What happens if you have cataracts and you don't have them removed?

Vision will worsen: Once cataract formation has started, there is no know way to reverse it or prevent progression. Inevitably, if the patient lives long enough a cataract will continue to worsen and diminish the vision - even to blindness. This is usually a gradual process and can be surgically addressed at any point on that continuum. However, very advanced cataracts do have more surgical complications.

Vision loss: Cataracts can eventually lead to blindness if you wait long enough. However, it's considered a reversible blindness since they can be surgically removed. Usually age-related cataracts progress slowly over years of time.

Generally nothing: Cataracts almost never have to be removed. In certain cases of narrow angle closure glaucoma they can be removed as an effective treatment. In the case of traumatic cataracts, such as during a penetrating injury, they can incite inflammation and need to be removed. Also for young children with large cataracts they need to be removed early to prevent irreversible blindness from amblyopia