Imagine hearing those words when you discover that cataracts are the culprit behind your poor vision.
You might immediately think, “My vision isn’t that bad, I can live with it… cataract surgery sounds terrifying. ”
But millions of Americans can testify to the positive life-changing effects of regaining vibrant vision after cataract surgery. Patients consistently describe the experience as transformative, being born again and getting my eyes back. Most wish they had the procedure done sooner.
Cataract surgery is one of the safest, most effective procedures performed in the US, restoring vision for millions of patients each year. For every 1,000 surgeries, less than one results in a serious complication. This statistic alone helps confirm that the risk of living with compromised vision is actually greater than performing cataract surgery.
If you’ve been diagnosed with cataracts, or hearing those words for the first time, how do you know it’s time for surgery?
First things first. What is a cataract?
Cataracts occur as a normal process of aging. No one is spared from cataracts if they live long enough.
A cataract forms within the natural, clear lens of the eye. The purpose of the lens is to focus and bend light to the back of the eye. In its normal state, the lens is clear and flexible. With age, protein fibers of the lens denature, forming a hazy cataract. Eventually, the cataract grows thick and dense.
Vision is affected at varying degrees during cataract development as light refracts abnormally around the cataract. Light is eventually unable to pass through the lens as the cataract matures and thickens.
Most often, cataract growth is slow, along with subtle changes in vision. Colors begin to fade and brightness dims. During this time, your brain adapts and compensates for the changes. Over time, it becomes more difficult to recall the vibrancy of normal vision before the cataract.
If you have signs of cataract, you’re not alone. Currently, about one in six adults over age 40 have evidence of cataracts. By age 70, one in two are affected by cataracts.
How do cataracts affect my vision?
Cataracts negatively affect vision, even in early development. Typical symptoms include:
- Blurred Vision: Especially noticeable when driving, watching TV, or looking at details across a room or in the distance.
- Sensitivity to Glare: Discomfort and squinting from bright sunlight or car headlights. You may find it harder to follow the flight of golf or tennis balls in the bright daylight.
- Ghost Images or Halos: Problems seeing double images and halos around lights can mean the cataract is scattering light as it enters the eye.
- Needing Extra light: As a cataract matures, less light reaches the back of the eye making it more difficult to see in low light conditions, especially when reading or driving.
- Frequent Changes to Prescription Eyewear: Updating eyeglasses can help for a time but will eventually be ineffective as the cataract matures. The cost to update glasses is also expensive and time consuming, while not correcting the baseline problem of the cataract.
When should I have cataract surgery?
While most ophthalmologists agree ‘you’ll know when it’s time’, there are plenty of signs along the way. These signs can be gradual or sudden.
You may notice that you start to limit activities like driving or exercise due a lack of confidence in your vision. For seniors especially, vision remains the primary physical sense used to independently engage with the world.
It’s important to note that health risks from cataracts are not localized to just the eye. Vision changes from cataracts impact patient safety and wellbeing. The best time for surgery is when cataracts negatively impact quality of life, and glasses or contacts are no longer effective. — Dr. Satyesh Rana, MD, Board Certified Ophthalmologist, St Lucie Eye
Consider these facts about cataracts:
- Untreated cataracts result in vision loss. When left untreated, the cataract will impair vision completely, causing blindness. Throughout the world, cataracts are the leading cause of blindness where modern surgery is not readily available. A simple, fifteen-minute outpatient procedure can restore clear vision.
- Cataracts are a degenerative condition. Once cataracts develop, they will never become clear. Surgery is the only treatment that effectively restores vision with a replacement lens (IOL).
- Cataracts interfere with daily activities. Glare and blurriness interfere with normal activities, causing people to limit participation in activities they enjoy. When changes in vision cause you to be less active or productive, it is time to talk about cataract surgery.
- Cataracts make night driving a safety hazard. Cataracts can make your eyes overly sensitive to glare. Streetlights, neon signs, and oncoming headlights can significantly impair vision, putting you and other drivers at risk.
Several well-known studies document an increased risk of falls, hip fracture and automobile accidents when needed cataract surgery is delayed.
Dr. Rana confirms, We strongly encourage all patients to be pro-active with their safety. An increase in car accidents, tripping, falling, or ‘near misses’ can mean reaction times have slowed due to decreased visual cues. Our ophthalmology team is here to help guide your decision about cataract surgery.
- In a sample of nearly 300 patients from a US study, patients aged 55-84 who underwent cataract surgery had half the rate of crash involvement during the follow-up period compared with cataract patients who did not undergo surgery.
- In another Canadian based study, over half a million patients aged 65 and older were tracked for up to 5 years after cataract surgery. The results showed an astounding 75 percent decrease in traffic crashes after cataract surgery compared to baseline. These results suggest that vision improvement following cataract surgery are associated with decreased driving risks.
- In another study from the Journal of the American Medical Association (JAMA), over 400,000 Medicare patients were evaluated for risk of hip fracture after cataract surgery compared with a matched group who did not have their cataracts removed. For those who elected cataract surgery, the research showed 30 percent fewer hip fractures in the year following cataract surgery. This was especially important for patients 80 years and older.
Is it ever too early or too late for cataract surgery?
While cataracts can be removed at any stage of development, there is nothing to gain by waiting. The surgery is appropriate for Medicare and insurance purposes when it meets the standard of visual impairment and negatively impacts quality of life.
The immediate benefit of cataract surgery is that it restores clear, vibrant vision.
The main risk of delaying surgery is that you will continue to have compromised vision. Without surgery, you can expect symptoms of vision loss and glare to increase as the cataract grows.
Additionally, evidence shows that patient outcomes are more successful when cataracts are removed earlier.
I’m quick to remind patients that it’s always their decision on timing, says Dr. Rana. However, we emphasize that vision will not improve without cataract surgery and only get worse over time.
More importantly, he adds, removing a hyper-mature, or dense cataract can damage delicate eye tissue and actually lengthen the patient’s healing time.
We know that many patients have a fear of eye surgery. This is completely understandable as patients experience cataract surgery once in a lifetime, whereas we see this every day. Our team works hard to reduce patient anxiety by thoroughly answering all questions and discussing all appropriate options.
The vast majority of patients tell us their one regret with cataract surgery was waiting so long to have the procedure. On average, we find that patients delay cataract surgery five years longer than necessary. That’s five years of struggling needlessly with the frustrations and limitations of poor vision!
What’s Next?
If you notice changes in your vision and are unsure of the cause, visit your ophthalmologist. The Academy of Ophthalmology (AAO) recommends all adults over age 50 get a baseline comprehensive exam to detect for evidence of cataracts, or any other issues.
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