Dear Dr. SerVaas: I have cataracts and am worried about the possibility of developing normal-tension glaucoma (NTG). During a dilated pupil exam, can an ophthalmologist adequately visualize the optic nerve through a clouded lens?Another question: should cataract surgery be performed on someone with NTG? Julia Andrulot Destin, Florida Dear Reader: We sent your questions to glaucoma specialist Dr. Darrell WuDunn at Indiana University. Dr. WuDunn responds: "The ability of an ophthalmologist to visualize your optic nerve is dependent on having a fairly clear view through your eye. In addition to cataracts, other eye conditions can impair the view. In general, however, mild or even moderate cataracts should not be a major problem. Your ophthalmologist can tell you if your cataract is severe enough to impair his or her view of your optic nerve. Usually by that point, your vision is compromised enough that you would probably want to have the cataracts removed anyway to improve your own vision. "A person with normal tension glaucoma can certainly undergo cataract surgery if desired. However, cataract surgery often affects the control of eye pressure. Sometimes the eye pressure increases after cataract surgery and sometimes it decreases. Your glaucoma eyedrop regimen may need to be adjusted afterwards. In some instances, a glaucoma operation can be performed at the time of cataract surgery. Whether to undergo cataract surgery if you have glaucoma is an issue that should be fully discussed with your ophthalmologist."
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