I recently examined a very nice elderly patient. She was accompanied by her son. Her vision had recently deteriorated so she made an appointment to see what could be done.
The woman was essentially blind in one eye and slightly better in the other eye. She admitted that she wasn’t seeing as good as in the past, but things slid dramatically over the past two months.
The cataracts were easy to diagnose: dense, opaque, brown lenses. Seeing the back of the eye required maximum illumination with my indirect ophthalmoscope – the instrument with that very bright examination headlight. She never flinched.
Oh, did I mention that the patient was 91 years old?
“So,” she politely asked, “when do I get my operation?”
I reviewed her medical records: no diabetes, no high blood pressure, minimal medications. In many respects she was healthier than many obese smokers who have yet to collect Social Security.
Her biggest risk factor for surgery was simply the fact that she was 91. Was this woman too old for eye surgery?
I began my usual explanation about proposed benefits and possible risks of complications. No sooner had I finished when she declared, “Sign me up. Even if it is only one month, I intend to see clearly until the day these eyelids close forever!”
This delightful and feisty lady exemplifies all of the ‘quality of life’ concerns we have for the elderly. Age is irrelevant in her situation. She is as alive and functional today as any previous time in her life. Her family supports her decision and will be available to help during her recovery from elective cataract surgery, now scheduled for early April.