What Are Cataracts

Mar 2, 2021

A cataract occurs when the natural lens of your eye turns cloudy, leading to serious changes in your sight. This is the result of proteins in your lens which break down and then things begin to appear blurry or foggy,  and even dull in color. It’s possible for a cataract to grow in either one eye at a time or both eyes at once. The lens of your eye is composed of tissue that, under normal circumstances, remains clear and aims light into your retina by bending or refracting the rays that enter your eyes. The retina is composed of a layer of nerve cells that run across the back wall of the inner eye. It is in your retina that light is transformed into nerve signals that send information to your brain. It may be true that cataracts are a sign of disorder and frequently can be helped by the appropriate treatment, you should also keep in mind that they are a common and routine part of aging. The fact of the matter is, that by the time they turn 80, over one-half of the population of the United States will develop one or more cataracts, states the National Eye Institute. Generally, most cataracts are age-related, but there are also specific types that can develop for other reasons, such as due to surgery, taking certain drugs, various health problems, or trauma. Some can even develop during childhood. While they may not be a problem at first, cataracts do become steadily worse, until eventually, they distort your vision to the point where they disrupt your daily life. When that happens, it’s important to take action. However, you should make a point of talking to your doctor once you begin to experience any problems with your eyesight. He can tell you what options there are for treating your cataracts, and recommend which are best for you.

Cataract Signs and Symptoms 

Usually, the most common symptom that first indicates the presence of a cataract is noticing a small area where your vision is blurred. This might not be alarming at first, but with the passage of time, this area is guaranteed to grow bigger as your lens becomes cloudier. Ultimately, it may get to the point where your vision in general just stays blurry or dull.  As if that isn’t bothering you enough, you may further undergo color changes in your lens that give everything you see a brownish or yellowish hue. Down the road, you may find that you have difficulty differentiating between colors, especially shades of blue and purple, and also doing tasks that necessitate that you distinguish colors, and this includes reading. Besides cloudy vision and changes in the way you view color, cataract symptoms can include: 

  • Double vision 
  • Increased sensitivity to light 
  • Experiencing difficulty seeing at night, or requiring more light for reading 
  • Viewing bright colors as yellow or faded 
  • Seeing halos around lights 
  • Having to make frequent changes to your prescription for contacts or glasses 

If you are aware of any such changes in your vision be sure that you schedule an eye exam. Above all, if you develop any sudden changes in vision, make sure that you see your eye doctor immediately.

Causes and Risk Factors For Cataracts 

Many people don’t know this, but the lens of your eye is primarily composed of protein and water. It is positioned directly behind your pupil and iris, (which are the black and colored areas of your eye). These are covered by your cornea, (the clear outer layer of the eye).  Nature has arranged the proteins in your lens in such a manner that the lens stays clear. However, due to the normal changes brought about by age, these proteins can start to clump together, which leads to cloudy areas of vision. There are many factors that can increase your chances of developing cataracts. These include:

  • Aging 
  • Excessive exposure to sunlight, particularly without wearing sunglasses 
  • Family members with cataracts 
  • Living at a higher altitude
  • High blood pressure 
  • Receiving radiation treatments on the upper part of the body 
  • Past history of injury, inflammation, or surgery of the eye 
  • Smoking 
  • Excessive drinking 
  • Using corticosteroid drugs long term

In the case of age-related cataracts, under most conditions, they continue to develop slowly. Other cataracts, such as those found in people with diabetes develop faster. There is no way for doctors to predict how quickly a cataract will develop.  The majority of cataracts develop due to the aging process, but some people are born with cataracts or have them develop during childhood. These types of cataracts are called congenital cataracts. Congenital cataracts can develop due to genetic causes, or as a result of trauma or some type of infection in the uterus. Conditions that can cause them to include: 

  • Galactosemia, a rare disorder of the metabolism 
  • Neurofibromatosis type 2, an illness that causes tumors to grow on nerves 
  • Myotonic dystrophy, similar to muscular dystrophy 
  • Rubella, often referred to as German measles 
  • Cytomegalovirus, a viral infection 
  • Toxoplasmosis, a type of parasitic infection 
  • Herpes simplex virus 
  • Syphilis

It’s not a given that congenital cataracts will disturb your vision, but in the event they do, they are normally treated with surgery shortly after being diagnosed.

How Are Cataracts Diagnosed?

An eye doctor, such as an optometrist or ophthalmologist diagnoses cataracts by employing a variety of vision and eye tests.  A dilated eye exam may be required, which means that drops are put in your eyes in order to make your pupils widen so the doctor can better see the interior of your eyes. Tests to aid your eye doctor in diagnosing cataracts are: 

  • Visual acuity test — You read a series of letters off a chart
  • Slit-lamp exam — A special microscope is employed to see objects in the front of your eye in greater detail
  • Retinal exam — Your eyes are dilated, and your eye doctor views the backs of your eyes using a slit lamp or other device

Cataract Prognosis 

There are things you can do to slow the progression of cataracts, such as making sure you wear sunglasses or eyeglasses that are made to block the ultraviolet (UV) rays of the sun.  It’s important to know that cataracts will not get any better nor will they go away by themselves. There are many people who have taken steps to adjust to living their lives with cataracts, but the only real treatment for them, if they want to have better vision, is surgery.

How Long Do Cataracts Last? 

As stated above, cataracts will not disappear on their own. There is no natural cure for cataracts. So if you develop them, the negative effects they have on your vision will remain unless you have surgery to solve the problem.  Normally people develop cataracts due to age, caused by changes in the eye which occur about the age of 40. However, it can take many years before cataracts produce any notable changes in your vision.  By the time they reach the age of 60, it’s normal for most people to experience some clouding in the lenses of their eyes. That’s usually not a problem until years later.  Opting to undergo surgery for cataracts can be put off. It is usually determined by the effect your condition has on your daily activities and quality of life. The length of time it takes for cataracts to grow to the point where they become a nuisance is different from one person to the next.

Types of Cataracts, Determined By Cause and Location

Cataracts can be divided into four categories, although somewhat broadly, according to their causes: 

  • Age-related cataracts — The majority of cataracts fit into this category. 
  • Secondary cataracts — Here cataracts develop due to diseases such as diabetes, or by long-term use of drugs like corticosteroids. 
  • Congenital cataracts — Many varying factors can cause cataracts in children and babies.  Traumatic cataracts — Injuring one or both eyes can lead to cataracts. This doesn’t have to happen right away but can occur years later.

Cataracts can further be categorized according to what part of the lens they affect. There are three cataract locations:

  • Nuclear cataracts — This cataract is located in the center of the lens. It causes clouding and yellowing in the area. 
  • Cortical cataracts — Cataracts like these affect the edges of the lens. They cause streaks and white marks that slowly extend until they reach the center of the lens. 
  • Posterior subcapsular cataracts — These cataracts affect the back of the lens. It starts off with a small opaque area directly in the way of your vision, and then progresses and grows more quickly than other cataracts.

Medication and Treatments For Cataracts

The only surefire way to reverse the damage caused by cataracts is through cataract surgery lens replacement to replace the lens in the eyes with an artificial one.  Deciding to go ahead with cataract treatment surgery is determined by your basic health and just how much the cataracts are hindering your everyday life. In the case where you have still retained the ability to either drive yourself or make use of public transportation, accomplish the things you need to at home or work, and, of course, read, you may opt to delay surgery.  After you’ve made the decision to proceed with the surgery, it’s important that you talk about what to expect with your eye doctor in regards to the length of time you’ll have to spend at the hospital, what symptoms you should expect after surgery, and the type and amount of help from others you might require afterward.  If you do delay surgery for cataracts, you should know that it won’t affect the extent to which your vision will recover, because the lens in your eye is replaced with a brand new one.

Options For Medication

Currently, the only option to improve vision in patients with significant cataracts is surgery. There are no drops, pills, exercises, or glasses that can reverse cataract development. Fortunately, modern cataract surgery is a relatively quick and painless way to improve vision that has deteriorated from cataracts.

Cataract Prevention

There is essentially not one basic approach that you can take to absolutely keep cataracts from developing, but there are certain lifestyle changes that make it less likely they will appear, or that will help slow their growth. They include the following: 

  • Get into the habit of wearing sunglasses or glasses that can block ultraviolet (UV) light 
  • Quit smoking
  • Keep your diabetes or high blood pressure under control 
  • Keeping alcohol consumption at a moderate level
  • Maintain a healthy diet with lots of fruits and vegetables

The great thing is that doing most of these things will have the extra benefit of improving your health in other ways, not just promoting good eye care. There is much continuing research being done in regards to cataracts in many areas, such as genetic causes, methods to make surgery more successful, and possible nonsurgical treatments. Dr. Fishman and Dr. Wu at Vision Center of New York are world-class cataract specialists, having attended the top schools and receiving the top training in the U.S. Restore your vision and quality of life with a thorough eye exam. Give us a call today to schedule your appointment.