Question
Hi- thanks for volunteering. I'm writing for a friend who I think needs more info for the decision she's making. She has PSC Cataracts, which I understand degenerates quickly. I'm suggesting that she cash in a 401k and get the surgery ASAP. But she says she'd rather wait until her insurance will pay for the surgery. They say her condition has to be worse before they will pay for the surgery. She's been told she could be totally blind in 5 years. I'm very uncomfortable for her that she is waiting, and for an insurance company at that!

What do you think? Are there specific degrees that you can tell me about, like grade 1 or grade 2 or something? I'm wanting to know how serious PSC cataracts can get as she's waiting for her insurance to pay.
Any advice is appreciated!
Lisa
Jacksonville, Florida

Answer
Lisa,

This is what I found when I googled PSC. Below is the biggest symnptom it causes.

Paradoxical Vision. Poor vision in bright light and improved vision in dim light may seem contradictory at first, but the answer depends on the type of cataract that is forming and which part of the lens is affected. When most of the clouding is centered on the back or posterior surface of the lens, the cataract will have its greatest impact when the pupil is small, which happens in bright light. The brighter the light, the smaller the pupil, the worse the vision. This type of cataract (posterior subcapsular cataract or PSC) is more common in patients with diabetes and in those on long-term cortisone treatments for severe arthritis or asthma. This blocking of the "bull's eye" in the lens may be quite incapacitating to a patient with even a relatively small PSC cataract, since the level of vision may be markedly reduced on anything other than a cloudy day. Drops to keep the pupil dilated may improve vision temporarily until cataract surgery is performed. The problem may not even be readily apparent in the ophthalmologist's office because most of the time the room is kept fairly dark when tests are made. Should such a cataract be detected, another test should be undertaken with the lights on. This will give a more realistic assessment of diminished eyesight

I suggest she gets a second, and possibly third, opinion. If her doctor's are telling her to hold off, she may want to consider waiting. There was no rush with my cataracts either. It was time to take them out when I could no longer handle the symptoms. And if she has not already, she may want to try drops (mentioned above) that control the pupil size...I have used them, too.

Cataracts vary, but eventually they take away your vision. It is fixable though! They simply need to remove the lens in her eye and either replace it or fit her for glasses. This doesn't affect the front of the eye, or the retina. The lens gets blurry, and keeps getting blurry, till it's too blurry to see. It will not result in permanent blindness, to my knowledge. I am NOT a doctor, so this is something you want a doc's opinion on. However I have never heard of it, a cataract alone, causing total permanent blindness.

I know one thing for sure, you need a healthy sum for retirement...especially if you have eye/health problems. I would strongly stress that she not touch her 401K unless she is basically blind, and can no longer learn to function. If she cashes the entire thing, she may be penalized and charged a BUNCH of tax on it. She will need to call her banking institution that handles the 401. They allow you to borrow from it, with interest but that interest is paid back into your 401K so you do not lose money. However, in some cases, there is a time period to repay this. However, this should still be a last resort.

Tell her to get some other opinions, and also to get some visual aids...such as magnifiers...to help her until she can get the surgery. Her doctor's can point her in the direction of a Low Vision Thepaist. I know it may be frightening, and the thought of losing your vision is awful, but no surgery should ever be rushed into. Trust me, I learned that the hard way.

God bless,
Jeannine