The “Ripe” Time for Cataract Surgery

by William Corkins, O.D. Eye Specialists of Mid-Florida
Whenever I tell a patient that he or she has cataracts they immediately ask if they need to have surgery.
We start thinking about cataract surgery whenever the patient’s quality of life is affected. Common complaints include, “I can’t read road signs,” or “I can’t read the writing on TV,” or “I can’t read small print.” If I cannot make the glasses prescription better, then we start to consider surgery.
Another very common complaint that drives cataract surgery is glare at night caused by oncoming headlights or rainy nights.
I often hear from patients, “I thought you did cataract surgery when it was ripe.” Cataracts are not tomatoes; they do not get ripe! This expression came about when Medicare used the criteria of 20/50. If, with the best glasses, your corrected vision was worse than 20/50, then the cataract was “ripe” and Medicare would pay 80% of the cataract procedure. We have learned that using 20/50 as the criteria for cataract surgery is not adequate. Glare from the cataract is a more debilitating problem. You can have a person who can read the 20/20 Snellen line, but under glare conditions, this person’s vision drops to 20/80 or worse!
I explain this to my patients and they understand that the doctor is not the person who decides when to do cataract surgery, the patient does. When I examine my patients’ eyes annually, I listen for complaints. If the patient is happy with his or her vision and is functioning well visually, we schedule a follow-up appointment in one year. If the patient becomes symptomatic before then, they know to schedule an appointment sooner so we can talk about cataract surgery.
BIO:  Dr. Corkins served as a Captain in the U.S. Navy Reserve and still has a passion for aviation. He is currently building a Glasair III high performance, retractable gear airplane.

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