In most cases, the timing of cataract surgery depends on your lifestyle, symptoms and personal preference.
Cataracts are a normal part of aging. They form when the clear lens inside the eye hardens and becomes cloudy. Most people experience very gradual symptoms or changes in vision over several years.
Other types of cataracts — although less common — may develop if you’ve had an eye injury or eye surgery, take certain medications, have diabetes or spend a lot of time in the sun.
For many who develop cataracts, the most difficult question is when to have surgery.
According to Katie Luo, M.D., Ph.D., a cataract specialist practicing at Mass. Eye and Ear’s Longwood location, this is a personal choice. “Not everyone needs to have surgery right away. But if changes in your vision affect your daily life, or if you have a type of cataract that develops quickly, it may be time to consider surgery,” she said. “Ideally, it’s a choice you make with the help of your eye surgeon after weighing the risks and benefits.”
Here are some important things to consider before booking your cataract surgery:
Are Your Cataracts Interfering With Daily Life?
“First, your eye surgeon will want to know if changes in your vision affect your daily activities,” Dr. Luo explained. “We take into account both your symptoms and your lifestyle, because everyone relies on their vision for different things. For instance, the needs of a professional truck driver are very different from someone who uses a computer all day.”
Surprisingly, it’s not always easy to gauge your symptoms. For one thing, it can be difficult to tell the difference between cataract symptoms and normal signs of aging. Other times, the symptoms may be so gradual that you don’t even realize you have a hard time seeing.
That’s why Dr. Luo focuses on her patients’ ability to perform certain tasks.
“The number-one complaint people with cataracts have is difficulty driving, especially at night,” Dr. Luo said. Patients often report being sensitive to glare or seeing halos around bright lights. As a result, they may avoid driving at night altogether.
Another common symptom is difficulty reading, even while wearing reading glasses. Patients typically find that they need more light or a bigger magnifier to see clearly.
Many patients also find that their eyeglass prescription needs to be changed frequently. “It’s not uncommon for patients to get new glasses and then suddenly have difficulty seeing again six months later,” Dr. Luo explained.
Other signs might include clouded, blurred or dim vision.
How Fast Are Your Cataracts Progressing?
Most age-related cataracts develop slowly, while other types may develop more quickly and require prompt treatment. For instance, an eye injury can cause a traumatic cataract in a matter of months. And some medications, like steroids, can also lead to rapidly growing cataracts.
Do You Also Have Glaucoma?
If you have both cataracts and glaucoma — a group of eye diseases that damage the optic nerve — you may have more options to consider.
If you have early signs of glaucoma, cataract surgery alone may be recommended. Studies have found that cataract surgery can help to lower pressure inside the eye and prevent more nerve damage. That’s because the artificial lens is much smaller than the cataract, which can improve fluid drainage in the eye.
If you have more advanced glaucoma that is not well-controlled with medications, your doctor may recommend having glaucoma and cataract surgery at the same time.
“As always, it’s important to talk with your doctor to determine the best option for you,” Dr. Luo said.
Is it Okay to Delay Cataract Surgery?
In most cases, there is no harm in delaying cataract surgery for a while. But don’t wait too long. As a cataract matures, it hardens and can be more difficult to remove.
Dr. Luo stresses the importance of being proactive about your eye health: “If you think you might have cataracts, don’t delay your eye exam. Your eye doctor is your best resource. He or she can help you decide if and when you might need surgery.”
Your eye doctor can also help calm any fears about surgery. “In my experience, most patients delay surgery because they’re afraid of losing vision or that it’s going to be painful,” Dr. Luo said. Today, more than 95 percent of cataract surgeries are successful — making it one of the safest surgeries. And there is minimal, if any, pain during and after surgery.
“The more trust you have in your surgeon, the less anxiety you will have.”
About Our Expert
Katie Luo, M.D., Ph.D., is an ophthalmologist in the Comprehensive Ophthalmology and Cataract Consultation Service at Mass. Eye and Ear, Longwood. She does routine and complex cataract surgeries, laser vision procedures and cornea surgeries. She also directs Project Gafas, a global health initiative to provide donated glasses to underserved population around the world.
my friend is 86 with end stage heart failure…she is very uncomfortable with her lack of eyesight due to cataract impairment over the last 3 years…but her surgery keeps getting postponed…. Can Mass Eye and Ear take such a risk in this situation (by the way what is the risk to someone with heart failure?)….thanks for any information.
Hi Joel, thank you for reading. This is a great question for your friend to ask her doctor. If she’d like to see a specialist at Mass. Eye and Ear, she can call 617-573-3202 or request an appointment online.
I tell my patients that the timing of surgery is entirely up to them and that it is never too late
to remove a cataract. A dense cataract can be safely removed doing an extracapsular
Damn informative!! Thanks for sharing the informative post regarding cataract surgery. I’ve been having problems with my vision, but it’s not blurriness like I experience without my glasses, it’s more cloudy. Then, I decided to visit my family eye doctor at Vision Associates Inc. and they discussed the reason for that cloudy vision. Next week I am going to have my cataract surgery, I am quite nervous about that. Can you please share some tips to overcome the nervousness? Thanks!!
Can a hypermature cataract or posterior polar cataract be safely removed with laser and ultrasound? Or is the extracapsular procedure necessary?
Can there be more than one cataract inside the lens? I was told that one eye has an anterior cataract, nuclear sclerosis, and posterior polar cataract.
Hello.I’ve had the pre- exam for cataract but I have had to wait because of other personal problems for the surgery. How long can i wait before I’ll need another exam.
Hi Ed, thanks for reading. You should follow up with your medical provider for that information. If you’re a patient at Mass. Eye and Ear, you can call or 617-573-3202 send a message through Patient Gateway to check how long the pre-exam results should last.
I am 50 years old with astigmatism and prescription glasses since I was a young child. I have been told by my Ophthalmologist(s) over the past 5 to 6 years that cataracts have been forming and they are starting to impact my vision. My profession requires me to work on computers 8-10 hours per weekday for past 25 years. Are there studies that confirm the early development of cataracts from long term exposure to blue light generated by computer displays? Are the yellow tinted blue light blocking glasses recommended?
Thank you for your time!
Your blog is very interesting to read and very informative too.
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My friend wanted to have laser eye corrective surgery. He has very early stages of cataract which doesn’t affect his vision. When is having corrective cataract surgery too early? If it is had to early will it prevent future cateract?
I am 68 and have 20/400 vision in one eye since childhood. I am developing cataracts, have trouble reading without additional magnification or additional light, and have quit driving at night unless it’s well lit and I am familiar with the route, but my Dr. says I should wait because of the risk of losing sight in my one good eye. I do not want to wait but am really unsure of what to do. Should I seek a second opinion, and how does one find the best eye surgeon available in my area?
A relative with astigmatism needs cataract surgery. The doctor wants to perform the second surgery a week later. This seems soon to me. Is it too soon. ? Tks. Don
I would like some feed back on the VIVITY lens for cataracts. I understand it is fairly new. I have decided against multi focal lens and was thinking the vivity would give me better distance and intermediate distance than the mono focal lense for distance .
Hi Anette, thanks for your comment, we actually just published a post on the different types of lenses. If you have specific questions about brands, it might be best to follow up with your cataract surgery. https://focus.masseyeandear.org/which-cataract-lens-is-right-for-me/
This blog is really helpful for me as I’m going to have my surgery next week. But I think people should avoid bumping their eye into objects even if they are not recovering from an eye surgery :D. Also, I’m reading everything I can find about cataract surgery and found the content on Clarus Eye center’s(https://www.claruseye.com/cataract-surgery/) website useful. I’m having my surgery their and the doctors have been really co-operative throughout the process.
I am 58 years old, I had a laser surgery + 10 years ago, without any scar in my cornea. I would like to have another laser eye corrective L eye only surgery. I have early stages of cataract . When is having corrective cataract surgery is too early? I would rather have a cataract surgery now and avoid to have laser. Is it possible to have Cataract surgery in the early stage? Please let me know
Hi Marcia, since we can’t give specific medical advice over the blog, we suggest you contact our Laser Vision Correction/Refractive Surgery service at 1-833-LASER-99. Here’s more information: https://www.masseyeandear.org/specialties/laser-vision-correction
this blog is really informative
My eye doctor recommended I have a cataract consult. She noticed about two/three years ago cataract developing on my right eye. Last year she didn’t mention it. This year she it was in both eyes and needed a consult.
I am having trouble driving, reading, watching TV, and my depth perception is changing. I would like to have a consult soon. Please.
Sincerely , Diane Summerhays
Hi Diane, to arrange an appointment with a Mass Eye and Ear cataract specialist, please call 617-573-3202. Here’s more info on this service: https://www.masseyeandear.org/conditions/Cataracts