cataract vs. myopic degeneration

[kg17]

Are there methods to distinguish whether visual symptoms are caused by early cataract or myopic degeneration.  Physical exam reveals both conditions exist, but cataract doctor claims my symptoms are related to my abnormal maculas while the retinal specialist says the early cataract is the primary reason.  This leaves me confused.

[Michael J Kutryb, MD]

You know I saw a patient like this today.  How you tell is a detailed look at the cataract and the macula.  A pinhole test should show improved vision if the cataract is to blame for the decreased vision.  If myopic degeneration is the culprit then pinhole vision will not improve.  An OCT scan of macula is also very helpful.  Some practice have a potential acuity meter which would be very helpful and there are other tests that can simulate what the best potential vision could be after cataract surgery.  You may never completely know for sure until someday the cataracts are removed.  I usually wait until the cataract is obviously decreasing the vision because with some myopic degeneration and increased retinal detachment risk, there is some definite chance for disappointment and you want to make sure it is all worth the trouble.  Make sure your surgeon gives your case careful consideration before planning surgery.

Michael Kutryb, MD