Cataract · Observe vs Surgery

Step-by-step decision

Choose step by step as prompted; reaching an endpoint gives the management recommendation. You can go back a step or restart anytime.

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Full pathway

1. [Decision] Functional impairment? + complications
   Degree of functional impairment? Any complications/fundus needs?
   • Lens opacity but mild functional impact, correctable → Mild impact → observe/correct
   • Vision loss affecting daily life/work, or patient preference (glare/reduced contrast sensitivity) → Functional impairment → phaco + IOL
   • Complications (lens-induced glaucoma/uveitis, or need to view/treat the fundus) → Complications → clear surgical indication
2. [End] Mild impact → observe/correct
   Mild functional impact → observe + refractive correction, improve lighting; no fixed visual-acuity threshold, follow up periodically by symptoms.
3. [End] Functional impairment → phaco + IOL
   Vision/function impaired affecting life or work, or glare/reduced contrast sensitivity, or patient preference → phacoemulsification + intraocular lens (phaco + IOL, standard); femtosecond laser-assisted (FLACS) is an option; preoperatively assess corneal endothelium/fundus/IOL power.
4. [End] Complications → clear surgical indication
   Lens-induced glaucoma/uveitis, or a clear refractive medium needed to assess/treat fundus disease → clear surgical indication, operate promptly (combined procedures as needed).

Source guidelines & references

• Cataract surgery indications (AAO Preferred Practice Pattern)

This pathway is our own synthesis of the decision logic in the guidelines above (not the guideline verbatim); thresholds and workflows change as guidelines update — in practice follow the latest guideline, your institution's protocol and the individual patient.

Other pathways