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July 9, 1997

Clinical Crossroads Update: An 82-Year-Old Woman With Cataracts

Author Affiliations

Ohio State University Columbus

JAMA. 1997;278(2):116. doi:10.1001/jama.1997.03550020048029

To the Editor.  —In discussion1 of the follow-up of an 82-Year-old Haitian woman with cataracts that were increasingly impairing her ability to function, I feel that misleading information has been presented that could adversely affect a primary care physician's ability to properly weigh the risks and benefits of cataract surgery on an elderly patient. This could lead to an inappropriate recommendation to withhold or delay needed cataract surgery.Cataract surgery is indicated when a patient has a cataract that is interfering with the individual's ability to function and when the ophthalmic examination reveals that there is potential for visual improvement. If the retina, optic nerve, and neural pathways to the visual cortex are functioning properly, there is a high likelihood that vision will improve following successful cataract surgery.In the case in question, the patient has had delayed return of vision following cataract surgery and appears to be