Updated by Mike Rosco, MD on 3/30/23 at 2:45 PM PST
Cataract surgery becomes necessary when your vision is not as good as you’d like, and your eye doctor feels that the procedure would help. In cases of diabetic retinopathy and macular degeneration, there may be other factors that weigh in on the decision of having cataract surgery.
Cataract extraction is usually considered elective surgery. While insurance does cover most cataract surgery, there are a few criteria for undergoing the operation. Most of the criteria are based on certain vision measurements taken at your eye doctor’s office. Your visual acuity, with or without glasses, may simply be poor enough to qualify you for surgery. Sometimes your daylight vision is fine, but you may suffer from significant glare when driving at night with oncoming headlights. In addition to vision, your doctor simply needs to confirm the presence of a cataract and the likelihood of improvement with surgery.
There is no rush to have surgery. Think of it more like a leisurely stroll than a sprint; you truly have ample time to decide when the moment is right. Choose a time that is convenient for you and your friends or family; whoever may be helping you during the process.
Don’t worry about straining the other eye while waiting for cataract surgery. There really is no such thing as overworking the other eye.
Patients with diabetes have some additional concerns regarding the timing of their surgery. If you have a history of diabetic retinopathy, make sure that the diabetic retinopathy is stable at the time of surgery. The only way to assess stability is with a dilated eye exam with your ophthalmologist and/or retina specialist.
While the timing is not that crucial in cases of macular degeneration, the expectations of the operation should be reviewed with the doctor. By definition, patients with macular degeneration already have decreased vision from their retinal disease. Ensure that you and your doctor have a mutual understanding regarding your post-surgery expectations.
What does this mean? Cataract surgery can be a life-changing event. In most cases, there is likely to be full restoration of vision. The timing of cataract surgery is basically up to you, based upon your own tolerance, or intolerance, of temporary blurry vision.
If you have cataracts or suspect that you do, we recommend scheduling an examination with your eye doctor soon. Use this visit as a fact-finding mission; you’ll be surprised how much there is to learn about cataract surgery. This does not obligate you to have surgery.
Take your time to schedule the procedure and make sure you are ready.
If you have retinal disease, such as diabetic retinopathy or macular degeneration, ensure that you and your doctor are on the same page about the timing and expectations of the surgery
8 replies on “Cataract Surgery: Timing, Considerations, and What to Expect”
[…] Cataract surgery does not cause macular degeneration. Macular degeneration, however, is often discovered just after cataract surgery when the vision fails to improve as hoped, causing many patients (and their frustrated families) to wonder if the cataract surgery caused macular degeneration. […]
A few questions about cataract surgery.
1. Can one ever wait too long to have (c/s) cataract surgery?
2. I have already had a tractional retinal detachment and vitrectomy. Is there still a chance that I could have another detachment from cataract surgery or not so much having had a vitrectomy?
3. Is there a chance of getting better vision after c/s than what I test at with having the cataract? Vision has gone from 20/30 to 20/150 in 7 months and w/ correction I am now at 20/40 where 7 months ago I was at 20/30.
4. Do you know the pros and cons of gettting a lense that is near-sighted (so I won’t have to wear glasses to read)? My ophthalmologist doesn’t do or recommend them so I want to get a 2nd opinion from his associate.
Thank you for your time. ‘your site has a lot of valuable information.
1. No not really. Technically the cataract can cause problems if it becomes white (gives you a white pupil), but this is very, very unusual in the U.S. and other developed countries.
2. Yes, there is, but unlikely. There are sometimes signs of recurrent tractional detachment before cataract surgery.
4. Personal preference. I do know that many surgeons prefer performing bilateral cataract surgery using the “premium” IOL’s within a short period. I’ll stress that this is not the case for the traditional “monofocal” lenses.
My vision is very blurry in my left eye that had the vitrectomy for floaters. There are some small residual spots left over. I had long distance vision before but now with my left eye I can see close up. My last visit my eye pressure was at 30 and I am taking Combigan eye drops twice a day for the left eye. My right eye was 17 IOP.
When is it safe to get the cataract surgery? How experienced are most Opthamologist with doing cataract surgery after having a vitrecomy and the difficulty level of the surgery.
Thanks for answering.
Cataract surgery can really be done almost anytime following vitrectomy. Most cataract surgeons who work closely with retinal specialists are accustomed to operating on people with your circumstances. Cataract surgery is usually not too difficult without the vitreous.
[…] will need cataract surgery. Just like grey hair, everyone gets cataracts; some early in life and some later in life. […]
I’m getting cataract surgery in 2 weeks on right eye I have wet macular degeneration and getting shots in that eye and that eye I have a cataract . I responded very well to avastin on first shot . My vision is really bad and I’m worried that my retina is damaged . Having such bad anxiety so scared Dr keeps saying they will not be able to tell if retina is damaged till the do the surgery I’m going nuts with worrying
We completely understand your concerns about your vision in that right eye. It’s good news to hear you are keeping up with your macular degeneration treatment and that your retina is responding so well to the Avastin.
The only true way to assess visual potential in that eye is to remove the cloudy lens and replace it with a clear one. After that, there will be an unobstructed visual pathway to your retina and this will offer a true assessment of visual capacity.
Regardless, generally speaking, removing the cloudy lens will help!
Thanks for writing in and best of luck,
Mike Rosco, MD