Goals of Treating Cataracts in Cats
The goals of treating cataracts are to restore a cat’s vision, prevent the development of secondary problems such as uveitis, glaucoma and retinal detachment and improve the cat’s overall quality of life. Owners should seek veterinary advice if they suspect that their cat has cataracts. The only way to eliminate cataracts is to remove them surgically. Short of blindness, cataracts can develop into glaucoma and retinal detachment, at which point surgery may no longer be a viable option. Some owners decide not to treat cataracts, because cats typically adjust quite well to progressive vision impairment.
Cataracts in very young kittens sometimes spontaneously improve (or never worsen) and may not need to be treated. New cataracts that have very low opacity (classified as immature, incipient, non-progressive or incomplete cataracts) may also not need treatment unless and until they interfere with the cat’s vision. In some of these cases, topical anti-inflammatory eye drops may increase the cat’s comfort. The progression of cataracts caused by nutritional deficiencies may be delayed with appropriate dietary supplementation under a veterinarian’s supervision.
The only effective treatment for cats whose vision is impaired from cataracts is surgical removal of the affected lens (cataract extraction) and replacement of it with an artificial lens. Before surgery, the cat’s eyes should be examined with ophthalmic ultrasound and electroretinography, to make sure that the back part of the eyes are normal. There are several different ways to extract cataracts, each of which normally is performed by a specialized veterinary eye doctor (ophthalmologist). These procedures include: 1) extracapsular lens extraction (ECLE); 2) intracapsular lens extraction (ICLE); and 3) phacofragmentation or phacoemulsification (“phaco”). Most ophthalmologists prefer the phacofragmentation technique, which uses ultrasound waves to liquefy the damaged lens. The liquefied particles are removed through a sensitive suction instrument, and the eye is irrigated with a soothing sterile solution. An artificial lens can be implanted into the eye to restore vision; otherwise, the cat will be extremely far-sighted, with little useful vision. The prognosis is best if surgery is done early in the course of cataract development. Of course, the veterinarian will make sure that the cat is healthy and systemically stable before any surgery takes place.
Cataract surgery is expensive, and many owners decide that it is unnecessary due to their cat’s ability to acclimate to their environment even with vision loss. Cats use their sense of smell for most of their navigation activities and actually usually don’t have very good eye-sight to begin with. Cats with decreased or total loss of vision should be kept indoors at all times for their safety and well-being. If an owner elects not to have his cat’s cataracts removed, they still should be monitored by a veterinarian regularly to keep track of their progression. If a cat loses all or most of its vision, it often will have some accompanying pain. At that point, it may be best to surgically remove the affected eye(s).