Cataracts – What You Need to Know

Cataracts are a common vision issue that often develops over time, usually affecting people as they age. The condition involves the clouding of the eye’s lens, which can lead to blurred vision, difficulty with night vision, and other visual impairments. It’s important to be aware of the signs and symptoms of cataracts to ensure timely treatment and maintain good eye health.

Although cataracts predominantly affect older individuals, they can also occur in younger people due to various factors like genetics, underlying health conditions or exposure to certain medications. 

As cataracts progress, symptoms may become more apparent, including sensitivity to glare, seeing halos around lights, and experiencing frequent changes in eyeglass or contact lens prescriptions. In some cases, cataracts might only affect one eye or be more advanced in one eye than the other.

Cataracts in elder woman

Understanding Cataracts

Definition and Causes

Cataracts are a common vision problem affecting the eye’s lens, which results in cloudiness or opacity that impairs vision. They mostly affect older adults, but other factors can also cause cataracts, including:

  • Age-related changes in the lens
  • Congenital factors (present at birth)
  • Diabetes
  • Long-term use of corticosteroids
  • Certain eye conditions

The primary cause of cataracts is the clumping of proteins in the lens, which can be triggered by various factors such as UV light exposure, smoking, excessive alcohol consumption, or a family history of cataracts.

Types and Characteristics

There are four main types of cataracts, each with distinct characteristics:

  1. Nuclear cataracts: These form in the central part of the lens (the nucleus) and are usually associated with ageing.
  2. Cortical cataracts: Known for their wedge-like “spokes,” they originate at the outer edge of the lens and progress towards the centre.
  3. Posterior subcapsular cataracts: Located near the back of the lens capsule, these cataracts typically develop comparatively quickly and are often associated with diabetes or steroid use.
  4. Congenital cataracts: Present at birth or developed in early childhood, they may be hereditary or result from infections, trauma, or metabolic disorders.

Recognising Symptoms

Cataract symptoms can vary depending on the type and progression, but common signs include:

  • Blurred or hazy vision
  • Increased sensitivity to glare or light
  • Double vision in one eye
  • Colour vision changes, often with a yellowish or brownish tinge.
glare from water

Diagnosis and Risk Factors

Professional Diagnosis

Diagnosing cataracts typically involves a comprehensive eye examination by an eye care professional. The process includes assessing visual acuity with a Snellen chart, measuring pupillary function, and examining ocular alignment and motility. 

An ophthalmoscope can also be used to inspect the eyes for opacity of the lens, which may be observed through defects in the red reflex if a cataract is present.

Risk Factor Overview

There are various risk factors that can contribute to the development of cataracts. Some common risk factors include:

  • Ageing: The most common cause of cataracts in adults, as people over 60 years old often experience a gradual accumulation of yellow-brown pigment in the lens of their eyes.
  • Family history: Genetics can play a role, making individuals with a family history of cataracts more likely to develop them.
  • Smoking: Smoking can increase the risk of cataracts due to the harmful substances present in tobacco and their impact on eye health.
  • Alcohol consumption: Excessive alcohol intake may also put individuals at a higher risk of developing cataracts.
  • Diabetes: Diabetes can cause oxidative stress, inflammation, and hyperglycaemia, which might contribute to the development of cataracts.
  • Eye injury: Trauma to the eye can lead to the formation of cataracts in the injured eye.
  • Other risk factors: Some eye diseases and previous eye surgeries can also increase the likelihood of developing cataracts.
smoking can cause cataracts

Treatment Options

Non-Surgical Approaches

In some cases of mild cataracts, non-surgical approaches can be considered. These might include:

  • Glasses: Stronger prescription lenses can help improve your vision temporarily as cataracts develop.
  • Lighting: Using brighter reading lights or increasing ambient lighting might make it easier for you to see.

However, it is important to understand that cataracts worsen over time, and eventually, surgical intervention may be necessary.

Surgical Procedures

Surgical treatment is the only proven effective solution for cataracts. Surgery aims to remove the affected lens and replace it with an artificial one. There are two main surgical procedures to treat cataracts:

  1. Phacoemulsification: This is the most common type of cataract surgery. The surgeon makes a small incision in the eye, inserts a probe that emits ultrasound waves to break up the cloudy lens, and then removes the fragments with a suction device.
  2. Laser procedure: In this method, a laser is used to create an incision and soften the cataract, allowing for easier removal with phacoemulsification.

During cataract surgery, the surgeon replaces the natural lens with an artificial intraocular lens (IOL). The IOL becomes a permanent part of your eye and restores your vision. In some cases, however, artificial lenses might not be suitable for certain patients. In such cases, the surgeon will discuss alternative options with the patient.

Recovery from cataract surgery typically takes six to twelve weeks, with surgeries for each eye being performed separately to allow for one eye to heal before operating on the other.

surgery for cataracts

Prevention and Management

Lifestyle Adjustments

One of the best ways to prevent cataracts is by adopting a healthy lifestyle. A well-balanced diet, rich in antioxidants, can help maintain good eye health. Include plenty of fruits, vegetables, and whole grains in your daily meal plan. Additionally, quitting smoking and limiting alcohol consumption can benefit your eyes.

Don’t forget the importance of protecting your eyes from harmful ultraviolet (UV) rays. Make it a habit to wear sunglasses with 100% UV protection to shield your eyes from the sun’s damaging effects. This can help prevent or slow down the progression of cataracts.

Post-Treatment Care

If you’ve had cataract surgery, it’s important to follow your eye doctor’s instructions for post-treatment care. You may experience some temporary limitations in your daily activities such as reading, driving, and other tasks. Always consult your eye doctor regarding any restrictions or precautions you should take during your recovery.

One possible postoperative complication is posterior capsule opacification (PCO), which occurs when remnants of the lens’s epithelial cells proliferate and form an opaque membrane. This can lead to decreased visual acuity, blurred vision, or glare. If you experience any of these symptoms after surgery, consult your eye doctor for a proper assessment and intervention if necessary.