From the Guidelines
For cataract treatment, you should be referred to an ophthalmologist, not an optometrist, as ophthalmologists are medical doctors who specialize in eye care and are trained to perform cataract surgery, which is the only effective treatment for cataracts 1. While optometrists can diagnose cataracts during routine eye exams and may manage your eye care before and after surgery, they cannot perform the surgical procedure. The typical treatment involves removing the cloudy lens and replacing it with an artificial intraocular lens (IOL), and this outpatient procedure usually takes less than an hour, with minimal discomfort and quick recovery 1.
Key Considerations for Cataract Treatment
- Cataract surgery is a surgical disorder, and dietary intake and nutritional supplements have demonstrated minimal effect on the prevention or treatment of cataract 1
- Refractive cataract surgery, including astigmatism management, intraoperative refractive guidance, and specialty IOL implantation, has the potential to reduce a patient’s dependence on eyeglasses or contact lenses for distance, intermediate, and near vision 1
- Topical nonsteroidal anti-inflammatory drugs (NSAIDs) reduce the incidence of early postoperative cystoid macular edema (CME), but a long-term benefit has not been demonstrated 1
Postoperative Care
After surgery, you'll likely use antibiotic and anti-inflammatory eye drops for a few weeks, and you may need to wear an eye shield temporarily 1. Most patients experience significant vision improvement within days. Cataracts develop when proteins in the eye's natural lens break down and clump together, causing cloudiness that progressively worsens over time, so surgical intervention by an ophthalmologist is necessary to restore clear vision. According to the latest guidelines, there is substantial evidence that intracameral antibiotic administration reduces the risk of postoperative bacterial endophthalmitis 1.
Nonsurgical Management
While nonsurgical means can manage the symptoms of cataract before surgery is necessary, such as changes to glasses and contact lens prescriptions, low-vision devices, and pupil dilation, these are only temporary measures and do not replace the need for surgical intervention 1. Currently, no pharmacological treatments are known to eliminate existing cataract or retard its progression, and ophthalmologists should advise patients that there is insufficient evidence to support the use of pharmacological treatments for cataract 1.
From the Research
Cataract Treatment Options
- Optometry and ophthalmology are two fields that deal with the diagnosis and treatment of eye disorders, including cataracts.
- Cataract treatment typically involves surgical removal of the cataractous lens and replacement with an intraocular lens (IOL) 2, 3.
- Phacoemulsification is a common surgical technique used to remove cataracts, which involves breaking up the lens using ultrasonic waves and then suctioning out the pieces 2, 3, 4.
Referral for Cataract Treatment
- Patients with cataracts can be referred to either an optometrist or an ophthalmologist for treatment, depending on the severity of the condition and the patient's overall eye health.
- Optometrists can diagnose and manage cataracts, but they may refer patients to an ophthalmologist for surgical treatment 2, 3.
- Ophthalmologists are medical doctors who specialize in the diagnosis and treatment of eye disorders, including cataracts, and are qualified to perform cataract surgery 2, 3, 5, 6, 4.
Considerations for Referral
- The decision to refer a patient to an optometrist or an ophthalmologist for cataract treatment depends on various factors, including the patient's medical history, the severity of the cataract, and the presence of other eye conditions 2, 3, 6.
- Patients with complex eye conditions, such as glaucoma or retinal disease, may require referral to an ophthalmologist for specialized care 2, 3.
- Advances in technology, such as three-dimensional digital visualization, have improved the safety and efficacy of cataract surgery, making it a viable option for many patients 4.