Cataracts and cataract surgery

An 80-year-old lady is bought in by her son for continuing care of mild nonproliferative diabetic retinopathy, cataracts, and geographic atrophy. She is a well-established patient and is familiar with the physician and the office staff. The ophthalmic technician notes that the patient required more assistance than usual to navigate to the exam chair. The son remarks that his mother had recently moved to an assisted living center and feels that she is less involved with visually oriented tasks and is more socially withdrawn despite what he considers expanded social and occupational opportunities at the living center. The patient initially denies any problems, but after some discussion admits she has had increasing difficulty watching television and ambulating. She denies being sad or depressed as a cause of her social isolation but states her activities are impacted because her vision seems worse. The patient is apologetic about “complaining” and wary because her own mother had a poor outcome from cataract surgery years previously.