Diagnosis

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

  • Visual acuity test. A visual acuity test uses an eye chart to measure how well you can read a series of letters. Your eyes are tested one at a time, while the other eye is covered. Using a chart or a viewing device with progressively smaller letters, your eye doctor determines if you have 20/20 vision or if your vision shows signs of impairment.
  • Slit-lamp examination. A slit lamp allows your eye doctor to see the structures at the front of your eye under magnification. The microscope is called a slit lamp because it uses an intense line of light, a slit, to illuminate your cornea, iris, lens, and the space between your iris and cornea. The slit allows your doctor to view these structures in small sections, which makes it easier to detect any tiny abnormalities.
  • Retinal exam. To prepare for a retinal exam, your eye doctor puts drops in your eyes to open your pupils wide (dilate). This makes it easier to examine the back of your eyes (retina). Using a slit lamp or a special device called an ophthalmoscope, your eye doctor can examine your lens for signs of a cataract.

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 or interfere with your ability to perform normal daily activities, such as reading or driving at night.

It's up to you and your doctor to decide when cataract surgery is right for you. For most people, there is no rush to remove cataracts because they usually don't harm the eye. But cataracts can worsen faster in people with diabetes.

Delaying the procedure generally won't affect how well your vision recovers if you later decide to have cataract surgery. Take time to consider the benefits and risks of cataract surgery with your doctor.

If you choose not to undergo cataract surgery now, your eye doctor may recommend periodic follow-up exams to see if your cataracts are progressing. 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 positioned in the same place as your natural lens. It remains a permanent part of your eye.

For some people, other eye problems prohibit the use of an artificial lens. In these situations, once the cataract is removed, vision may be corrected with eyeglasses or contact lenses.

Cataract surgery is generally done on an outpatient basis, which means you won't need to stay in a hospital after the surgery. During cataract surgery, your eye doctor uses local anesthetic to numb the area around your eye, but you usually stay awake during the procedure.

Cataract surgery is generally safe, but it carries a risk of infection and bleeding. Cataract surgery increases the risk of retinal detachment.

After the procedure, you'll have some discomfort for a few days. Healing generally occurs within eight 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 eyeglasses or contact lenses are the most accurate prescription possible
  • Use a magnifying glass to read if you need additional help reading
  • Improve the lighting in your home with more or brighter lamps
  • When you go outside during the day, wear sunglasses or a broad-brimmed hat to reduce glare
  • Limit your night driving

Self-care measures may help for a while, but as the cataract progresses, your vision may deteriorate further. When vision loss starts to interfere with your everyday activities, consider cataract surgery.

Preparing for your appointment

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

Because appointments can be brief, and because there's often a lot to talk about, it's a good idea to be well-prepared for your appointment. Here's some information to help you get ready.

What you can do

  • List any symptoms you're experiencing, including any that may seem unrelated to the reason for which you scheduled the appointment.
  • Make a list of all medications, 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 accompanies you may remember something that you missed or forgot.
  • List questions to ask your doctor.

For cataracts, some basic questions to ask your doctor 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 delaying 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 cope 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 to ask your doctor, don't hesitate to ask questions at any time that you don't understand something.

What to expect from your doctor

Your doctor 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. Your doctor may ask:

  • When did you begin experiencing symptoms?
  • Do you have your symptoms all the time or do they come and go?
  • Do you experience 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 (iritis)?
  • Have you ever received radiation therapy to your head or neck?