CONTEXT: Aged-related cataract is the leading cause of vision impairment in the elderly. Elderly individuals with cataract not only suffer from the difficulties in daily activities, but also are more prone to depression. OBJECTIVE: To examine the impact of cataract surgery on depression among older adults. DESIGN: Longitudinal follow-up study. SETTING: Outpatient ophthalmology and optometry clinics in Birmingham, Alabama. PATIENTS: Potential subjects were identified through consecutive chart review of patients seen in 10 ophthalmology and 2 optometry clinics. Three groups of individuals were identified: cataract patients who underwent surgery, cataract patients who did not undergo surgery, and patients without cataract. MAIN OUTCOME MEASURE: Depressive symptoms as measured by the Center for Epidemiological Studies-Depression Scale (CES-D). RESULTS: There was no significant difference between the baseline and follow-up CES-D scores within each group. The unadjusted CES-D score changes did not differ significantly among the three groups. Adjustment for visual acuity and contrast sensitivity in the better and worse eyes, co-morbid conditions, age, gender, and education did not alter this pattern of results. CONCLUSIONS: Cataract surgery does not appear to have an effect on reducing depressive symptoms in elderly people.