Cataracts: Surgery, symptoms, and causes (original) (raw)

Cataracts involve a clouding of the lens in the eye, leading to cloudy vision. They usually take several years to develop but can lead to vision loss. Surgery can often restore a person’s vision.

Cataracts are the most common cause of vision loss worldwide. They are more common in people over 40 years old.

However, some people develop them earlier due to genetic factors, and some are born with cataracts. Other causes include inflammation, glaucoma, and diabetes.

Currently, around 24.4 million people in the United States have cataracts.

When a cataract occurs, the lens becomes opaque or cloudy. Light does not pass through easily, and vision becomes blurry, like looking through a fogged-up window. The cloudier the lens, the harder it will be to see.

This article will look at age-related cataracts.

A person may notice the following changes:

• blurry vision
• seeing double
• changes in color vision
• difficulty with night vision
• sensitivity to glare, such as headlights
• a halo effect around lights
• a frequent need to change the prescription for glasses or contact lenses

Some of these symptoms can occur with other conditions. It is best to check with an eye doctor if a person has concerns about vision changes and other eye problems.

Without treatment, cataracts typically slowly progress and cause deterioration or loss of vision. Cataract surgery can improve vision and quality of life

The only cure for cataracts is surgery, but other strategies can help a person manage if they do not want to have surgery just yet.

Home and lifestyle remedies

Options for managing at home include:

• using brighter lights
• wearing antiglare glasses or sunglasses
• using a magnifying glass for reading
• having an eyesight test to see if a new prescription will help

Surgery

For severe cataracts, the only effective treatment is surgery.

• cataracts affect a person’s quality of life
• the person is unable to carry out their daily tasks
• the individual has no health condition or other factor that makes surgery unsuitable

Before surgery, the doctor will measure the person’s eye and prepare an artificial lens.

1. put in eye drops to dilate or widen the pupil
2. apply an anesthetic, either combined with the eye drops or as an injection into the tissue around the eye
3. remove the clouded lens
4. replace it with the new lens

The person will return home on the same day. The person may feel some discomfort, but this usually resolves within a couple of days. The individual should avoid vigorous activities during the recovery period.

After surgery, a doctor may recommend:

• using prescription eyedrops for 1–4 weeks
• following up with the surgeon at intervals
• having an eye test after a few weeks, in case their prescription has changed

Cataract surgery is usually minimally invasive. The National Eye Institute (NEI) describes it as “very safe” and says that 90% of people who have it see better as a result.

While most people find surgery can help their vision, there is a risk of complications.

These include:

• an infection after surgery, such as endophthalmitis
• posterior capsule opacification, which can easily be treated with a laser procedure if needed
• retinal detachment

After surgery, a person should contact their doctor at once if they notice that:

• their vision is worsening significantly
• they have increasing pain
• there is worsening redness or swelling around the eye

These may be signs of an infection that needs urgent medical attention.

Most cataracts happen because the fibers in the eye’s lens become hardened as a person gets older. As a result, the nucleus of the lens becomes compressed. This is called nuclear sclerosis.

Proteins in the lens begin to break down and clump together, and they take on a yellow-brown color. This affects the transparency of the lens and its ability to react as light passes through it.

People may have a higher risk of developing cataracts if they:

• are 40 years of age or older
• have a family history of cataracts
• have had an eye injury or eye surgery
• have had radiation therapy on their upper body
• have had a lot of sun exposure
• take steroids to treat a health condition, such as arthritis
• have previously had eye inflammation
• have a sedentary lifestyle
• smoke

A number of health conditions can increase the risk of cataracts, such as:

• high blood pressure, obesity, and other features of metabolic syndrome
• diabetes mellitus
• atopic dermatitis
• myotonic dystrophy
• type 2 neurofibromatosis
• hypoparathyroidism
• chronic anterior uveitis, an eye inflammation
• high myopia
• alcohol use disorder
• a deficiency of certain vitamins and antioxidants, such as lutein, zeaxanthin, and zinc

It is not always possible to avoid cataracts, but the following tips may help:

• avoiding or quitting smoking
• eating plenty of fresh fruits and vegetables, especially dark green leafy vegetables, which provide eye-friendly nutrients
• maintaining a suitable body mass index (BMI), as this will reduce the risk of type 2 diabetes, a risk factor for cataracts
• working with the healthcare team to manage conditions such as diabetes
• wearing sunglasses that block UV radiation
• doing regular physical activity
• wearing eye protection when doing tasks where there is a risk of something penetrating the eye

Anyone who has concerns about cataracts may wish to speak with an eye doctor, also called an ophthalmologist.

The doctor will likely carry out some tests, such as:

• a visual acuity test to find out how clearly a person sees
• a slit-lamp examination to examine the cornea, lens, and other parts of the eye
• pupillary responses to check the shape and other features of the pupil
• tests to rule out other conditions, such as blepharitis or chronic conjunctivitis

If the doctor notices signs of a cataract, they will discuss the person’s options with them.

There are three main types of cataracts, depending on how they affect the eye:

• Nuclear cataracts involve cloudiness or discoloration of the lens that affects a person’s vision. They tend to progress slowly and often affect distance vision rather than near sight. There are also subtypes of nuclear cataracts.
• Cortical cataracts have a spoke-like appearance when an ophthalmologist examines them. The person may complain of glare.
• Posterior subcapsular cataracts are the most common type to occur in younger people. They cause problems with vision and glare.

Here are some questions people ask about cataracts.

Can cataracts spread from one eye to another?

Cataracts can develop in both eyes but cannot spread from one eye to another.

When should a person contact a doctor about cataracts?

• their vision is becoming cloudy
• they have trouble driving, especially at night
• they have frequent falls
• they are unable to carry out daily tasks because of worsening eyesight
• the cataracts affect their quality of life or mental health

How long does a cataract take to grow?

Age-related cataracts usually develop over several years. However, cataracts that develop after an eye trauma, such as surgery, may grow more quickly. In one study, people developed cataracts within 2 years of surgery for other eye conditions.

Cataracts are a common eye condition that many people experience as they get older. They are relatively slow to develop but can lead to vision loss.

Some tips can help a person see better while cataracts are developing, such as using a magnifying glass to read.

Ultimately, the only treatment is surgery, and it is minimally invasive. According to the NEI, 9 out of 10 people say they can see better after.