Timing of Cataract Surgery

As the population of elderly increases, management of patients with cataract is becoming an issue of increasing importance. Progress in surgical equipment and techniques has increased the safety of cataract surgery, and the insertion of an intraocular lens at the time of surgery has ensured many patients of good postoperative visual function. The mainstay of current cataract treatment is surgery, and it is possible to obtain improved vision if patients and surgical techniques are properly chosen. The timing of surgery is also an important factor. Visual acuity is not an infallible index because it may vary according to the conditions of measurement and the patient’s physical and/or mental status. The level of visual acuity required may also vary among different patients according to their lifestyle. Surgery is indicated for patients with nuclear cataract or posterior subcapsular cataract because daylight vision is affected even if the patients have good indoor vision. Surgery should be considered when decreased contrast sensitivity and increasing glare are noted. Since the visual field and fusional amplitude are narrowed when visual acuity is less than 0.5, such changes help in deciding when to perform surgery. The timing of surgery in elderly patients should be determined after consultation with an internist, because cataract patients often have concomitant