I perform a lot of cataract surgery in Traverse City, MI and I’ve found that many patients like to know what to expect when they come to my office for a cataract consultation.
If I know the patient has a visually significant cataract, either because I have seen them previously or because they were referred by their optometrist, then the visit will proceed as below. However, if the patient has not had a recent dilated eye exam then we will start with a complete exam to determine if any cataract is present.
One important point that I’d like to mention is that if someone is a contact-lens wearer, they need to stop wearing their contacts completely for a period of time before their cataract evaluation. This is because the contacts can alter the shape of the cornea and throw off the cataract surgery measurements mentioned below. Soft contact lenses should be not be worn for at least 1-2 weeks prior to the visit, and hard contacts for a longer period of time (our office can guide you on this).
Eye Measurements for Cataract Surgery
This is the first step of the cataract evaluation, and one of the most important. It is performed first because these measurements can be affected by the drops we use to dilate your eyes or check eye pressure, so we want to get pristine measurements before doing anything else. The results of these measurements also help to guide our discussion regarding potential cataract surgery.
What are these eye measurements for cataract surgery? A cataract is the natural lens in the eye getting cloudy and yellow, and when a cataract is removed it must be replaced with an acrylic intraocular lens (IOL) to allow the eye to see again. We use specialized state-of-the-art equipment to measure the exact dimensions of an individual eye, and these measurements are entered into complex mathematical formulas and artificial intelligence algorithms to predict the best IOL for an eye to see at a given distance.
Having modern equipment and using advanced IOL calculation formulas is one of the most important aspects of successful cataract surgery, and I pride myself on both of these points!
Dilated Eye Exam
Once we have the cataract measurements, we proceed to the comprehensive eye exam. This includes checking visual acuity, effects of glare on visual acuity, glasses prescription, eye pressure, and pupils (among other things) prior to dilation. Next the eye(s) are dilated. Since eye dilation can affect one’s ability to drive, we recommend having a driver accompany you to your cataract evaluation.
Your eyes must be dilated to examine your cataract because the cataract (lens in the eye) is right behind your iris (the colored part of the eye) and can only be fully examined through a dilated pupil. Dr. Potthoff has a state-of-the-art camera on the slit lamp microscope he uses to examine your cataract, this allows the patient and any friends/family to see what their actual cataract looks like!
Once your eyes are dilated, Dr. Potthoff also examines the “back of the eye”, including the optic nerve and retina, including the macula. This is important because diseases in this part of the eye (i.e. glaucoma or macular degeneration) can affect the lens choice and ultimate visual outcome following cataract surgery. Advanced diagnostic testing, including OCT imaging (ocular coherence tomography) can also be used to further evaluate these eye structures.
Surgeon Discussion
Throughout the visit, which typically takes about an hour, I discuss the various aspects of cataract surgery with the patient. This starts with what symptoms the patient is experiencing from their cataract and why they want to have cataract surgery. Often times a good part of the discussion is focused on the visual goals for a specific patient and how these can be met with the various IOLs and technology available to us. It’s also important to discuss the small but real risks associated with cataract surgery, since no surgery is ever 100% safe. Finally, we talk about what the patient can expect to experience on the actual day of cataract surgery.
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