When is a Cataract "Ripe?"

I have always felt that this is a lousy analogy although used by many, many eye doctors.  It puts the patient in a more passive mode and relinquishes decision making to the doctor.  It sounds like there is a finite time to have cataract surgery and only the doctor can tell.  It is similar to going to the market and figuring out if a melon is ripe.  Does it feel right?  Does it smell right?  Does it sound right?  The fact is, you can, and should, be able to determine when cataract surgery is indicated.  

As with fruit, the cataract can get so far gone that it makes it more difficult to remove and may even cause problems associated with the over mature lens.  These lenses are termed “hypermature” cataracts and do require special techniques to remove.  These “hypermature” cataracts are so rare in the western world that I have seen on one in my career.  They basically don’t exist as cataract surgery is so accessible, that most cataracts are removed before progressing to this state.  

Cataracts cause blurry vision, glare and the need for more lighting.  Cataract surgery must meet certain criteria for insurance purposes, but basically can be removed when you can’t see as well as you’d like.  For instance, if you can’t read or see the TV well enough, can’t drive at night without tremendous glare, etc.

Many doctors use the fruit analogy to save time, as if, they know when your cataracts are bothering you.  Simply stating that they “aren’t ripe” puts you in a more dependant, passive mode.  Truth is cataract surgery is indicated when you want to see better and we, the doctors, agree that cataract surgery may help you.

Some people like bananas with no spots, yet other people like them with only spots.  Aren’t they both ripe?


Randall V. Wong, M.D.
Ophthalmologist/ Retina Specialist

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