Diagnosis: Bilateral cataracts, bilateral macular degeneration
Visual acuity: 6/9 right eye, 6/9 left eye
OCT scan showed atrophy and mild subretinal fluid at the left macula, and retinal pigment epithelium disturbance with no fluid at the right macula. Both eyes are white and quiet and lens opacities were noted bilaterally. Geographic atrophy was noted at the left macula with some subretinal fluid. Retinal pigment epithelium disturbance was noted at the right macula with patchy hyperpigmentation. No treatment is indicated at present.
We have explained to him the risks and benefits of cataract surgery and the guarded prognosis due to macular degeneration. We have given him some information to read regarding cataract surgery and we will see him again in 2 to 3 months time with his decision......
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The 'Guide to cataract surgery' says nothing about the 'guarded prognosis due to macular degeneration', but since 95 out of 100 notice an improvement in their vision and only 1 in 1,000 experience a total loss of vision after surgery it is a good bet. The Guide says there isn't a point when the condition is 'ripe' or 'ready' for surgery, but it should be when it affects daily life. Though I can still drive, 6/9 is getting close to the margin, so I think I'll ask to go ahead at the next appointment.
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