Ophthalmologist
Medically-indicated cataract surgery is recommended when vision loss is significant, and the patient cannot function adequately with their present level of vision.
The Doctors of British Columbia have established the following specific guidelines on Indications for Surgery (medically indicated cataract surgery):
https://www2.gov.bc.ca/gov/content/health/practitioner-professional-resources/bc-guidelines/cataract
I. Visual disability with Snellen Acuity of 20/50 or worse:
The ability to carry out needed or desired activities is impaired and ocular examination confirms that the best correctable visual acuity in the affected eye is 20/50 or worse and that the cataract is responsible for this.
II. Visual disability with Snellen Acuity of 20/40 or better:
The visual impairment produced by the cataract is responsible for any of the following situations:
III. Visual ability in the one-eyed patient:
The indications for surgery for the one-eyed patient (legally blind in the other eye) are the same as for two-eyed patients, except that the risk of total blindness must be considered and emphasized.
IV. Other indications for cataract removal:
a) Lens induced disease: phacomorphic glaucoma, phacolytic glaucoma, and other lens induced diseases may require cataract surgery and the need for extraction may be urgent.
b) Concomitant ocular disease that requires clear media: cataract extraction may be required to adequately diagnose other ocular conditions such as diabetic retinopathy.
“In conclusion, although the evidence does not indicate a precise benchmark for cataract surgery, it does provide a measure of guidance. As visual impairment is one of many risk factors for falls, fractures, and MVCs in the elderly, and as VA is shown to deteriorate over time, the results support timely access to surgery for individuals with visual impairment due to cataract. (Conner-Spady 2007, AAO PPP Cataract/Anterior Segment, Cataract in the Adult Eye October 2016)”
The American Academy of Ophthalmology adds that second-eye surgery patients experience significant improvement in visual function. The indications for surgery are the same as for first eye surgery.
The views and opinions expressed here are those of Dr. David Butler. They do not necessarily reflect the opinions of manufacturers or other doctors. Rev Feb 22-21