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How Accurate is a Previous Diagnosis of ?Cataract??

Paul Varner

Purpose: To determine the accuracy of a previous diagnosis of cataract in patients presenting to a VA Medical Centre in SE Missouri, and to ascertain whether patient anxiety influenced this diagnosis.

Methods: 100 consecutive patients self-reporting a prior diagnosis of cataract were examined for accuracy of diagnosis. Standard Snellen visual acuity was used as the primary outcome. Cortical and posterior subcapsular cataracts were graded based on proximity to visual axis; nuclear sclerotic cataracts were classified based on a previously-reported grading scale of the author. Medical records were examined for pre-existing diagnosis of anxiety or generalized anxiety disorder.

Results: Only 15% of patients with a pre-existing diagnosis of cataract were found to have lenticular opacities causing decrease in best-corrected visual acuity.

Conclusions: Previous diagnosis of cataract is often inaccurate and far exceeds reporting misdiagnosis rates. Strict definition of cataract is not followed in this part of the United States.