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When Should an Individual Have Cataract Surgery?

By Tina D. Turner, M.D.

Treatment: Surgical Removal

To date, no medication or eye drop has been proven to prevent or reverse cataract formation. If a cataract is causing nearsightedness or a change in an individual’s prescription, new prescription eyeglasses can help improve blurred vision. The only treatment for a cataract, however, is surgical removal of the natural lens.

When to Remove? Sooner or Later?

A cataract should not be removed simply because it is present. Many people have cataracts that do not cause blurred vision, interfere with activities of daily living, or otherwise prevent them from leading active and productive lives. In such cases, these individuals should not undergo unnecessary surgery to remove their cataracts.

However, if an individual has blurred vision that makes it difficult to read print or read signs while driving; has disabling glare while driving at night; or has difficulty engaging in hobbies such as knitting, crocheting, or card games, it is time to consider cataract surgery.

In short, if an individual has a cataract and resultant blurred vision that makes it difficult to do anything he or she wants and needs to do, it is time to consider cataract surgery.

If there are cataracts in both eyes that require surgery, the surgeries are usually performed several weeks apart. Cataract surgery on both eyes at the same time is not recommended because there is a possibility of complications affecting both eyes; the most worrisome is infection.

Professor John Hull (1935-2015), Author of Touching the Rock: An Experience of Blindness

head shot of Professor John Hull

The late Professor John Hull is the author of Touching the Rock: An Experience of Blindness, his compelling memoir that documents the process of becoming blind. As a young university lecturer in the early ’60s, Hull had adapted to cataracts and the early signs of retinal detachment brought on by numerous surgeries.

“For the first few years after I registered as being blind,” he said, “I was not, in effect, a blind person. I was a sighted person who couldn’t see. It’s such a difference. It wasn’t until the light sensation completely vanished and I knew there was no way back that I said, ‘I’ve got to try to understand blindness; otherwise it will destroy my life.'”

Learn more about ways to find emotional support for you – and your family members – after a vision loss diagnosis:

How Much Should the Cataract Develop Before Having Surgery?

A cataract does not have to become “ripe” before it can be removed. In the past, the lens could not be extracted safely from the eye unless it was at a relatively advanced stage of development. With modern advances in cataract surgery, the lens can now be removed from the eye at any stage of development.

It is true that the longer a cataract develops, the more it hardens. At advanced stages, a firmer or more developed cataract can be difficult to remove. In certain situations, it is safer to remove a cataract sooner rather than later; in most cases, however, an individual should not undergo cataract surgery unless he or she is experiencing blurred vision caused by the cataract.

It is also true that if cataracts are allowed to develop for long periods of time, they can cause inflammation or increased intraocular (within the eye) pressure that can lead to glaucoma.

In these situations, it is extremely important to remove the cataract to prevent loss of vision from the resultant inflammation or glaucoma. This scenario rarely occurs in the United States, however, due to regular access to most types of health care.

The Patient’s Decision

It’s important to understand that it is the patient who should – and must – make the decision to undergo cataract surgery. It is the doctor’s responsibility to educate patients and give them the knowledge they need to make an independent and well-informed decision regarding cataract treatment.