Cataract and Visual Field Defect

Question: I have a homonymous visual field defect as a result of a cerebrovascular (CVA) accident three months ago. Will this affect my ability to have and to benefit from cataract surgery on my right eye?

Answer: Cataract Surgery after a stroke or cerebrovascular accident (CVA) can be beneficial under certain circumstances-but in NO way will the removal of a Cataract reverse or improve the visual field defect. If the homonymous visual field defect is with "macular sparing" and you have reduced vision or other symptoms related to the formation of a Cataract, then it will be beneficial to have Cataract Surgery. If, the CVA caused any compromise of the nerve fibers or visual cortex that is responsible for central vision from the macula, then the likelihood of much improvement in central vision will be questionable after the Cataract is removed. Thus, in order to determine what you might expect it is important to have repeat visual field testing with specific protocols to determine relative or partial compromise of the macular functioning. It may be obvious or it may be difficult to determine depending on the type, density and location of the Cataract as these factors can adversely impact the ability to get an accurate visual field test. The CVA in and of itself should not limit your ability to have Cataract Surgery if you are otherwise in reasonable health.

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