PATIENT SELECTION ON

CATARACT SURGERY
Non Surgical Management
Prescribe new eyeglasses
or contact lenses to correct
vision.
Pupillary dilation, achieved either
pharmacologically or by laser
pupilloplasty, may improve visual function
by allowing more light to pass through
peripheral portions of the lens.
Aldose reductase inhibitors, which block
the conversion of glucose to sorbitol, have
been shown to prevent cataracts in
animals with experimentally induced
diabetes mellitus.
Use of specialized tints may
reduce glare, and brighter
illumination can improve the
contrast of reading material.
No known pharmacologic
treatments can eliminate or
slow progression of
cataracts.
Antioxidants such as zinc and
beta carotene and vitamins E and
C do not slow cataract
progression.
Indications for Cataract Surgery
Common indication for Cataract Surgery
Patient’s desire for improved vision (visual function)

Assess the degree of lens opacity affects vision & determine

whether surgery will improve the patient’s quality of life?

Patient’s expectation
Question
Indications for Cataract Surgery
Elderly person Monocular cataract
• Spectacle independence, decrease • Loss of stereopsis, diminished
frequency of falls & hip fractures  peripheral vision, disabling glare,
reduce morbidity & mortality symptomatic anisometropia

Bilateral cataract
• Performs 1st in the eye with the more advance
cataract
• In severe systemic illness/other ocular diseases
contributing ti decreased vision: appropriate to
operate 1st on the eye with better visual potential
• Other strategies: facilitate patient adaption include
on the dominant eye/more ametropic eye first
Other Indication for Cataract Surgery
indications

Additional
indication
Medical

Phacolytic glaucoma Presence of cataract obscure the

view of the fundus & impair
Phacomorphic glaucoma diagnosis or management of other
ocular diseases (Diabetic
Phacoantigenic uveitis Retinopathy, Macular degeneration
Lens dislocation or glaucoma)