Cataracts get worse over time. Unfortunately, your doctor can't say how fast this will happen. There hasn't been any good research on this.

Not everyone with cataracts needs an operation to take them out. Some people get by with their cataracts for longer than others because their poorer sight doesn't bother them much. For example, a person whose hobby is listening to music might decide to have the surgery later than a person who loves bird-watching. And older people sometimes put off having an operation or decide not to have it at all.

In the past, doctors told people that their cataracts had to be very bad before it was worth having an operation. This was for two reasons:

But now we have safer and quicker operations. So cataracts are generally taken out earlier, before they cause serious problems. Also, now we have good artificial lenses, which are put in place of your own cloudy lens. These let you see better without thick glasses.

Your eye test can help you tell if now is a good time to have surgery. Doctors use a score to talk about the results of this test. The score tells how good or bad your vision is.

 

 

 

 

 

Source:
Khaw PT, Shah P, Elkington AR.
Cataracts.
In: ABC of Eyes. 4th edition. BMJ Books, London; 2004.

 

 

 

 

 

¹ To read more, see Eye tests.

But your doctor will probably suggest the operation when your cataracts get in the way of your daily life rather than when you have a certain score on your eye test. With some cataracts, you might be able to read well on the eye chart indoors, but you get a lot of glare from light outside. Having cataracts might mean you can't see well enough to read, work, play sport, go shopping or drive.

 

 

 

 

 

Source:
The Royal College of Ophthalmologists.
Understanding cataracts.
2001. http://www.rcophth.ac.uk/about/publications (accessed on 5 March 2009).

 

 

 

 

 

²

 

 

 

 

 

Source:
American Academy of Ophthalmology.
Cataract in the adult eye: preferred practice pattern.
September 2006. Available at: http://www.guideline.gov/ (accessed on 1 March 2008).

 

 

 

 

 

³

Your doctor might suggest taking out your cataracts even if you don't have trouble seeing. This could be because you have another eye problem that needs treating, and the cataracts are in the way.

 

 

 

 

 

Source:
Solomon R, Donnenfeld ED.
Recent advances and future frontiers in treating age-related cataracts.
Journal of the American Medical Association. 2003; 290: 248-251.

 

 

 

 

 

⁴ For example, if you have

 

 

 

 

 

diabetes
Diabetes is a condition that causes too much sugar to circulate in your blood. It happens when your body stops making a hormone called insulin (type 1 diabetes) or when insulin stops working (type 2 diabetes).

 

 

 

 

 

diabetes, the other eye problem could be leaky blood vessels in the back of your eye. Doctors called this diabetic retinopathy. Or the center of the back of your eye may be damaged. Doctors call this macular degeneration.

A cataract operation can:

And if you drive, this operation could make you safer on the road.

 

 

 

 

 

Source:
Owsley C, McGwin G, Sloane M, et al.
Impact of cataract surgery on motor vehicle crash involvement by older adults.
Journal of the American Medical Association. 2002; 288: 841-9.

 

 

 

 

 

⁵ Research shows older drivers who have had surgery to take out their cataracts are half as likely to be involved in a car crash.

An operation also has risks that you should talk about with your doctor. Your eyesight probably won't be perfect afterward. And you might need to wear glasses some of the time.

Cataract surgery can help even very old people.

 

 

 

 

 

Source:
Monestam E, Wachmeister L.
Impact of cataract surgery on the visual ability of the very old.
American Journal of Ophthalmology. 2004; 137: 145-155.

 

 

 

 

 

⁶ One study looked at people over 85 who had their cataracts taken out. It showed that:

Another study looked at the benefits of having cataract surgery in women over 70. After one year, the women who'd had cataract surgery were:

 

 

 

 

 

Source:
Harwood RH, Foss AJ, Osborn F, et al.
Falls and health status in elderly women following first eye cataract surgery: a randomised controlled trial.
British Journal of Ophthalmology. 2005; 89: 53-59.

 

 

 

 

 

⁷

Almost one-third of people with cataracts have another eye problem at the same time.

 

 

 

 

 

Source:
The Royal College of Ophthalmologists.
Cataract surgery guidelines.
April 2007. Available at http://www.rcophth.ac.uk/about/publications (accessed on 4 March 2009).

 

 

 

 

 

⁸

For example, if you have cataracts, you might also have:

If you have cataracts plus another eye condition, you probably won't see as well after cataract surgery as someone who has only cataracts. But about 8 in 10 people, including those with other eye problems, can see well enough to drive after a cataract operation.

 

 

 

 

 

Source:
Desai P, Minassian DC, Reidy A.
National cataract surgery survey 1997-8: a report of the results of the clinical outcomes.
British Journal of Ophthalmology. 1999; 83: 1336-1340.

 

 

 

 

 

⁹

If you choose not to have surgery, your cataract will not get better on its own. In fact, it will keep growing until your whole lens is cloudy. Your sight will slowly get worse until you can't see anymore.

Also, cataracts can cause other problems that can badly harm your sight. And leaving them to grow can make surgery harder. If you wait, it's more likely that something will go wrong during the operation.

One study found that people who waited several months for cataract surgery had more falls, compared with people who had the operation right away.

 

 

 

 

 

Source:
Hodge W, Horsley T, Albiani D, et al.
The consequences of waiting for cataract surgery: a systematic review.
Canadian Medical Association Journal. 2007; 176: 1285-1290.

 

 

 

 

 

¹⁰ Roughly half the people had a fall, whether they'd had cataract surgery or not. However, people who hadn't had their cataracts removed seemed to fall more often. About 25 in 100 people who hadn't had surgery fell two or more times, compared with 18 in 100 people who'd already had their cataract removed.

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