How are cataracts diagnosed?

Cataracts are relatively simple to diagnose by an ophthalmologist or an optometrist during a routine eye examination. It is important, when making the diagnosis of cataract, to also examine the entire eye for evidence of any other eye disease which may be compromising the vision. In addition to taking a medical and ocular history and visual acuity test, the ophthalmologist will check eye movements and pupillary responses, measure the pressure inside the eyes and examine the front and back of the eyes after the pupils have been dilated with drops.

What is the treatment for cataracts?

People with early cataract will find that changing their glasses, using sunglasses to decrease glare and having better lighting to read can significantly alleviate their symptoms. Magnifying lenses for close work and reading fine print may also be helpful.

Many cataracts are not bothersome, causing few symptoms. In that situation, no surgical treatment is necessary. However, the only true treatment for cataract is surgical removal of the cloudy lens. Surgery is suggested if the patient loses the ability to perform necessary activities of everyday life, such as driving, reading, or looking at computer or video screens, even with glasses, and there is the expectation that vision will improve as a result of the surgery.

Depending on a patient's specific visual needs, surgery is sometimes done on cataracts that are not very dense or surgery can wait until the cataract and the vision gets more cloudy. Patients' responses to cataracts vary. A cataract in only one eye may be disturbing to a particular patient and may not cause significant symptoms in another patient.

Cataracts usually do not harm your eye, so you can have surgery when it is convenient for you. Once you understand the benefits and risks of surgery, you can make an informed decision about whether cataract surgery is right for you. In most cases, delaying cataract surgery will not cause long-term damage to your eye or make the surgery more difficult.

If the eye has other diseases that have caused visual loss such as glaucoma, macular degeneration, diabetic retinopathy, or optic nerve damage from glaucoma, cataract surgery may not improve the vision.

Occasionally, your doctor may recommend removal of a cataract if it prevents diagnosis or treatment of another eye problem, such as macular degeneration or diabetic retinopathy.

If both eyes have cataracts and surgery is agreed upon, the surgery on the second eye is generally planned at least a week after the first eye. There is usually no harm in waiting a much longer period of time between the two eye operations.

Since the lens of the eye is necessary to accurately focus light onto the retinal surface and removal of the cataract involves removal of the lens, modern cataract surgery combines removal of the lens with placement of a new artificial lens into the eye. Measurements for the size, shape, and power of this lens will be taken at least a week prior to the surgery so that the lens can be ordered and available at the time of surgery.

More than 2 million cataract surgeries are performed annually in the United States. It is extremely safe and effective, improving vision in the vast majority of patients. 

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