When evaluating a patient with cataracts, the ophthalmologist must assess the degree to which the lens opacity affects the patient’s vision and determine whether surgery will improve the patient’s quality of life. Considering the answers to the following questions is important in the evaluation and management of cataract:
What is the functional impact of the cataract?
What are the morphological characteristics of the cataract?
Is surgery indicated either to improve the patient’s quality of life or to aid in the management of other ocular conditions?
What are the patient’s expectations regarding the refractive results of surgery?
Does the patient have ocular or systemic comorbidities that might affect the decision to proceed with surgery or alter the management plan?
What are the possible barriers to obtaining informed consent or to ensuring good postoperative care?
In most cases, cataract surgery is an elective procedure. Thus, in addition to answering the preceding questions, it is important for the ophthalmologist to inform the patient or the patient’s surrogate about the impact of the cataract, the risks and benefits of surgical management, the alternatives to surgery, and the options regarding the intraocular lens (IOL) to be used if surgery takes place. Ultimately, it is important that the patient or surrogate and physician be satisfied that surgery is the appropriate choice for improving vision.
This chapter focuses on the evaluation and management of cataracts in adults. For discussion of cataract in pediatric patients, refer to BCSC Section 6, Pediatric Ophthalmology and Strabismus.
Excerpted from BCSC 2020-2021 series: Section 11 - Lens and Cataract. For more information and to purchase the entire series, please visit https://www.aao.org/bcsc.