Answer

The expected utility of not having the operation is zero (no change in vision, no cost or discomfort due to the operation). The expected utility of having the operation is (5 $\times$ 0.46) + (2 $\times$ 0.44) + (0 $\times$ 0.09) + (10 $\times$ 0.01)2 = +1.08. The expected utility of having the operation is larger than the expected utility of not having the operation, so Fred should have the operation.