Can cataracts be treated without surgery?
While cataract surgery can make a huge difference to a person's vision and quality of life, some people don't need surgery, and others simply don't want it. Here I cover the non-surgical options for cataracts – what works, what doesn’t, and whether it’s safe to avoid surgery.
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Important disclaimer: This is an informational overview, and every individual patient’s situation is different. This article is not a replacement for personal medical advice. For advice specific to your situation please see a health professional.
A “cataract” is when where the natural lens inside your eye (also known as the “crystalline lens”) ages, changing its focus and making it less clear. This can cause various symptoms such as blur, haziness, glare, and even double vision.
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Surgery is the only way to get rid of a cataract
Once you have a cataract and your lens is cloudy, there is no way to “undo” the cataract and return your crystalline lens to its natural state. Cataract surgery is the only treatment that can permanently get rid of a cataract. This is a day surgery procedure where I remove the cloudy cataract and replace it with an intraocular lens implant, or IOL. IOLs provide good, clear eyesight with the option to optimise for a range of visual tasks.
So what about other options? Currently, there are no effective non-surgical treatments to reverse a cataract. There are websites and other sources selling eye drops, tablets, supplements, and devices that claim to treat cataracts. Some of these are based on sensible theories about how cataracts form, some not so much, but in studies none of them have proven to be effective for cataracts in humans.
“Being diagnosed with cataracts doesn’t mean you must have surgery right away … glasses and good lighting may help you see better prior to having cataract surgery”
As our understanding of cataracts improves, we might be able to apply these insights to develop effective medical treatments. Unfortunately these medical treatments do not exist yet.
It is safe to delay surgery?
Being diagnosed with cataracts doesn’t mean you must have surgery right away. It’s almost always safe to delay cataract surgery until you’re ready to go ahead.
If you choose to wait, the cataract won’t improve on its own and your vision may get more blurry, but you can be confident that you’re not doing any permanent damage to your eyes (there are some exceptions, see below). If you later decide that you want to have surgery, the cataract will be completely removed at that time and your final vision will be as good as if you’d had surgery when the problem was first diagnosed. Evidence of this is the remarkable improvement that patients achieve after cataract surgery in the developing world, where cataracts are many times worse than those seen in metro South Australia.
There are some situations where delaying cataract surgery might cause problems. These are uncommon situations and your eye specialist will advise if they apply to you:
Cataracts causing glaucoma: cataracts worsen narrow-angle glaucoma, which can cause irreversible damage to the optic nerve.
Cataracts in children under 7 years old: a child’s rapidly developing brain needs clear vision to learn to see. Delaying this may have permanent effects.
Driving: cataracts may cause your vision to drop below the legal driving standard. It is possible to drop below this standard despite feeling like your vision is “not too bad”.
Safe mobility: cataracts and other causes of low vision increase a person’s risk of falls.
Mature cataracts: the most severe form of cataract. These are more challenging to operate on and have an increased risk of surgical complications. It’s best to operate before the cataract gets this bad.
How to get the most from the vision you have
Cataracts cause a range of symptoms including blurred vision, glare, trouble in low light, and double vision. Cataract surgery addresses all of these problems, but there are things you can do to see better before (or instead of) surgery:
Keep your glasses up to date: if you already wear glasses cataracts can change your prescription, and if you don’t wear glasses cataracts can cause you to need them for the first time. See your optometrist to ensure you have up-to-date glasses.
Wear sunglasses: normal polarised sunglasses are available over-the-counter and will reduce glare in bright conditions. Sunglasses also reduce UV light which may slow down cataract progression. For glare indoors your optometrist might recommend tinting your glasses slightly.
Use good lighting: this could be sunlight, room lights, a strong lamp to read by, or even the light from your mobile phone when you’re out and about. Reading on backlit electronic devices (phone, iPad, etc) is easier that regular books.
Slow down cataracts with healthy habits
Smoking is a major risk factor for the progression of cataracts. Quitting smoking can slow the progression of cataracts, along with many other eye and general health benefits.
Uncontrolled diabetes is a common reason to develop early-onset cataracts, and good blood sugar control can delay cataract onset. It’s important to remember that diabetic retinopathy and diabetic macular oedema are also caused by poor sugar control, and these conditions lead to irreversible vision loss. If you have reduced vision and diabetes, call me to make an appointment for a diabetic eye check.
How do I know what’s right for me?
If you have reduced vision and you don’t why, see your optometrist, see me, or see any eye specialist to arrange a check-up. It could be something simple like needing new glasses, it could be cataracts, or it could be something more serious needing treatment.
If you already know you have cataracts and want to find out what the best option is for you, call me on 8326 6900 to arrange a telephone or clinic appointment.