Question:
My mom's friend (75 or so) had an optic nerve stroke a year or so ago,
rendering that eye useless. Now her doctor wants to remove the cataract
from her other eye, and the friend is absolutely terrified that her
remaining vision will be destroyed. She sees well enough to drive, but has
stopped driving on the freeway simply because she's afraid that if she had
a stroke in the other eye she could kill someone. From this I conclude
that her current vision is not all that bad. She is the type of person who
believes that The Doctor Is God, and trusts him to make The Right
Decision. I don't have quite that much confidence in an HMO
ophthalmologist in Apple Valley, California. Since she lives alone by
choice, losing significant vision will have devastating consequences.
I've seen isolated reports of cataract surgery causing retinal detachment
or MD, but haven't been able to find any serious discussion.
My feeling is that under the circumstances it's a good idea to put off the
cataract surgery until it's so bad that she really has no other option.
Any papers, references, professional opinions, etc.?
Answer:
There can be a few serious complications (rd- ret detachment/cme-
cystoid macular edema)and as a rule to be more cautious on
cataract surgery on the remaining functional eye. If your mother
is not being bothered much by the cataract and has not reduced
her quality of living it would safe to hold off. But if her visual
acuity is actually poor (say 20/100 best corrected vision) and
is still driving serious consideration of the surger needs to
be addressed. Again,this is a surgery that is generally safe
to hold off if the person is satisfied with the present vision.
