Cataracts

Diagnosis

To determine whether you have a cataract, your eye doctor will review your medical history and symptoms. They also will perform an eye exam. Your doctor may do several tests, including:

• Vision test. A vision test, also called a visual acuity test, uses an eye chart to measure how well you can read a series of letters. One eye is tested at a time, while the other eye is covered. A chart or a viewing device with letters that get smaller is used. With this, your eye doctor determines if you have 20/20 vision or if you have trouble seeing.
• Eye structure exam. An eye structure exam, also called a slit lamp, allows your eye doctor to see the structures at the front of your eye up close. It's called a slit lamp because it uses an intense line of light, a slit, to light up the structures in your eye. The slit allows your doctor to view these structures in small sections. This makes it easier to find anything that may be wrong.
• Retinal exam. A retinal exam looks at the back of your eyes, called the retina. To prepare for a retinal exam, your eye doctor puts drops in your eyes to open your pupils wide, called dilation. This makes it easier to see the retina. Using a slit lamp or a special device called an ophthalmoscope, your eye doctor can examine your lens for signs of a cataract.
• Fluid pressure test. This test, also called applanation tonometry, measures fluid pressure in your eye. There are multiple different devices available to do this.

Treatment

When your prescription glasses can't clear your vision, the only effective treatment for cataracts is surgery.

When to consider cataract surgery

Talk with your eye doctor about whether surgery is right for you. Most eye doctors suggest considering cataract surgery when your cataracts begin to affect your quality of life. This may include your ability to perform daily activities, such as reading or driving at night.

For most people, there is no rush to remove cataracts because they usually don't harm the eyes. But cataracts can worsen faster in people with certain conditions. These include diabetes, high blood pressure or obesity.

Waiting to do cataract surgery typically won't affect how well your vision recovers. Take time to consider the benefits and risks of cataract surgery with your doctor.

If you choose not to have cataract surgery now, your eye doctor may recommend periodic follow-up exams to see if your cataracts are getting worse. How often you'll see your eye doctor depends on your situation.

What happens during cataract surgery

Cataract surgery involves removing the clouded lens and replacing it with a clear artificial lens. The artificial lens, called an intraocular lens, is put in the same place as your natural lens. It remains a permanent part of your eye.

For some people, artificial lenses can't be used. In these situations, once the cataract is removed, vision may be corrected with eyeglasses or contact lenses.

Cataract surgery is typically done on an outpatient basis. This means you won't need to stay in a hospital after the surgery. During surgery, your eye doctor uses a medicine to numb the area around your eye. You usually stay awake during the procedure.

Cataract surgery is generally safe. However, it carries a risk of infection and bleeding. Cataract surgery also increases the risk of the retina being pulled out of place. This is called retinal detachment.

After the procedure, you may be sore for a few days. Healing usually happens within a few weeks.

If you need cataract surgery in both eyes, your doctor will schedule surgery to remove the cataract in the second eye after you've healed from the first surgery.

Lifestyle and home remedies

To deal with symptoms of cataracts until you decide to have surgery, try to:

• Make sure your prescription for your eyeglasses or contact lenses is up to date.
• Use a magnifying glass to read if you need more help reading.
• Improve the lighting in your home with more or brighter lamps.
• Wear sunglasses or a broad-brimmed hat to reduce glare during the day.
• Limit driving at night.

Self-care measures may help for a while, but your vision may get worse as the cataract grows. When vision loss starts to affect your everyday activities, consider cataract surgery.

Preparing for your appointment

Make an appointment with your usual eye care professional if you notice changes in your vision. If they determine that you have cataracts, then you may be referred to an eye specialist who can perform cataract surgery.

There's often a lot to talk about. It's a good idea to be well prepared for your appointment so that you can make the most of your time. Here's some information to help you get ready.

What you can do

• List any symptoms you're experiencing, including any that may not seem related to the reason you scheduled the appointment.
• Make a list of all medicines, vitamins or supplements that you're taking.
• Take a family member or friend along. Sometimes it can be difficult to absorb all the information provided during an appointment. Someone who comes with you may remember something that you missed or forgot.
• List questions to ask your health care team.

For cataracts, some basic questions to ask include:

• Are cataracts causing my vision problems?
• What kinds of tests do I need?
• Will cataract surgery correct my vision problems?
• What are the potential risks of cataract surgery? Are there risks in waiting to do surgery?
• What will cataract surgery cost, and will my insurance cover it?
• How much time will I need to recover from cataract surgery?
• Will any usual activities be restricted after cataract surgery? For how long?
• After cataract surgery, how long should I wait before getting new glasses?
• If I use Medicare, will it cover the cost of cataract surgery? Does Medicare cover the cost of new glasses after surgery?
• If I don't want surgery right now, what else can I do to help with my vision changes?
• How will I know if my cataracts are getting worse?
• I have these other health conditions. How can I best manage these conditions together?
• Are there any brochures or other printed material that I can take with me? What websites do you recommend?

In addition to the questions that you've prepared, don't hesitate to ask questions at any time if you don't understand something.

What to expect from your doctor

Your health care team is likely to ask you a number of questions. Being ready to answer them may allow more time later to cover other points you want to address. You may be asked:

• When did you begin having symptoms?
• Do you have your symptoms all the time or do they come and go?
• Do you have vision problems in bright light?
• Have your symptoms gotten worse?
• Do your vision problems make it difficult for you to drive?
• Do your vision problems make it difficult to read?
• Do your vision problems make it difficult to do your job?
• Have you ever had an eye injury or eye surgery?
• Have you ever been diagnosed with an eye problem, such as inflammation of your iris?
• Have you ever received radiation therapy to your head or neck?