Do I Really Need Cataract Surgery?

Cataracts are part of the natural aging process. Everyone gets them to one degree or another if they live long enough. Cataracts, as they progress, create increasing difficulty with the normal activities of living. The symptoms vary from one person to another. Some people have more difficulty with their distance vision, some with reading. People may report difficulty with glare, or foggy, blurry, or hazy vision.

Doctors have noticed an increase in requests for second opinions because patients are sometimes told they have cataracts and they HAVE to have surgery--even though the patient has no visual complaints. Just having a cataract is not a reason to have cataract surgery.

According to the American Academy of Ophthalmology, "The decision to recommend cataract surgery should be based on consideration of the following factors: visual acuity, visual impairment, and potential for functional benefits." Therefore, the presence of a cataract is not enough to recommend surgery. There needs to be some degree of visual impairment that is altering the ability to perform your normal activities of daily living. There also needs to be some reasonable expectation that removing the cataract is going to improve vision.

A patients with advanced macular degeneration has significant visual impairment. If she has just a mild cataract, then removing that cataract is unlikely to alleviate the visual impairment. You therefore need to have both things - a visual impairment that interferes with your normal daily activities AND a reasonable expectation that removing a cataract is going to help improve vision to a significant degree.

There are some instances where a dense cataract might need to be removed even though the above criteria are not being met. One example is when a cataract gets so bad that it starts causing glaucoma. Another instance would be if the cataract interferes with treating a retinal problem because the retina cannot be well visualized if the cataract is severely hampering the view of the retina. Those conditions are VERY rare in the U.S.

Most people who need cataract surgery are aware they have a visual impairment and that impairment is altering their normal daily activities. There are times, however, when we recommend cataract surgery because there is a visual impairment but the patient is not aware of just how bad their vision is. For example, the legal driving requirement in New Jersey is 20/50 or better in at least one eye. So we do occasionally see a patient who think he sees fine but when tested his vision is worse than 20/50 and he is still driving. In that case we would recommend cataract surgery (assuming the cataract is the problem) even though the patient does not think he has an impairment.

If you have been told you need cataract surgery but feel you are not having any significant visual problem, you should consider getting a second opinion.

Contact Lens Hygiene 101

Hygiene is critical to wearing your contact lenses safely.

Contact lenses can significantly improve your vision, but it’s essential to care for them properly to avoid potentially serious infections or other problems.

These recommendations will help extend the life of your contact lenses and keep your eyes safe and healthy. 

Your lens insertion and removal routine

  • Before you handle contacts, wash and rinse your hands with a mild soap.
  • Make sure the soap doesn’t have perfumes, oils, or lotions. They can leave a film on your hands.
  • Dry your hands with a clean, lint-free towel before touching your contacts.
  • It’s a good idea to keep your fingernails short and smooth so you won't damage your lenses or scratch your eye when inserting or removing your contacts.
  • Lightly rubbing your contact in the palm of your hand with a few drops of solution helps remove surface build-up.
  • Rinse your lenses thoroughly with a recommended solution before soaking the contacts overnight in a multi-purpose solution that completely covers each lens.
  • Store lenses in the proper lens storage case.
  • Don't use tap water or saliva to wash or store contact lenses or lens cases.
  • If you use hair spray, use it before you put in your contacts.
  • Put on eye makeup after you put in your lenses. Take them out before you remove makeup.
  • Always follow the recommended contact lens replacement and wearing schedule prescribed.

Your supplies

  • Use doctor-recommended solution.
  • Rub and rinse your contact lens case with sterile contact lens solution. Never use water.
  • Clean the case after each use.
  • Replace your contact lens case at least once every three months. 
  • Don’t “top off” solution. Use only fresh contact lens disinfecting solution in your case. 
  • Never mix fresh solution with the old or used solution.
  • Change your contact lens solution according to the manufacturer's recommendations.

Your eye doctor

  • Visit us yearly or as often as recommended.
  • Ask us if you have questions about how to care for your contacts and case or if you are having any difficulties.
  • Remove your contact lenses immediately if your eyes become irritated. Call us and let us know what’s going on.
  • Call us if you have any sudden vision loss, blurred vision that doesn’t get better, light flashes, eye pain, infection, swelling, unusual redness, or irritation. 

Wear your contacts safely

  • Some contacts need special care and products. Always use the disinfecting solution, eye drops, and enzymatic cleaners your doctor recommends. Some eye products or eye drops aren’t safe for contact wearers.
  • Saline solution and rewetting drops do not disinfect lenses.
  • Use a rewetting solution or plain saline solution to keep your eyes moist.
  • Don’t wear your contacts when you go swimming in a pool or at the beach.
  • Don't sleep in your contact lenses unless prescribed by your eye doctor.
  • Don’t clean or store your contacts in water.
  • See us for your regularly scheduled contact lens and eye examination.
  • If you think you’ll have trouble remembering when to change your lenses, ask for a chart to track your schedule or make one for your needs.

Be sure to call us if you have any questions about caring for your contact lenses or if your eyes are having problems.

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Mission Statement

Our doctors and staff are committed to providing thorough care with personal attention. At Eye Doctors of Madison, you will find the compassionate care of a small-town doctors' office with the knowledge of a big-city institution. It is our mission to not only treat each patient uniquely but also like family.

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