Eye dilated vision exam

[avstan]

A recent exam showed I had cataracts in both eyes.My left eye was correctable to 20/20 but the right eye to only 20/40. I went to an opthalmologist. He dilated my eyes and had me read an eye chart with my recent glass prescription on. He said both eyes were between 20/50 to 20/60. I am confused that my dilated corrected vision showed much worse than my undilated corrected vision. He said I needed cataract surgery but that there was no hurry unless my vision deteriorated more before  my next exam in 6 months. I suspect my eyes would show worse because my correction was to undilated eyes. What numbers should I believe, my uncorrected eyesight before dilation or my dilated eyesight using my glassas? I am confused. Thanks for your response.

Aurel Stan

[Michael J Kutryb, MD]

Good question.  As you probably suspected, the visual acuity is usually significantly worse after dilation and should not be used as a basis for when to have surgery.  Sometimes the vision can actually be a little better after dilation in select cases but we will no there since this is not the norm.  Cataract surgery be considered when the cataract is causing a significant problem with performing activities of daily living, and the visual acuity has declined a reasonable amount and there is also a reasonable expectation that cataract surgery will improve the vision.\


MJK MD

[Sandy Feldman, MD, MS]

Dear avstan,

Cataract surgery is recommended if you have cataracts interfering with you vision that affects the activities that you like to pursue.  The dilated visual acuity may differ and may be worse than undilated due to the drops that were put in your eyes, a change in the prescription with dilation, or more scatter of light around the cataract.  I would recommend that you get checked again to evaluate the progression.

Dr. Feldman

Sandy T. Feldman, M.D., M.S.
ClearView Eye and Laser Medical Center
San Diego, California

[avstan]

Thank you very much for your reply. Much appreciated.

AV Stan