congenital cataract

[dbink]

Okay I went to my opthalmologist today because I've been having this blurriness in my right eye. My vision is 20/25 in my right eye and 20/30 in left eye. I have congenital cataracts as well, and a pvd in my right eye. My vision is not sharp and although I can see distance I still have that fog/blur in my right eye that is very disturbing. Dr. said cataracts are not fully ripe and would rather I held off on surgery. My concern is I've had these congenital cataracts all of my life and have been fine why all of a sudden if they haven't changed in size am I having such trouble with blur in my right eye?.....he is sending me for second opinion but was hoping for some insight on here.

[Doreen Fazio, M.D.]

Posterior polar cataracts are more risky to remove because the posterior capsule may tear and lead to vitreous loss, requiring a vitrectomy at the time of the cataract surgery. If the cataracts are affecting your vision and making it harder to function in terms of work, driving, etc, cataract surgery can be considered. There are techniques which can be used to help prevent this capsular tear during the surgery. You should consult a very experienced cataract surgeon.

[dbink]

Well Dr. Fazio, I went for my second opinion and am stymied at what he told me. He said my cataracts are polar cataracts (which I've had all my life and I knew that I had them all my life) What I didn't know is that they are 'polar' cataracts and that they are more risky to remove. He said my eyes are 20/25 in my right and 20/30 in my left, and these numbers are with or without correction. When I asked him why can't I have 20/20 vision with say glasses he said because the polar cataracts will always prevent me from having 20/20 vision. He did say i have border line dry eye and suggested using over the counter eye drops. What light can you shed on the subject?

[Doreen Fazio, M.D.]

I agree with the second opinion. The concept of waiting until the cataract is "ripe" is a very old one.  Now we remove cataracts when they bother the patient's vision and functioning, and we don't wait until they reach a certain level.  This is assuming that the cataract is the only cause of the visual problem, and there is no other pathology in the eye, such as with the retina.  A complete ophthalmological exam with dilation should detect any other issues.