Is it ok to leave things as they are or is the cataract surgery an absolute must?

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Dad is 73 years old. He has been told to have surgery to remove the cataract in this eye. Dad has dementia and is a very stubborn man, set in his ways. We are afraid that after the cataract surgery, he might rub his eyes continuously if he feels uncomfortable and makes things worse. I read about drops available online to help remove cataract. But since it is not the popular and widely recommended option, I have my reservations against that. My question being, if the cataract remains untreated, will it get worse to the point where he won't be able to see again? Dad does not drive or is expected to do anything that requires a great deal of clarity in vision.

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@geevesnc I just didn't know how much he can see or if he is in pain. Dad NEVER admits to any discomfort. He thinks he is too strong for any pain. If it keeps him from roaming, I'll be ok with that as long as there is no pain. Thank you for the advice.
@Countrymouse I discussed the possibility of being a bit tyrannical with my Sister and Mom after the operation. But when they are asleep, my Dad can't be guaranteed NOT to rub his eyes. It doesn't hinder much apart from household chores. Dad doesn't do much. They are retired. My folks live in a tiny little village. I just was hoping he could read books/newspapers again. Might make his life a little more joyful. But when he doesn't cooperate , I'd take NOT going blind over reading books/newspapers. I live far away from them in a different country altogether :( . But I'm hoping I can have them with me sometime soon and maybe I'd bring up the possibility of the cataract surgery again when I can physically do something about it rather than burden my Sister and Mom. For now, I think we'll avoid. the surgery. But for my own satisfaction, I wanted to see what others have done in similar cases. I wish you and your mother well. Thank you.
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BigHead, your father won't go blind exactly, but the misting will deteriorate until he's effectively looking through frosted glass - he won't lose light and dark, but he won't be able to read or see the t.v. meaningfully. That takes a fair old while, though. How much is his vision bothering him?

My mother had vascular dementia. The first cataract operation was a success, though keeping the plastic eye shield on (to prevent contamination, as well as stop her rubbing) involved being mean and tyrannical, and heavy-handed with the surgical tape. You also have to administer eye drops for a week - ? think it is - post-op, which can be difficult with an uncooperative patient. I was sufficiently ruthless to ignore the squealing and wriggling and use main force to prise her eyelids apart (cruel to be kind, and not crueller than absolutely necessary), but your mother and sister likely won't have that option. During the op itself, though, you can rely on the expertise of the surgical team - the surgeon will be assisted by experienced nurses, and bearing in mind their patient demographic they're pretty good at coaxing and calming elders.

The second operation was abandoned; partly because it just happened to be a bad day in the ophthalmology department - mother's slot kept getting 'bumped' by emergency admissions, it was late by the time they got round to her, and she was too tired and stressed out to comply with instructions - and partly because the potential improvement just wasn't worth the risk.

I'd suggest that your father and mother talk again to the surgeon, with your mother explaining her concerns about post-op care. If the surgeon still thinks it's worth having a go, then give it a go. Your mother can back out right up until the last moment; and there are all kinds of tips and wrinkles for aftercare, from plastic eye shields to boxing gloves.
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Having cataracts removed is not medically necessary. Yes, it may improved his vision but from what you've said, he may hinder healing, and also, the lack of vision has kept him from roaming. So, no, don't feel obligated to have it done. Cataracts don't cause pain or discomfort. He will be ok. Speaking from my own experience, my mother, 77, just had a HUGE cataract removed last week. She still can't see. The cataract removed uncovered macular degeneration which couldn't be seen because of the cataract. Now she has to see a retinal specialist. Sigh...There are definitely no GUARANTEES. Go with your gut. Best of luck!
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@Sunnygirl1 I totally understand what you're saying. A lot of them don't get how people with Dementia function. Seeing it first hand, it has been an eye-opener for me. Dad does not realize how he is hurting himself more than he is hurting anyone else. Thankfully our surgeon has been understanding. But there is nothing anyone can do if Dad won't cooperate. it is mostly my fear that he'd lose vision totally if he does not have this surgery. But at the same time, if he does have the surgery. he is highly likely to rub his eyes, dislocate the lens and go blind. That will just be an expensive way to get him blind. An option I'm not willing to take.

I really appreciate you taking the time to reply. I sincerely wish you and your LO a world of health and happiness going ahead.
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I would discuss the surgery and it's potential for harm in a loved one with the surgeon, but, I'd keep in mind that often doctors do not fully appreciate how a person with dementia functions. It's amazing how many people who have dementia, but the number of doctors who still don't get it. I think some doctors think dementia is just having memory problems. They don't get how it's odd behavior without filters and without the ability to process information.

I repeatedly encountered this with my LO, with her medical conditions, which did not include eye problems. Doctors would wrap her fractured hand, arm, etc. and then be confused that she would unwrap them. I had to explain her dementia behavior to them over and over. I had to do the same thing with ER staff, dentists, physical therapist, etc.

I don't think that they get just how a person with dementia may not be able to process and reason that they must not touch the eye, must lie still, etc. And even if they are able to understand, they FORGET and have no idea they are hurting themselves. So restraint is the only option. And that is tricky.

I might see an eye surgeon who has experience with dementia patients and be very specific and go into detail about what ifs. I've read a lot of stories about how with the cataract surgery, complete compliance with aftercare is required and being able to guarantee this is quite risky.
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@BarbBrooklyn

Yes. I guess it is pointless worrying about things we can't control. Either way, thank you for your well wishes and I wish you and your family the same.
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Bighead, when I first got here (must be like 5 years already) I was outraged by the idea that we were all simply waiting for "the fall" or some other event that triggered a need for a higher level of care, mandated by others.

I'm much more complacent now. This is so out of our hands.

Sending good thoughts your way. b
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@BarbBrooklyn Please don't apologize. You don't need to. It was more to do with me phrasing my question correctly. Mine is a very tricky situation. I'm more than a thousand miles away from where my parents are. So I'm not in a position to meet the Doctor myself. My Sister and Mom take my Dad to the Hospital. But since they are computer illiterate, I'm doing this to find out how I can help them. While Dad has numerous qualities that make him a fine human being, his refusal to admit his shortcomings make it difficult. He still thinks he is 40 years old. He tries to hop on his motorbike and go for a ride when he can barely walk. Till his vision got blurry, he used to take off for hours without telling anyone where he was going. So maybe the Cataract is some sort of a blessing in disguise. Since he won't admit his shortcomings, it is hard to gauge how bad things actually are. To the point what I fear the most is, if he can't see enough in the bathroom to slip, fall down and break something. It is a lot more stressful on my Sister and Mom. So I'm trying to help them in any way I can.

p:s I am really in awe of everyone who replies on this website helping out one another. I believe in karma and I hope every single soul is blessed in turn for what they do to help someone, small as it may be.
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Bighead, I'm sorry if my answer was less than useful.

I've found, in the past, that asking my mother's doctors "what would you do if this was your mom?" has produced good advice. One GI doc, who described extensive testing that he needed to do to figure out why my mom's food was getting stuck in her gullet, asked if he would proceed this way with his 90 yo mom said "h*ll, no". We needed to hear that; as a family, various members thought that we were being neglectful by not treating swallowing issues.
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@pamstegma Looks like not getting the surgery done just might be the way to go. It hurts seeing him struggle. But I wouldn't want him to go blind. That would be worse. Thank you for your reply.
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