Diagnosis
Your eye doctor will ask questions about your health and medical history and do a thorough examination of your eyes. These tests can show whether you have vision loss and what may be causing it. Tests may include:
- Vision test. A vision test, also called a visual acuity test, uses eye charts to measure how well you can read a series of letters. One eye is tested at a time, while the other eye is covered. Your eye doctor determines how well you can see and what kind of corrective lenses you may need.
- Microscopic exam. Your eye doctor may use a specialized microscope to look at the outer eye and structures inside the eye. This exam is often done with a device called a slit lamp. This uses bright light and a microscope to see precise details of structures or irregularities in your eye. Your eye doctor will look at the condition of the nerves at the back of the eye. This exam also can show if you have a cataract in a lens. With this exam, you may have eye drops to enlarge your pupils.
- Intraocular pressure test. This measures the pressure inside your eye. There are multiple devices available to do this.
- Questionnaire. You may fill out a form that asks you questions about how your vision affects your ability to do daily activities. If you have a cataract, this information helps in developing a treatment plan.
Treatment
When your prescription glasses or contacts 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 healthcare team.
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.
In rare situations, 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, most often your eye 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.
Preparing for your appointment
Make an appointment with your usual eye care professional if you notice changes in your vision. If you have a cataract, 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, the doses, and the reason for taking each one.
- Take a family member or friend along. Sometimes it can be hard 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 healthcare 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 healthcare 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 talk about. You may be asked:
- When did you begin having symptoms?
- Do you have your symptoms all the time or do they come and go?
- Is it hard for you to see in bright light?
- Is it hard for you to see at night?
- Have your symptoms gotten worse?
- Does your vision affect your ability to drive?
- Do you find it hard to read?
- Does your vision affect your ability to do your job?
- Have you ever had an eye injury or eye surgery?
- Have you ever been diagnosed with an eye disease?
- Have you ever received radiation therapy to your head or neck?