Cataract development and removal. How to answer the questions a patient asks

Cataract surgery with implantation of an intraocular lens is a safe procedure that, when indicated, can quickly and effectively improve vision. Indications vary with patients, but surgery is generally needed when vision has deteriorated to a level that interferes with the patient's life-style. The procedures of choice for cataract extraction are extracapsular surgery by conventional large incision and phacoemulsification by small incision with placement of a posterior chamber lens. Patients with macular degeneration do not benefit from cataract surgery as much as those with normal macular function, but they may enjoy brighter vision after surgery. Tests that can ascertain whether the macula is functioning allow the physician to inform the patient as to the likelihood of improvement. Ultimately, the patient must judge whether the benefit of surgery is worth the risk. If the patient elects to undergo surgery, sending flowers is a nice gesture, but the physician's real task is to let the patient see--as well as smell--the roses.