Patient Education

Protocol for Cataract Surgery (Dr. Jagat Ram)

How cataract occurrence manifests?

  1. Gradual progressive diminution or blurring of vision
  2. Increasing difficulty with vision at night
  3. Glare or halos around light
  4. frequent changes in eyeglass
  5. as if seeing through cloud

When to operate?

  1. When patient having cataracts begin to affect quality of life or interfere with ability to perform normal daily activities, such as reading or driving at night or professional work.
  2. When best corrected  visual acuity is 6/12 or less
  3. When density of cataract is appreciable on examination

What eye surgeon looks for ?

It  includes visual acuity, intraocular pressure, dilated pupil fundus examination to rule out age-related macular degeneration, retinal pathology, type of cataract, density of cataract, to rule out posterior polar cataract, associated pseudoexfoliation , subluxation or any corneal pathology like fuch’s atropy- is required. Other exam like blood pressure, blood glucose level and ECG also required

What type of cataract surgery?

Mostly it is Phacoemulsification with posterior chamber intraocular lens implantation. One should also explain what type of intraocular lens is being implanting i.e hydrophobic acrylic or hydrophilic or silicone. We prefer hydrophobic acrylic IOLs. One should explain whether mono-focal or multifocal IOL is being implanted and why along with cost issues!

Ethical issues in Cataract Surgery:

  1. Performing cataract surgery in a case where there is no cataract or only early cataract changes, is unethical unless there is other indications for performing cataract surgery such as associated narrow angle glaucoma or gross anisometropia, which must be explained to patient in details.
  2. Forcing patient to undergo cataract surgery when patient is not willing or is happy with the present vision
  3. Implanting multifocal IOL without explains its outcome/cost – advantages or disadvantages are unethical.
  4. Performing cataract surgery with intraocular lens implantation without explaining the outcome, without taking consent and without telling actual cost effectiveness is unethical.
  5. In case of occurrence of any complications during surgical procedure- hiding the actual complication and its management modality is unethical.

Dr. Jagat Ram

Professor AEC PGI

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