Is It Time for Cataract Surgery? How to Know—and What to Ask First
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My dad has always been the steady one in our family — an engineer through and through. Logical. Methodical. Never rushed, never dramatic, always wanting every data point before he makes a decision.
So when his vision started slipping, you’d think having two ophthalmologists in the family would make the next steps obvious. But every time I gently suggested cataracts might be playing a role, he brushed it off with the same phrase he’d heard decades ago:
“They’re not ripe yet.”
If you’re from his generation, you’ve probably heard that phrase too — this idea that cataracts are like fruit you have to wait on, even if you’re squinting through nighttime glare and pretending the street signs haven't changed.
And for my dad, the clues were subtle at first:
– He always drives, even though my mom is younger and frankly has better reflexes.
– He mentioned that headlights were starting to “explode” across the windshield at night.
– Wrong turns became more frequent — which he blamed on the fact that everything in Hawai‘i “starts with a K.” (Not entirely false…but still.)
When he visited us last year, it became clear just how much he’d been adjusting, adapting, coping — without realizing how much he’d lost.
So we sat him down, took a closer look, and sure enough, his cataracts were much more advanced than he realized.
And here’s the part that breaks my heart a little, because I see it all the time in my clinic:
So many people from his generation believe they have to wait until they’re practically incapacitated before cataract surgery is an option.
They don’t want to complain. They don’t want to “make trouble.” They don’t want to seem dramatic.
But the truth?
We no longer use “ripe” as a measure — because it doesn’t reflect how we determine whether cataract surgery will genuinely help you.
What Cataracts Actually Are (and What They’re Not)
Cataracts aren’t a film, a growth, or something sitting on the eye. You can’t see them just by looking at someone.
A cataract is simply the natural lens of the eye becoming cloudy.
That cloudiness can show up in different parts of the lens — the center, the edges, the back — and each pattern causes slightly different symptoms:
Blurry or dull vision
Glare and halos while driving at night
Colors that look washed-out
Difficulty reading in dim light
Needing new glasses every year
Or sometimes, no obvious symptoms at all — just subtle changes you chalk up to aging.
The tricky part is that cataracts progress slowly. You don’t wake up one day and suddenly see fog. Instead, you adapt without realizing just how much you’re compensating.
My dad certainly did.
Why “Just Driving at Night Is Hard” Actually Does Matter
A lot of people tell me:
“My daytime vision is fine. It’s only nighttime that’s bad.”
“I can read just fine, I just hate driving now.”
“Headlights are brutal — but that means it’s not time yet…right?”
Actually, those are classic signs that it is time to talk about surgery.
Cataracts don’t have to take away your ability to read 20/20 on the eye chart before they become meaningful. What matters is how much they interfere with your life.
If you’re avoiding night driving, struggling to see friends’ faces across a room, or giving up things you enjoy because of vision frustrations — that’s your sign.
So When Is the Right Time to Have Cataract Surgery?
Here’s our modern answer, and it’s wonderfully straightforward:
When cataracts start interfering with the things you need or love to do, it’s time.
Not when they’re “ripe.”
Not when you can barely see.
Not when someone else decides for you.
It's about functionality and quality of life — your life.
There’s no magic number on the eye chart that qualifies you. It varies for each person.
And because cataract surgery, while extremely safe, is still surgery, we want the benefit to be worth the small (but real) risk. That’s why ophthalmologists may occasionally say, “Not quite yet,” even when a cataract is present — not because it’s too early, but because you may not see enough improvement yet.
What Cataract Surgery Is Like Today
Cataract surgery has come so far that many people describe it as easier than getting dental work done.
A few things to know:
It’s outpatient — you walk in and out the same day.
You are awake (but relaxed) with numbing drops.
The actual procedure is roughly 10–15 minutes.
Your surgeon removes the cloudy lens and replaces it with a clear artificial one.
Most people see dramatically better within a few days.
There’s no patch, no stitches, and typically very little discomfort.
And for many people, it feels like getting their world back.
My dad didn’t realize how dim and hazy everything had become until the morning after his surgery — when he called me amazed because “everything is white again.”
(Which, if you live in Hawai‘i, is saying something.)
Questions to Ask Your Ophthalmologist
If you’re helping a parent make this decision — or you’re considering it yourself — here are the most important questions to bring to your visit:
Is the cataract the main reason my vision is blurry?
(You want to know this before expecting surgery to fix everything.)What type of artificial lens do you recommend for my lifestyle?
Distance-only? Reading? Multifocal? Astigmatism-correcting?
There is no one-size-fits-all.What risks apply to my eyes specifically?
High nearsightedness, retinal conditions, glaucoma — all factor into planning.What should I do before surgery?
(Medication adjustments, avoiding lash extensions, stopping certain drops.)What will my recovery look like?
Most people resume normal activities quickly, but it’s helpful to know what to expect day by day.
Here’s the Bottom Line
There’s no prize for waiting until your world looks like a Monet painting — beautiful, but blurry and lacking contrast.
And there’s certainly no reason to struggle alone when cataract surgery is one of the most successful procedures we perform in medicine.
If you’re noticing changes in your parents over the holidays — more hesitancy while driving, more comments about glare, more missed steps in dim lighting — trust those instincts. These small signs matter.
And if you’re noticing them in yourself?
Don’t wait for the cataracts to be “ripe.”
Clarity is available long before that.
Want to Learn More?
This is just the beginning. In upcoming episodes, we’ll explore:
-How screen time and digital habits are shaping our kids’ development
–The connection between vision and overall health
–What you need to know about common eye procedures like LASIK and cataract surgery
–Practical ways to advocate for your child’s visual needs
You can subscribe to my podcast, In Focus, anywhere you listen—or follow along on Instagram for updates and tips.
Watch this episode on Youtube right now!
Thanks for reading—and for doing what you can to protect your child’s vision, one step at a time.
– Dr. Rupa Wong
Pediatric Ophthalmologist | Surgeon | Mom of 3
This episode is brought to you by The Pinnacle Podcast Network! Learn more about Pinnacle at learnatpinnacle.com
