Cataracts are a clouding of the lens of your eye, resulting in changes to your vision. A cataract can develop in one eye at a time or both eyes simultaneously. However, it cannot spread from one eye to the other. Cataracts are very common in older people. It typically begin developing in people age 40 years and older.
According to the National Eye Institute, by age 80, more than half of all Americans either have a cataract or have had cataract surgery. However, younger people can develop cataracts, too. Cataracts in children can be due to a genetic mutation that affects proteins, metabolic disorders or by trauma (eye injury).
What is the lens?
The lens is a clear part of the eye that helps to focus light, or an image, on the retina. The retina is the light-sensitive tissue at the back of the eye. The lens is mostly made of water and protein. The protein is arranged in a precise way that keeps the lens clear and lets light pass through it.
In a normal eye, light passes through the transparent lens to the retina. Once it reaches the retina, light is changed into nerve signals that are sent to the brain. The lens must be clear for the retina to receive a sharp image. If the lens is cloudy from a cataract, the image you see will be blurred.
What causes cataracts?
The lens inside the eye works much like a camera lens, focusing light onto the retina for clear vision. It also adjusts the eye’s focus, letting us see things clearly both up close and far away. But as we age, some of the protein may clump together and start to cloud a small area of the lens. This is a cataract, and over time, it may grow larger and cloud more of the lens, making it harder to see.
No one knows for sure why the eye’s lens changes as we age, forming cataracts. But researchers worldwide have identified factors that may cause cataracts or are associated with cataract development. Besides advancing age, cataract risk factors include:
- Exposure to sunlight
- Cataracts can also happen after an eye surgery
- Previous eye injury or inflammation
- Use of certain medicines such as corticosteroids
- Health problems such as diabetes
- Significant alcohol consumption
- Family history of cataracts
What are the signs and symptoms of a cataract?
Cataracts are a normal aging change of the eye. They often form slowly and cause few symptoms. When symptoms are present, they can include:
- Cloudy or blurry vision.
- Colors seem faded.
- Need for brighter light to read.
- You may see glare from lamps or the sun. You may have trouble driving at night because of glare from car headlights.
- Poor night vision.
- Double vision or multiple images in one eye. (This symptom may clear as the cataract gets larger.)
- Your near vision may improve for a short time if you get a cataract.
- Frequent prescription changes in your eyeglasses or contact lenses.
However, these symptoms also can be a sign of other eye problems. Therefore, if you have any of these symptoms, check with your eye care professional.
How are cataracts diagnosed?
Cataract diagnosis is generally by an eye doctor thus either an optometrist or ophthalmologist by using a variety of eye and vision tests.
You’ll likely be given a visual acuity test, in which you attempt to read the letters on an eye chart. You may also have a slit-lamp test to see the structures in the front of your eye, as well as tonometry, to measure the pressure within your eye.
Your specialist will also perform a retinal exam. During the exam, your doctor will put drops in your eyes that will enlarge your pupils. This is called dilating your eyes. Doing this makes it easier for the doctor to view the back of your eye (the retina).
After dilation, your doctor will use a bright light to examine your natural lens for any signs of cataracts. He or she will evaluate the size and shape before recommending treatment.
What are the treatment options available?
When symptoms begin to appear, you may be able to improve your vision for a while using new glasses, strong bifocals, magnification, appropriate lighting or other visual aids. Keep your eyeglasses or contact lens prescription up to date. Also make sure you have plenty of lighting in your home. You may be able to avoid or delay surgery. But if these measures do not help, surgery is the only effective treatment. Surgery involves removing the cloudy lens and replacing it with an artificial lens.
The decision to have surgery depends on your general health. It also includes how much your cataract is interfering with your daily life. If you are still able to drive, read, and perform the tasks you need to do in your home or workplace, you may decide to wait to have surgery.
Once you decide to go ahead with surgery, you should discuss what to expect with your doctor. This will help you know how long you’ll likely be at the hospital and what kind of symptoms are normal after surgery. It will also tell you what kind of help or care from others you may need afterwards.
What happens after surgery?
Itching and mild discomfort are normal after cataract surgery. Some fluid discharge is also common. Your eye may be sensitive to light and touch. If you have discomfort, your doctor can suggest treatment. After one or two days, moderate discomfort should disappear.
For a few weeks after surgery, your doctor may ask you to use eyedrops to help healing and decrease the risk of infection. Ask your doctor about how to use your eyedrops, how often to use them, and what effects they can have. You will need to wear an eye shield or eyeglasses to help protect your eye. Avoid rubbing or pressing on your eye.
When you are home, try not to bend from the waist to pick up objects on the floor. Do not lift any heavy objects. You can walk, climb stairs, and do light household chores. In most cases, healing will be complete within eight weeks. Your doctor will schedule exams to check on your progress.
Can problems develop after surgery?
Problems after surgery are rare, but they can occur. These problems can include:
- loss of vision
- double vision
- high or low eye pressure
- But with prompt medical attention, these problems can usually be treated successfully.
How can you prevent cataracts?
There is no proven way to prevent cataracts. But there are some things you can do that may help slow cataract growth. Don’t smoke. Wear a hat or sunglasses when you are in the sun. And avoid sun lamps and tanning booths. Eat healthy foods. And keep diabetes under control. Above all, see your eye doctor regularly.
Besides, most of these actions have the additional health benefits beyond good eye health.