How long does it usually take for cataracts to ‘ripen’ enough for removal?

The old story of a cataract needing to "ripen" before it could be safely treated surgically should be abandoned. Back when I began my Ophthalmology residency in the late 1970s, the shift to small incision surgery with lens implants was just beginning. Prior to that, cataracts (the hardened and opacified natural lens) had to be manually removed through a large incision in the eye. If the cataract broke apart during that exercise, there would be more inflammation and an overall poorer prognosis for visual recovery. So the story of "ripening" was used to explain the necessity to put off surgery as long as possible to avoid these problems of the cataract (the aged natural lens) fragmenting during the operation.

With today's ocular surgery technology, a natural lens with any degree of dysfunction due to age (which is the more modern definition of "cataract") can be safely removed and replaced with a lens implant at any time during its development. The decision then as to when to perform surgery is more based on risks vs. benefits as balanced against cost, not "ripening."

_Written by J. Trevor Woodhams, M.D. - Chief of Surgery, Woodhams Eye Clinic