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Cataract Care

When to Have Cataract Surgery

When to have cataract surgery depends on several factors, including:

  • Your needs and preferences
  • Your doctor’s evaluation
  • Any risks or other eye conditions
  • When your insurance covers surgery

After considering these factors, you and your doctor will make the decision together. The right treatment for you is one that fits your eyes, your health and your life.

It could be time to have cataract surgery if vision changes are making it difficult to:

  • Work
  • Do activities you enjoy
  • Do everyday activities such as shopping, cooking or yard work
  • Drive, read or watch TV

At Oregon Eye Specialists, we’re here to help you meet your personal needs and goals. We know that everyone is different and that some activities require sharper vision than others. For example, if you are a pilot, you will probably need cataract surgery earlier than someone with another job or hobby.

If a cataract is preventing treatment for another eye condition, such as age-related macular degeneration (AMD) or diabetic retinopathy, you might have cataract surgery. The cloudy lens caused by a cataract can make it difficult for your doctor to treat these conditions.

In general, insurance pays for cataract surgery when it is medically necessary (needed to restore vision). For example, Medicare standards for medically necessary cataract surgery include:

  • Seeing 20/40 or less with glasses or contacts
  • Being less able to do daily activities such as reading, driving, watching TV or doing work tasks
  • Having cataracts that lessen your doctor’s ability to treat another eye disease

These are just some of the standards Medicare uses to determine if cataract surgery is medically necessary. Your doctor can tell you if your eye condition meets them, or if surgery is medically necessary for other reasons.

Other insurance companies may have similar or different standards for cataract surgery. If you have any questions, please talk to our insurance and billing staff as well as your doctor. We’ll work with you to help you understand what your insurance covers and create a treatment plan. Because cataract surgery does involve a small risk, your doctor will probably recommend waiting to have surgery if your cataracts are minor and you can tolerate any vision changes. Changing your glasses prescription and using brighter light for reading can help you see better in the meantime. Talk to your doctor about how to make the most of your vision before surgery.

Results of Cataract Surgery

About 95 percent of people who have cataract surgery see better after the procedure. But if another eye condition affects your vision, such as glaucoma or macular degeneration, you might not have good vision even after cataract surgery. Talk with your doctor about:

  • How much cataract surgery could improve your vision
  • Surgery risks if you have another eye condition
  • If the benefits of cataract surgery are greater than the risks

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