems are impacting your quality of life enough to make it worth the risk, time and cost.  Unfortunately it is hard to know how much difference it will make in night driving for instance since it can be hard to remember exactly  how different it was before cataracts interfered with it, or to decide whether it is bad enough to be concerned.

[SoftwareDeveloper]

Where the software stuck in *s, substitute the word "evaluate". I used a different word (substitute "a" for "L" in "Lssess")  that the questionable software chose to censor due to the first 3 letters.

[JohnHaganMD]

Read this carefully it will answer your questions:

http://www.medhelp.org/user_journals/show/1648102/Consider-ALL-the-Options-Before-Your-Cataract-Surgery-Working-Through-Whats-Best-For-You