A diagnosis of cataract can only be made by a thorough eye examination including slit lamp (microscopic) evaluation.
Other devices are sometimes used to determine if glare interferes with vision. If cataract surgery is being considered, an ophthalmologist will also examine the posterior aspect of the eye, which will include evaluation of the retina and optic nerve. If a cataract is mature (extremely dense) or hypermature (white), an ultrasound device known as a B-scan may be used to rule-out retinal detachment and ocular tumors prior to proceeding with cataract surgery.
The progression of cataracts is highly variable, however, they will invariably worsen in severity. Changing glasses may sometimes be useful in improving vision as the cataract progresses, since cataracts may induce relative nearsightedness. This is the answer as to why some patients with hyperopia (farsightedness) will actually have better vision without glasses in the early stages of cataract development.
For most patients, however, changing glasses has minimal impact on overall visual quality. Besides changing glasses, the only other option for treatment of cataracts is cataract surgery.
Your ophthalmologist will examine and test your eyes to make a cataract diagnosis. This comprehensive eye exam will include dilation. This means eye drops will widen your pupils.
Your ophthalmologist will examine your cornea, iris, lens and the other areas at the front of the eye. The special slit-lamp microscope makes it easier to spot abnormalities.
When your eye is dilated, the pupils are wide open so the doctor can more clearly see the back of the eye. Using the slit lamp, an ophthalmoscope or both, the doctor looks for signs of cataract. Your ophthalmologist will also look for glaucoma, and examine the retina and optic nerve.
Refraction and visual acuity test
This test assesses the sharpness and clarity of your vision. Each eye is tested individually for the ability to see letters of varying sizes.
Once I have a cataract diagnosis, what should I do?
Have an eye exam every year if you’re older than 65, or every two years if younger. Protect your eyes from UV light by wearing sunglasses that block at least 99 percent UV and a hat. If you smoke, quit. Smoking is a key risk factor for cataracts. Use brighter lights for reading and other activities. A magnifying glass may be useful, too. Limit driving at night once night vision, halos or glare become problems. Take care of any other health problems, especially diabetes. Get the right eyeglasses or contact lenses to correct your vision. When it becomes difficult to complete your regular activities, consider cataract surgery. Make an informed decision about cataract surgery. Have a discussion with your ophthalmologist about:
- The surgery, preparation for and recovery after surgery
- Benefits and possible complications of cataract surgery
- Cataract surgery costs
- Other questions you have