Life as a retina specialist is very rewarding. It has special challenges.
There are two conditions that increase as we age; macular degeneration and cataracts. Most people understand cataracts. Cataract surgery is intuitive. Vision blurs, glasses don’t help, cataract surgery is performed and vision returns! Simple…………..right?
What happens when cataract surgery doesn’t help? Frustration, anxiety and doubt develop. Frustration over the surgery, anxiety about going blind and doubt weakens your faith in your doctor.
It is at this point in the process, someone suggests a visit with Dr. Wong. This is my least favorite type referral. I don’t do well with frustrated angry people. It is now my job to reduce the frustration, ask for forgiveness on behalf of the cataract surgeon, restore the faith in the referring doctor, establish trust in a new doctor (me) and still make a diagnosis! These are my special challenges.
Many times the actual reason a patient does not see well after cataract surgery is due to macular degeneration. There are a lot of patients that never find out about macular degeneration until after the cataract surgery. Sometimes, I’ll be consulted before cataract surgery and will warn the patient about macular degeneration. While this is the best scenario, it doesn’t always happen. Why?
Macular degeneration is sometimes difficult to diagnose, especially if you can not see the retina very well. Remember, patients that need cataract surgery can not see out of the eye very well, but this also means that doctors may have trouble seeing into the eye as well. Sometimes, there are subtle signs in the retina that are missed due to the cloudy cataract.
On occasion, macular degeneration seems to have been caused by the cataract surgery. While there is no scientific evidence linking cataract surgery to macular degeneration, the timing of the events has long begged the question.
In the end, if you have developing cataracts, I would recommend you ask your doctor if there is any reason, other than cataract, that may be causing your symptoms. While cataract surgery may still be in your best interest, your understanding of potential problems prior to cataract surgery will pay off in the end and maintain that special relationship with your doctor.
Randall V. Wong, M.D.
Ophthalmologist, Retina Specialist