Does it feel like when you look at things, they aren’t as crisp, clear or colorful as they used to be? Do things look cloudy or blurry even when you’re wearing glasses? These could be symptoms of cataracts.
Cataracts is one of the leading causes of vision loss in the US and the primary cause of blindness in the world. More than 24 million Americans over 40 are currently living with cataracts. Though rare, children can be affected by cataracts, too.
A cataract is a clouding of the lens in the eyes that affects vision. By the age of 80, more than half of all Americans either have a cataract or have had cataract surgery in one or both eyes.
What causes cataracts?
The lens of your eye lies behind the iris and the pupil and it works much like a camera lens. The lens focuses light onto the retina at the back of the eye and it also adjusts the eye’s focus. The lens is made of mostly water and protein. The protein is arranged in a precise way that keeps the lens clear and lets light pass through it.
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. Over time, the cataract may grow larger and cloud more of the lens, making it harder to see.
How do cataracts affect vision?
When a cataract is small, the cloudiness affects only a small part of the lens. You may not notice any changes in your vision. Cataracts tend to “grow” slowly, so vision gets worse gradually. Over time, the cloudy area in the lens may get larger, and the cataract may increase in size. Seeing may become more difficult and your vision may get duller or blurrier.
The clear lens slowly changes to a yellowish/brownish color, adding a brownish tint to vision.
As the clear lens slowly colors with age, your vision gradually may acquire a brownish shade. At first, the amount of tinting may be small and may not cause a vision problem. Over time, increased tinting may make it more difficult to read and perform other routine activities. This gradual change in the amount of tinting does not affect the sharpness of the image transmitted to the retina.
If you have advanced lens discoloration, you may not be able to identify blues and purples. You may be wearing what you believe to be a pair of black socks, only to find out from friends that you are wearing purple socks.
Who is at risk for cataract?
The risk of cataract increases as you get older. Other risk factors for cataract include:
- Certain diseases (for example, diabetes)
- Personal behavior (smoking, alcohol use)
- The environment (prolonged exposure to ultraviolet sunlight)
What are the most common symptoms of a cataract?
- Cloudy or blurry vision.
- Colors seem faded.
- Glare. Headlights, lamps, or sunlight may appear too bright. A halo may appear around lights.
- Poor night vision.
- Double vision or multiple images in one eye. (This symptom may clear as the cataract gets larger.)
- Frequent prescription changes in your eyeglasses or contact lenses.
These symptoms also can be a sign of other eye problems. If you have any of these symptoms, check with your eye care professional.
Are there different types of cataract?
Yes. Although most cataracts are related to aging, there are other types of cataract:
- Secondary cataract. Cataracts can form after surgery for other eye problems, such as glaucoma. Cataracts also can develop in people who have other health problems, such as diabetes. Cataracts are sometimes linked to steroid use.
- Traumatic cataract. Cataracts can develop after an eye injury, sometimes years later.
- Congenital cataract. Some babies are born with cataracts or develop them in childhood, often in both eyes. These cataracts may be so small that they do not affect vision. If they do, the lenses may need to be removed.
- Radiation cataract. Cataracts can develop after exposure to some types of radiation.
How is a cataract detected?
Cataract is detected through a comprehensive eye exam that includes:
- Visual acuity test. This eye chart test measures how well you see at various distances.
- Dilated eye exam. Drops are placed in your eyes to widen, or dilate, the pupils. Your eye care professional uses a special magnifying lens to examine your retina and optic nerve for signs of damage and other eye problems. After the exam, your close-up vision may remain blurred for several hours.
- Tonometry. An instrument measures the pressure inside the eye. Numbing drops may be applied to your eye for this test.
- Your eye care professional also may do other tests to learn more about the structure and health of your eye.
How is cataract treated?
The symptoms of early cataract may be improved with new eyeglasses, brighter lighting, anti-glare sunglasses, or magnifying lenses. 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.
A cataract needs to be removed only when vision loss interferes with your daily activities, such as driving, reading, or watching TV. Talk to your eye care professional about the benefits and risks of surgery so you can make an informed decision about whether cataract surgery is right for you. In most cases, delaying cataract surgery will not cause long-term damage to your eye or make the surgery more difficult. You do not have to rush into surgery.
Sometimes a cataract should be removed even if it does not cause problems with your vision. For example, a cataract should be removed if it prevents examination or treatment of another eye problem, such as age-related macular degeneration or diabetic retinopathy.
If you have cataracts in both eyes that require surgery, the surgery will be performed on each eye at separate times, usually four weeks apart. Cataract removal is very common and is one of the safest and most effective types of surgeries with 90% of people having better vision afterwards.
Make sure your doctor knows of all the medications you are taking prior to cataract surgery as certain medications can increase the risk of bleeding during surgery. After surgery, you must keep your eye clean, wash your hands before touching your eye, and use the prescribed medications to help reduce the risk of infection. Serious infection can result in loss of vision.
What can you do to protect your vision?
- Wearing sunglasses and a hat with a brim to block ultraviolet sunlight may help to delay cataract.
- If you smoke, stop.
- Researchers also believe good nutrition can help reduce the risk of age-related cataract. They recommend eating green leafy vegetables, fruit, and other foods with antioxidants.
- If you are age 60 or older, you should have a comprehensive dilated eye exam at least once every two years. In addition to cataract, your eye care professional can check for signs of age-related macular degeneration, glaucoma, and other vision disorders. Early treatment for many eye diseases may save your sight.