When is cataract surgery not indicated

The case presentation below is about a young patient referred for cataract surgery who noticed deteriorating vision which was significantly affecting his quality of life and had resulted in him giving up driving due to safety concerns.

He was seen by his community optician who noted cataracts and referred him to one of the many community providers who perform high volume cataract surgery. He was listed for sequential cataract surgery but was unhappy with the management plan and decided to seek a further expert opinion from Mr Mohamed privately.

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In Mr Mohamed’s service, he was noted to have longstanding (likely from birth) cataracts which were not the cause of his symptoms. He also had signs and symptoms of ocular surface disease as well as keratoconus (a condition affecting the cornea that results in poor vision).

Cataract surgery in such cases is inappropriate and carries significant risk to vision.

His ocular surface disease and keratoconus were managed non surgically using eye drops and local treatment measures. He was visually rehabilitated and could return to his normal life including driving.

This case highlights the importance of careful assessment of the patient by an experienced ophthalmic surgeon before surgery is considered to prevent inappropriate surgery.

Please watch the presentation below for further details about the case.

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