Cataracts

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A cataract is a change in the lens of the eye leading to cloudy spots or an opaque lens. This is a progressive condition that can take years to obstruct vision, but if left untreated, cataracts can lead to blindness.

The lens of the eye is located behind the iris. The lens is responsible for refracting light into the back of the eye, onto the retina, which processes images through the optic nerve and into the brain. When something is wrong with the lens, images of the world will not be transmitted well into the brain. This can lead to fuzzy, blurry, colorless, or doubled images, depending on what is wrong with the lens.

In the case of cataracts, proteins in the lens are damaged, leading to clumps that eventually obstruct vision. While the condition is painless, it can be frustrating as it develops, and it can eventually be debilitating.

Millions of people develop cataracts, typically starting after age 40, with most developing around age 55. By 80 years old, around half of American adults either have cataracts or have had cataract surgery. Cataracts will develop in both eyes, but one will typically get worse than the other and need more immediate attention.

For the most part, it takes years for cataracts to reach a point that they require medical treatment. Most optometrists and ophthalmologists will monitor the progress of a cataract in annual exams unless vision suddenly and rapidly changes. There are some lifestyle changes you can make to slow down the cataract’s progress, but ultimately, all cataracts will need surgery.

Fortunately, cataract surgery has a high success rate, and with a little time to heal and adjust, most people regain vision enough to go about their daily lives without intrusion. About 22.3 million Americans have cataracts at some point, making it one of the most common eye conditions in the country.

There are many symptoms you may experience as a result of cataracts. If you notice any of these signs, we encourage you to schedule an appointment with one of our board-certified clinicians for an exam that includes state-of-the-art diagnostic testing.  

• Vision that seems foggy, blurry, or dulled 
• Progressive loss of vision 
• Double-vision 
• Noticeable glare 
• Poor vision in low-light and nighttime conditions 
• Need for additional light to read or complete other activities 
• Marked loss of vision that affects quality of life 
• Appearance of halos surrounding bright lights 
• Frequent vision prescription changes 
• Shadowy double images (“ghost images”) 
• Faded or yellowed perception of colors Light sensitivity

Most cataracts develop due to aging or injuries that change the functioning of your eye lens. Some risk factors that predispose to cataract formation include:

• Chronic diseases, including diabetes mellitus or glaucoma.
• Diseases during pregnancy including toxoplasmosis, herpes simplex, rubella, syphilis, or cytomegalovirus.
• Excessive production of oxidants
• Smoking
• Trauma or accidents
• Exposure to UV radiation
• Smoking
• Radiation therapy
• Long term use of steroids and medications used to treat arthritis, lupus, and other health conditions
• Previous eye surgeries
• High blood pressure
• Excessive alcoholism
• Old age
• Family history of cataracts

There are several factors influencing whether or not you are at risk of developing cataracts.

• Family history
• Age
• Gender (Women may have a slightly higher risk than men.)
• Substance abuse history
• Sun exposure
• Other medical conditions

When you experience changes in your vision and you go for an eye exam, your doctor will run a series of tests and ask you several questions to understand more abut your condition. Some of the diagnostics will include:

• Getting a patient history or updating an existing patient history about how vision has progressed and may be limiting current daily activities.
• Visual acuity measurements, such as the Snellen chart and other tools to determine the extent of refractive error, color change, eye shape change, and other issues that may be caused by the cataract or that may have led to the cataract.
• Slit lamp tests, allowing your optometrist to see into the back of your eye.
• Refraction error to determine how glasses or contact lenses can improve vision.
• Evaluation of the lens, using light and high magnification to illuminate the lens to see where proteins are clumping and diagnose the type of cataract that is forming.
• Evaluation of the retina to understand if there are additional diseases or damage that may be causing visual problems.
• Measurement of fluid pressure in the eye.
• Color and glare sensitivity testing.

Typically, your eye doctor will notice the cataract during a routine exam, or your vision will change enough that you will need to see a doctor for a diagnosis before your vision is severely impaired by the cataract. Most eye doctors will monitor the progress of the cataract before it becomes a very serious issue, so they will not immediately send you into surgery to replace the lens, but eventually, you will need to have your biological lens replaced with an artificial lens, called an intraocular lens (IOL).