Jun 19, 2008

THE EYE MAN: When is the right time for cataract surgery?

By Andrew Soss / Daily News Columnist

Dr. Soss,

I have been told I have cataracts and should have them removed. The doctor has recommended an implantable lens that would allow me to see clearly near, intermediate and far. However I feel I am still seeing clearly and that my "clouding" is not apparent to me. I am having a little difficulty with night driving but that is all.

Why should I have this surgery now? If I wait will it be detrimental to my eyes? Since I seem to have no apparent problem with my sight now, why would this surgery improve my vision? And how would I know if it did?
C.K.



C.K.,

Cataracts, as you may know, are a very common disorder seen more prominently with advancing years. This condition involves the progressive opacification of the otherwise clear natural lens inside our eyes. There is a great deal of variation from person to person as to how rapidly the decline of the vision may occur. However, provided the remaining eye structures, such as the retina and optic nerve are healthy, the eye itself will remain healthy (except in very rare circumstances). The benefit from this information is the knowledge that as you wait to have a cataract extraction procedure, the vision decline in almost all cases will be reversible.

Here is the important answer to your immediate concern. You do not need to have surgery at this time if you feel that your vision is satisfactory and it is within the Department of Motor Vehicles vision standards for operating a motor vehicle. I qualified my statement because I have experienced many patients over the years who claim that their vision is just fine. However, during the course of the eye examination, I find it to be anything but adequate for driving a car.

Additionally, I should mention that the implanted lenses which correct for distance, intermediate and near vision may themselves lead to a number of vision-related problems in many individuals. I would, at the very least, try eyeglasses which have a similar type of correction first to see if you can tolerate the optical characteristics of this type of correction. Of course, because you have cataracts, your vision may not be clear; but you will still have some basis as to whether or not you will adjust to this type of implanted surgical lens. Otherwise, implanted lenses that correct only for distance vision would be the lens of choice. The only eyeglasses which would then be required for you would be for reading.



Questions to Dr. Soss should be sent to his e-mail theeyedoctor@att.net or via his Web site at www.dr-andrewsoss.com. All answers and opinions are those of Dr. Soss and not necessarily shared, endorsed or affiliated with this or any of our newspaper agencies.

Dr. Andrew C. Soss, OD, FAAO, has been practicing for over 20 years. During that time he has been a clinical instructor in the department of ocular pathology at the University of California. As a primary eye care provider in private practice in Burlingame, he is also board certified in the diagnosis, treatment, and management of primary open angle glaucoma.