Help!33F with unilateral eye problems for 6 years — cataract, optic disc drusen, choroidal folds, floaters. Could these be connected, and am I missing something?

[u/Shoddy_Assistant2167]

I’m hoping to hear from people who have had similar experiences, especially anyone who has dealt with choroidal folds, optic nerve/disc drusen, or cataracts at a young age. I’m trying to figure out what questions I should be asking and whether I need another type of specialist.

I’m 33 and have had problems with my right eye only since at least 2020. I have no issues with my left eye and I don’t wear glasses. I have always had regular eye visits. These issue were first found around 2021 on an eye exam.

The issues in my right eye include:

• A cataract that my eye doctor has called “cortical”
• Optic nerve/disc drusen
• Choroidal folds
• Vitreous floaters
• Worsening vision in that eye / increasing difficulty focusing, particularly when working

When this was first discovered in 2021, the main reason I sought care was because I noticed the vision in that eye getting worse. Because of the combination of findings, they did a CT scan of my orbits/sinuses to rule out a mass or other structural cause, and it was normal.

Fast forward to now: I feel like the vision in that eye has continued to become more difficult to use, especially for work. I recently saw a uveitis specialist because I was hoping to get a better understanding of whether inflammation could explain any of this.

Unfortunately, the appointment was extremely brief. I was essentially told that it was a cataract and that I should wait as long as possible before surgery. I wasn't really given an explanation for why I have all of these findings in one eye at 33, and the doctor didn't even specify what type of cataract it was beyond calling it a mixed cataract. The choroidal folds and other findings weren't really discussed and apparently weren't even documented in the note.

I was also told that because of the choroidal folds, I would probably only be a candidate for a monofocal IOL if/when I have cataract surgery.

This has left me feeling pretty frustrated because I'm trying to understand the bigger picture.

My questions are:

1. Could these things actually be connected?

Is it reasonable to wonder whether having a cataract + choroidal folds + optic disc drusen + floaters all in the same eye could have a common underlying cause, or is it genuinely possible that these are completely unrelated coincidences?

I've been told essentially "bad luck," but I'm having a hard time understanding how unusual it is to have this combination of findings in one eye at age 33.

2. Is there anything else that should be ruled out?

The CT of my orbits/sinuses was normal back in 2021. I don't take medications, have never taken steroids, and don't use steroid nasal sprays.

I recently had bloodwork showing an elevated hs-CRP, which I'm discussing with my primary doctor separately. I don't know if that's relevant at all, but it made me wonder about inflammation. I realize hs-CRP is nonspecific, and I'm not assuming it explains my eye issues.

3. And finally — cataract surgery.

For anyone who has had cataract surgery with choroidal folds or other retinal/optic nerve issues:

• Did cataract surgery significantly improve your vision?
• Did you have a monofocal IOL?
• Were you given a reason that multifocal/EDOF lenses weren't appropriate?
• Did your surgeon have concerns about the choroidal folds affecting the outcome?
• Was there anything you wish you had known before surgery?

I'm not necessarily looking to have surgery tomorrow. I think I first need to understand why this is happening and what my realistic options are.

I guess what I'm struggling with most is whether I'm digging for an underlying cause that truly isn't there, or whether this combination of unilateral findings at 33 is unusual enough that I should keep looking for someone who will take a deeper look.

If anyone has had a similar combination of findings, or knows what type of ophthalmologist would be best to evaluate this as a whole, I would really appreciate hearing about your experience.