How do you come to know when you get cataract?

My cataracts developed slowly over time, but eventually my eyesight got so bad that it couldn't be corrected well enough with glasses. I had bad double vision and huge haloes around lights, so I stopped driving at night. But the last straw came when I went to the movies and couldn't easily read the subtitles while watching 'Parasite'. I was at my ophthalmologist's that week!

My optometrist warned me well in advance that I was slowly developing cataracts and that I would probably need surgery at some point. A few years went by and while I normally get an eye exam once a year, I let it slip to a year and a half, and had kind of forgotten about it. Then I started to notice that I was seeing the text on the TV screen double. I then noticed when I compared eyes that the vision was no longer crisp, and kind of fuzzy. I then went to the optometrist and was diagnosed with a cataract in one eye significant enough to have surgery. In Canada it helps to get on the wait list as soon as you can as it can be a long time. I probably wasted 6 months or so by forgetting about my annual eye exam as I'm sure the optometrist would have detected it then. In total with the COVID surgery delays I probably waited over a year from the time I noticed a problem.

Since I was still seeing well with my other eye, I suspect I was not noticing the loss in vision for quite some time. It is still well corrected with eyeglasses only or actually now a contact.

These are 2 different questions:

1. How know - I kept cleaning my glasses because I could not see well and thought they were dirty. In a million years I never thought I had cataracts, until I went for my Optometrist exam and he said I did.

2. When get Surgery

Now this is a tougher one and everyone is different. I wanted a premium lens that would give close vision and just did not like what I read about the existing lens. I did not want the Restore (bad in low light, glistening Abbie Number and so forth) and I read Tecnis MF 4.0 came with large halos.

When Symfony was announced I wanted that lens, but it was not approved in the US. So I thought about traveling to Europe to get it. Then one of the Clinical Trial Opthmalogist said he expected the Tecnis low-add MF to be approved in the US soon and his experience with patients with that lens was the best he had from all the premium IOLs. I mean he had tried them all and gave me a complete run down of the issues with each of them.

So when the Tecnis MF 2.75 became available I got it.

So I procrastinated the longest I could and got the best lens available IMHO at the time.

In fact I am doing the exact same thing again. My right eye is shot and I am procrastinating for the Symphony Plus or Synergy to become available. If I did not have the Tecnis MF in one eye, I might get the PanOptix in one eye, but would avoid having 2 light splitting lens in both eyes.

I think the PanOptix and Symfony Plus might make a good mix and match combination depending on how Real World Results come out. Or the Synergy and Symfony Plus depending on how bad dysphotopsias are with the Synergy IOL. I really want a clear explanation on how Synergy gets you close vision up to 33cm with out a high close vision add.

People usually find out they have cataracts when they go to their optometrist complaining that they can't see well even with a recent glasses prescription and the optometrist diagnoses them.

Doctors used to wait until your vision was VERY bad before doing the surgery because it was very invasive. Now it's so routine and safe and minimally invasive that they will do it on almost anyone. Even people who don't have cataracts and just want to treat their presbyopia. So it's completely up to you. If things are becoming hard to do or even dangerous (driving) then it's time.

Driving regulations may also be a deciding factor. Where I live you need to have at least one eye that is 20/40 or better to hold a drivers license. And optometrists are legally obligated to notify police if your vision is worse than that. And police will take action to revoke your licence (not just wait until it renews and then refuse to renew it but actually come knock on your door). I am 20/32 and 20/40 and driving still seems fine to me but I know it will have to be done soon. On the other hand it doesn't seem to be getting any worse.

Really it's up to you and often driving is the deciding factor. And if one or both eyes are 20/40 or worse you'll likely want the surgery anyway because once you're in the 20/40 or 20/50 range you'll probably just find your vision to be too bad for most things.

If you live somewhere with universal healthcare you can get aspheric monofocal surgery for free but you'll likely have to wait 6+ months. If you want a premium lens or can't wait you can go to a private clinic. In Canada you can expect to pay about $3000 for monofocals or $6000 for premium lenses. And the wait will likely only be a week or two.

As some have said cataracts can either take a long time yo develop to the point you need surgery and in my case they progressed fast. In Canada the surgery is covered by our medicare system and a standard monofocal lens is covered or that amounted credited should you choose a premium lens.

Generally the surgery is coveted when your vision cannot be corrected better than 20/40 by glasses or contacts.

You'll know when it's time as you cannot read road signs and you'll experience halos and glare in low light and need better lighting to read. My right eye was 20/60 and left eye 20/50 when I had my surgeries.

It has been kind of mentioned but the other issue that some have with cataracts is vision that is changing quickly. The cataract distorts the lens in your eye and changes the power and astigmatism of it. An eyeglass prescription update can correct or partially correct it. However, what some find is that an eyeglass prescriptions does not last very long. You are back in a couple of months looking for a different prescription. If you have vision changes that eyeglasses cannot reliably correct then it is probably time to get the cataract surgery done.