Before you just accept you Ophthalmologists advice to get cataract surgery there are many questions you should ask your Surgeon. Generally besides the inherent risks of the surgery itself as there are in all surgeries, there are other longer term risks just from getting the surgery. Basically these risks increase significantly if the patient has Diabetes. Cataract surgery is elective surgery and unlike cancer surgery it is often better to put it off until your vision becomes effected enough to prevent you from doings things you like to do. Here is a list for you to ask your surgeon before surgery. I asked them and he recommended that I wait. I will eventually have to get it but the later the better as far as increasing other diseases of the eye caused by the surgery itself.
1)Do you need it yet? The sheet pre-op nurse will give you before my surgery date says there were greater risks if you have surgery from diabetic complications down the road? So do you need it now? For me the Cataract was in my left eye. However my straight ahead vision was fine 20/25 or so. My right hand vision was fine. My left hand vision was 20/40, but this as of yet didn’t affect my driving. I told him I was not sure about night driving since I have not driven any long trips since my diagnosis. In certain lights such as mercury vapor lit stores there is some net affect. However could, I live with it? My answer was yes. My Doctor agreed with me. What a relief!
2)If you cover your affected eye can you see well? If I cover your good eye explain what you see to your Surgeon. In my case my right eye is the better eye and it’s like looking trough a smoky room and things are not as detailed. I can see a painting with my left eye and the major things in it, but not the details like thin plant stems, or artist’s signature. The Doctor said don’t cover my good eye. That made sense.
3)Can you read with my regular reading glasses? If not then this affects your quality of life. You must judge by how much and if it is worth having the operation now.
4)I you have Diabetes 2 timing is an issue. If your surgery is in the afternoon is there something you can do to prevent hypoglycemia? Lower or eliminate your medication? I thought maybe not taking the Metformin (my diabetes medicine might help. If so when should I stop taking it. If not what else can I do to prevent hypoglycemia from the fast the day of the surgery? The answer for me was to schedule a much earlier surgery in the morning. The only reason I had late surgery scheduled was there was no time available in the near future. The delay will take care of that as well.
5)Tell your Doctor all the medications and allergies you have and all the medications you take. I am allergic to Penicillin and get somewhat itchy if I take a Percoset and it interferes with sleep. I have high Cholesterol and take medication for it. Worst of all I take Uroxatral for an enlarged prostate. This can cause complications during the operation itself. If the Surgeon knows he can take precautions to minimize the risk from this drug.
6)Also ask your Surgeon what are the chances of each complication of the operation as stated in the risk sheet they give you.
7)Ask him to look at your eyes. If the Surgeon was the Doctor who recommended the operation, GET A SECOND OPINION!!! I can’t emphasis this enough. Ask if the Doctor thinks you need the operation now or should postpone it because of risks versus the benefits.
8)In my case, have some cataract in my right eye as well but it does not yet affect my vision. If this is true for you as well ask the Surgeon how long it will be before your second eye is affected. If you see equally poorly out of both eyes, it would affect your vision and ability to do things such as driving, reading, and many other quality of life routines.
9)Should you wait and see how things go or go ahead with the operation. The Surgeon most probably will not answer this question but he may venture a guess.
10)What are the odds that after the operation and a healing period, that your surgically altered eye will improve? How much of an improvement could be realistically expected?
11)If you take an anti-inflammatory the sheets warns you to discontinue it for ten days before the operation. The Doctor may advise you to continue to take this during this period. Does this increase risk?
12)Will all my charges be covered under my medical plan other than normal co-pay? If not what will I have to pay? Cataract surgery on one eye goes for about $5,000 a pop these days. This is vital information.
13)If you are in an HMO, what do you need to get from your primary care physician for insurance purposes?
14)How long will you not be able to drive for after the operation?
15)Do you have a person to drive you to and pick you up after surgery? You will not be able to drive.
16)What other restrictions will you have post-op.
17)Ask the Doctor if you missed anything he wishes to tell you about not in these question.
These are important questions. Never rush into elective surgery if it is not time critical. In the case of cataracts, time may be on your side.
My surgery was postponed because I asked the right questions. Hopefully these questions will help you and your Surgeon decide what is best for you.
