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What do patients experience before cataract surgery?

Well, before cataract surgery a majority of my patients come to me with specific symptoms and fall into fairly clear categories. A lot of my patients don’t have cataracts, so they get referred from their opticians and are concerned that their cataract is significant and will lead to issues in the future. There is a second group of cataract patients who have specific symptoms. In my younger patients, they tend to notice things like difficulty driving at night and notice glares from headlights and streetlamps. They also don’t feel confident driving at night for long periods. That is a very early symptom of cataract.

My older patients notice symptoms, such as difficulty reading small print, problems looking at their phones and newspapers, and a decrease in speed when reading. Many of my patients will come to me looking for new glasses to correct their cataract symptoms, thinking that it’s actually a problem with their glasses. They sometimes come in with multiple prescriptions from their various opticians saying, ‘These glasses don’t work,’ and actually, it’s a cataract that is causing their symptoms. At times it can be just in one eye, which is enough to cause concern because they think that it’s going to affect both eyes. This is especially prevalent in my patients who are still working.

A lot of people get a bit distressed. Obviously, there is anxiety around how bad the cataract is, and patients ask common questions like, ‘How quickly is it going to progress?’ In general, cataracts generally progress quite slowly, but there is a subgroup of patients who have cataracts which can develop quite quickly. These sort of cataracts are sometimes induced by taking medications such as steroids. The large majority of cataracts are age-related and develop fairly slowly. Many patients are more concerned about the surgery and the complications because they are fairly well-read and understand that surgery is the only option to treat cataract. So people are naturally worried about the invasive nature of the surgery and what that entails.

One recurring thing that I get with a lot of my patients is when they are watching television; they struggle with the subtext, the scrolling screen at the bottom, and watching television programmes. Some people actually go to drastic measures and buy bigger televisions, sit closer to the TV or buy magnifying glasses. They do all of these special things to overcome the symptoms because people’s natural reaction is to try and adapt in the least invasive way, but generally, there is a reason why people develop those sort of symptoms. We are all using small mobile phones that have small fonts and many patients struggle with reading these and need to enlarge their font. Patients have similar problems on computers with small font size, and people have to start increasing the size of the font, which decreases their reading speed. So their daily activities are starting to be negatively impacted and things, like using your mobile phone, laptop or watching television are big parts of people’s lives, so it starts to really worry them.

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