Determining When to Have Cataract Surgery

The appropriate timing of surgery is different for everyone. The first step is to determine with your doctor whether or not there is a reasonable expectation that surgery will benefit you. In addition, the following list of considerations that may help you decide the appropriate timing of your surgery.

Uncontrolled Eye and Medical Conditions

There are some medical and ophthalmologic diseases that should be well controlled prior to undergoing cataract surgery. Examples of conditions that should be controlled prior to surgery include, but are not limited to, uncontrolled blood sugar, uncontrolled high blood pressure, diabetic retinopathy, diabetic macular edema, wet (or neovascular) age-related macular degeneration, and uveitis. Your ophthalmologist may work in conjunction with an internist or retina sub-specialist to control these conditions prior to cataract surgery. Together, your doctors will determine when it is safe and appropriate to proceed with your cataract surgery. Please see “Cataract Surgery and Other Diseases” for additional discussion of some important diseases as they relate to cataract surgery.

Travel

Most cataract surgeons will want you to be in town for between one week and one month following your surgery. This is for your safety and the well-being of your eye. Should you develop an infection, inflammation, or other postoperative complication, it is preferable to be near your surgeon so that he or she can manage the problem. If you have plans to travel, be sure to let your operating surgeon know so you can be scheduled appropriately.

Planning Appropriate Assistance at Home

Although cataract surgery is short compared to most surgeries, it is still considered major surgery. It is a good idea to schedule your surgery at a time when you can have family and/or friends around to help you after surgery. For example, you may need help taking your eye drops, preparing meals, grocery shopping, cleaning your home, caring for animals, or performing yard work. You will have some restrictions placed on you for the first week after surgery, and this is the time during which you will want to have some assistance. Most patients are fine on their own after a day or so, but some will need assistance for longer, so it is best to have someone available.

Loss of Independence

Due to the fact that cataracts affect your vision, they can eventually affect your independence as well. This is most commonly manifested in the loss of one’s ability to drive, either at night, or altogether. Anticipating your needs and the impact that a loss of vision would have on your lifestyle is helpful in determining when to schedule your surgery. If you drive, or perform other regular activities that require good vision, and loss of the ability to perform these activities would be a burden to you, keep this in mind when you are considering whether or not to proceed with surgery.

Mobility and Falls

There is strong evidence that patients who have decreased vision are more likely to suffer from falls. In the elderly population, this has the added disadvantage of putting patients at risk of hip or other fractures. In fact, falls are the leading cause of fractures in the elderly population, and fractures in this patient population have an increased risk of hospitalization and death. If you are having difficulty getting around due to your vision, you should see an eye care provider as soon as possible.

Activities of Daily Living

Activities of daily living are slightly different for all individuals. They include basic activities, such as dressing, cooking, walking, etc. In addition, they include other activities that you either need or want to perform on a regular basis. These may include reading, golfing, running, needlepoint, watching television, etc. Decreased vision has been shown to negatively impact quality of life. If your decreased vision is affecting your ability to perform your specific activities of daily living and your general lifestyle, it may be a suitable time to have your cataract removed.

The appropriate timing of cataract surgery is different for every patient. In some cases, due to a particular set of circumstances, it may be prudent to defer your surgery date. In other cases, it may be better to schedule your cataract surgery as soon as it can be reasonably arranged. If you have questions about this, be sure to discuss it with your doctor and his or her staff. They can help guide you through this process.