How Long Can Cataract Surgery Be Postponed - Eye Bulletin

Contents hide 1 Your Profession and the Nature of the Work You Do 2 Role of Co-existing Medical Conditions in Your Eyes 3 Role of General Medical Conditions 4 The Age When the Cataract Develops 5 The Type of Cataract 6 Guidelines by American Academy of Ophthalmology 7 What We Recommend

For how long can cataract surgery be postponed? The answer is – it depends! There are multiple factors which will help you decide if you can delay the surgery.

If your surgeon has diagnosed you with cataract, there is simply one treatment for it and that is surgery. Cataract is not a disease. It happens with aging. Cataract formation is a progressive cloudiness in the eye that happens to almost everyone with advancing age.

In most of the people this process is very slow while in others this happens fairly quickly. Rapid development of cataract develops in people who have either some eye infection or inflammation or have some systemic illness such as diabetes. 

Talking of diabetes, the cataract may develop within a few days or even within a few hours. This happens because of fluctuating blood sugar levels. The vision of the eye deteriorates rapidly. Sometimes the patient goes to sleep with good vision in the eye and wakes up with blindness in the morning.

There are other diseases as well, which can cause a rapid diminution of vision. If you do not have any other disease or a problem like diabetes, then your cataract increases very slowly and your vision decreases gradually. 

Cataract surgery is elective which means you choose when you want to get operated.

There are a few factors which will decide when you would like to get your surgery done:

1. Your vision and the role of your vision in your profession or your daily life
2. Any co-existing medical conditions in your eyes
3. Any systemic illnesses you may have
4. The age when the cataract develops or is discovered
5. The type of cataract 

Here is a detailed discussion of the points listed above:

Your Profession and the Nature of the Work You Do

How soon you will need cataract surgery depends on your profession and how you make use of your vision.

For example, if your work involves a lot of near work and precision, you would prefer to get operated as soon as possible. On the other hand, a farmer whose work does not involve near work can wait for a few weeks or months for the surgery.

Broadly, if the poor vision caused by cataract interferes with your daily routine, you should prefer to get operated as soon as possible. But if you can manage your daily life with compromised vision to some extent, there is no harm in waiting for the surgery a little more.

Role of Co-existing Medical Conditions in Your Eyes

If you have any inflammation or infection of your eye or eyelids, your doctor will treat the above conditions first and then proceed for surgery later. If your eye is operated when your eyes already have undetected or missed inflammation or infection, it may cause post-operative infection in the eye.

Any infection in the eye after surgery will be of disastrous consequences. It is therefore advisable for you to make sure that you first treat the infection or inflammation and only then go for surgery.

Your doctor will be the best judge to decide when your eyes are fit for surgery in such a scenario.

If you have coexisting cataract and retinal disease, your doctor may ask you to get your cataract surgery done as soon as possible to enable him to evaluate the retinal disease in more detail.

Proper examination of retinal disease will make it easier for the ophthalmologist to treat the condition, especially if it requires laser or surgical treatment.

Role of General Medical Conditions

You need to be physically fit for cataract surgery.  Your blood sugar and blood pressure are important factors for fitness for cataract surgery.

If your blood sugar or blood pressure is high, you will have to delay your surgery till they become normal. So this alone is an important factor to determine when your cataract surgery should be done and how long you will have to wait for your cataract surgery.

Diabetes and hypertension are just two important factors for fitness for surgery. There is a long list of systemic medical illnesses which will need proper management and control before your cataract surgery is done. 

The Age When the Cataract Develops

If an infant is detected to have a congenital or developmental cataract, the eye should be operated as soon as possible. If the surgery is not done soon enough, the child may develop permanent blindness even after surgery is done later.

The above condition is called as amblyopia. In this condition, visual development at the level of brain does not take place in the early part of life because of lack of visual stimulation at the level of the eye.

In contrast to an infant, a grown-up child who develops cataract later in life, may not need surgery urgently.

For example, if a 15-year-old child develops a cataract there is no urgency to operate the eye immediately. Even if the eye is not operated soon, the child will still have good post-operative vision in case the surgery is delayed for any reason.

The Type of Cataract

Cataracts are of many types. Depending on the type of cataract, you may or may not postpone the cataract surgery. If your cataract is nuclear sclerosis or cortical type, you can postpone the surgery and manage your vision with glasses.

Nuclear sclerosis is the most common type of cataract which can be managed with minus lenses. 

But if you have posterior sub-capsular type of cataract, it cannot be managed with corrective glasses. In that case you will have to get your cataract surgery done soon to regain good vision.

When you visit your ophthalmologist, enquire about the type of cataract you have and ask if you can wait for the surgery. Your doctor should be able to advise whether you can defer the surgery.

Guidelines by American Academy of Ophthalmology

The American Academy of Ophthalmology offers four important questions for people to help them decide if they are ready for cataract surgery.

1. Is your cataract affecting your occupational activities or daily work at home?
2. Is your ability to drive at night safely affected?
3. Is your cataract interfering with your outdoor activities?
4. Are there any other ways to manage your cataract?

Answers to the above questions will give you a fair idea of the criteria to decide if you are ready for cataract surgery. Always keep in mind that cataract surgery is only recommended when the result is expected to improve your vision from what it is now.

What We Recommend

We advise that you should not postpone your cataract surgery beyond a stage when you have a moderate degree of visual disability.

If you delay the surgery for an unnecessarily prolonged period, the cataract may become harder in consistency. Removal of hard cataract may cause undesired complications during the surgery. 

Softer cataracts are easy to remove and the success rate of cataract surgery is much higher.  Statistically, visual recovery after surgery in a soft cataract is higher and faster than in advanced hard cataract.

Discuss with you ophthalmologist about the advantages of getting your cataract surgery done soon. Also discuss the advantages (if any) and disadvantages of delaying the surgery.

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