Cataract Surgery Over Age 90

Last week, I wrote that people should have cataract surgery when they have blurred vision that is not correctable with glasses (and we find a cataract that explains the blurry vision on exam). I wrote about my rule of thumb that patients should have cataract surgery if they turn 80 and have any vision imperfections despite updated glasses. A corollary is that it is not often wise to wait until age 90 to have cataract surgery. Very few individuals will not have some vision issues due to cataract by age 90. On the other hand, once age 90 approaches, patients usually start having more issues with following drop schedules, transportation, and the ability to cooperate with the surgery (they can’t lie still). These peri-operative issues only get worse with time, and the cataract also only gets worse with time. So, unfortunately, if people wait until that stage, they often decide that they are “too old” to get surgery and condemn themselves to poor vision for the rest of their lives. They are not too old in my opinion, but people understandably feel limited by their circumstances, especially if they don’t trust themselves to lie still. Before reaching that point, it is best to go ahead and have cataract surgery, which is another reason people in their 80s to pay careful attention to vision issues. You don’t want to be the 90-year-old who can’t see and feels too old to have surgery.