Cataracts

What are cataracts?

A cataract is a clouding of the lens of the eye. This is an area that is normally clear. As this clouding happens, it keeps light rays from passing through the lens and focusing on the retina. The retina is a tissue lining that is sensitive to light. It is located in the back of the eye. This cloudiness happens when some of the protein which makes up the lens of the eye begins to change its structure. It then gets in the way of your eyesight.

In its early stages, a cataract may not cause a problem. The cloudiness may affect only a small part of the lens. However, the cataract may grow larger over time and affect more of the lens. This can make it harder for you to see. If less light reaches the retina, it becomes even harder to see. Your vision may become dull and blurry. Cataracts cannot spread from one eye to another. Many people do, however, get cataracts in both eyes.

There are many types of cataracts:

• Age-related cataracts. The majority of cataracts are related to aging.
• Congenital cataracts. Some babies are born with cataracts. Some children develop them in childhood, often in both eyes. Some congenital cataracts do not affect eyesight, but others do and need to be removed.
• Secondary cataracts. Secondary cataracts usually happen because of another disease in the body (such as diabetes). Secondary cataracts have also been linked to steroid use.
• Traumatic cataracts. An injury to one or both eyes may cause you to develop a traumatic cataract. This can happen either right after the accident or several years later.

What causes cataracts?

Although experts don’t know for sure what causes cataracts, they think there could be several possible causes including:

• Smoking
• Diabetes
• Too much time in sunlight
• Steroid use
• Certain diuretic use
• Certain major tranquilizers

For many of the possible causes, more research is needed to set apart the effect of the disease from the effect of the medicines.

Who is at risk for cataracts?

Possible risk factors include:

• Age. Age is the greatest risk factor for cataracts. Age-related cataracts may develop between 40 and 50 years old.
• Where you live. Recent studies have shown that people who live in high altitudes are more at risk of developing cataracts.
• Too much sun exposure. People who spend more time in the sun may develop cataracts sooner than others.

What are the symptoms of cataracts?

The following are the most common symptoms of cataracts. However, each person may experience symptoms differently. Symptoms may include:

• Cloudy or blurry vision
• Lights are too bright and/or give off a glare or a halo
• Poor night vision
• Multiple (double) vision
• Colors seem faded
• Increased nearsightedness, increasing the need to change eyeglass prescriptions
• Distortion of vision in either eye

Often in the disease’s early stages, you may not notice any changes in your vision. Since cataracts tend to grow slowly, your eyesight will get worse slowly. Certain cataracts can also cause your close-up vision to get better for a short time. But your eyesight is likely to get worse as the cataract grows. The symptoms of cataracts may look like other eye conditions. Talk with a healthcare provider for a diagnosis.

How are cataracts diagnosed?

In addition to a complete medical history and eye exam, tests to diagnose cataracts may include:

• Visual acuity test. The common eye chart test that measures vision ability at many distances.
• Pupil dilation. The pupil is widened with eye drops to allow a close-up exam of the eye’s retina.

In addition, other tests may be done to help your eye care professional learn more about the health and structure of your eye.

How are cataracts treated?

Your healthcare provider will figure out the best treatment for you based on:

• Your age
• Your overall health and medical history
• How sick you are
• How well you can handle specific medicines, procedures, or therapies
• How long the condition is expected to last
• Your opinion or preference

The symptoms of cataracts sometimes look like other conditions or medical problems. Always see your healthcare provider for a diagnosis.

In its early stages, loss of eyesight caused by a cataract may be helped with the use of different eyeglasses, a magnifying glass, or stronger lighting. When these actions are no longer helpful, surgery is the only effective treatment available. A cataract only needs to be removed when loss of eyesight gets in the way of your everyday activities, such as driving, reading, or watching TV. You and your eye healthcare provider can make that decision together.

Cataract surgery is one of the most common surgeries. It is also one of the safest and most effective. Surgery involves swapping out the cloudy lens with a new lens. If you have cataracts in both eyes, they are usually not taken out at the same time. Your eye healthcare provider will need to do the surgery on each eye separately.

Cataracts are usually taken out in one of 2 ways:

• Small incision cataract surgery (Phacoemulsification). This is the most common type of cataract removal surgery. The healthcare provider makes a small incision on the side of the cornea. The cornea is a clear, dome-shaped surface that covers the front of the eye. A tiny probe gives off ultrasound waves to soften and break up the cloudy center of the lens. The cataract is then removed by suction through the same incision.
• Extracapsular surgery. During this surgery, a longer incision is made on the side of the cornea to remove the hard center of the lens. The rest of the lens is then taken out by suction.

The removed lens is replaced by an intraocular lens (IOL) in most cataract surgeries. An IOL is a clear, fake lens that does not need care. It becomes part of the eye. With an IOL, a person usually has better eyesight because light will be able to pass to the retina. The person does not see or feel the new lens.

What are the complications of cataracts?

Over time, cataracts will harm your vision. Cataract surgery can bring back your vision. However, a possible complication of cataract surgery is an “after-cataract.” An “after-cataract” happens when part of the natural lens that is purposely not taken out during cataract surgery becomes cloudy and blurs your eyesight. Unlike a cataract, an “after-cataract” can be treated with a method called YAG laser capsulotomy. The healthcare provider uses a laser beam to make a tiny hole in the cloudy membrane behind the lens to let the light pass through. After-cataracts may develop months, or even years, after cataract surgery.

Key points about cataracts

• A cataract is a clouding of the lens of the eye.
• As a cataract develops, your eyesight may become cloudy, blurry, or unclear.
• You may experience halos around lights, multiple vision, and poor night vision. Colors may seem faded.
• In its early stages, vision loss caused by a cataract may be helped with the use of different eyeglasses, a magnifying glass, or stronger lighting.
• Eventually, cataract surgery may be needed to fix your impaired eyesight.
• Cataract surgery is one of the safest and most effective operations.

Next steps

Tips to help you get the most from a visit to your healthcare provider:

• Know the reason for your visit and what you want to happen.
• Before your visit, write down questions you want answered.
• Bring someone with you to help you ask questions and remember what your provider tells you.
• At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you.
• Know why a new medicine or treatment is prescribed, and how it will help you. Also know what the side effects are.
• Ask if your condition can be treated in other ways.
• Know why a test or procedure is recommended and what the results could mean.
• Know what to expect if you do not take the medicine or have the test or procedure.
• If you have a follow-up appointment, write down the date, time, and purpose for that visit.
• Know how you can contact your provider if you have questions.