Cataract surgery does not cause macular degeneration. Macular degeneration, however, is often discovered just after cataract surgery when the vision fails to improve as hoped, causing many patients (and their frustrated families) to wonder if the cataract surgery caused macular degeneration.
Failure for Vision to Improve
In most cases of cataract surgery, vision gets better just after the surgery is completed. In the normal circumstance, surgery improves the vision quickly within a day or two.
Patients who fail to improve may be referred to a retina specialist for further evaluation.
Cataracts and ARMD
Both eye diseases become more common as we get older. Most of the time, it’s easy to distinguish between cataracts, macular degeneration or some other cause of visual loss.
Sometimes we can’t diagnose AMD because we can’t examine the retina.
When patients are referred for cataract evaluation, we do our best to ensure the cataract is indeed the cause of vision problem. In other words, can the degree of cataract cause all of the patients symptoms? A dilated eye exam is performed.
If there is an inconsistency, say when there is vision loss, but not much cataract (remember, cataract is clouding of the natural lens of the eye) then other causes of the visual loss must be considered, such as retinal disease, glaucoma, etc.
At times, however, the cataract is pretty dense (cloudy) making direct examination of the retina very difficult. Just as the patient is unable to see “out” of the eye, we are unable to see “in.”
When cataract surgery is performed, but the vision does not improve, everyone is disappointed…the patient, the family and the doctor. From our end, it is very difficult to explain that something else, for example, macular degeneration, is really causing the problem.
Not surprising, patients start to question if cataract surgery causes macular degeneration.
What Does This Mean?
Ideally, patients with dense cataracts and/or severe vision loss might benefit from an evaluation with a retina specialist. This “objective” evaluation might avoid some of the disappointment and frustration that results from a “surprise” diagnosis of macular degeneration.
In the end, every one would benefit, because surprises and disappointment erodes…trust.
Randall V. Wong, M.D.
Ophthalmologist, Retina Specialist
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