What is a cataract?

A cataract is the clouding of the eye’s natural lens. As this normally clear lens gets cloudy, it decreases your ability to see well. A cataract can make objects appear blurry. It can also make colors seem less bright.

Your eye’s natural lens is located directly behind the pupil. It is made up of mostly water and protein. As you get older, the protein parts of the lens can begin to clump together. These clumps start small but grow larger over time. The bigger they get, the more they can compromise your vision.

Cataracts are a common condition, especially for older people. Cataracts typically begin developing in people age 40 years and older. But they don’t usually begin to impair vision until after age 60. However, younger people can develop cataracts, too. These juvenile cataracts (in children) can be caused by a genetic mutation that affects proteins, by metabolic disorders or by trauma (eye injury).

What are the symptoms of cataracts?

The symptoms of cataracts are similar to those for myopia (near-sightedness). These symptoms may begin as minor annoyances and progress over time to impair vision. You may feel symptoms in both eyes or only one eye. They include:

  • Blurry or cloudy vision.
  • Faded colors.
  • Poor night vision, with halos around streetlights and car headlights.
  • Light sensitivity in daylight or to bright lights at night.
  • Double vision.
  • Frequent changes to your prescription for glasses or contacts.

If you have any of these symptoms, you should make an appointment with your eye doctor. If your symptoms include a sudden change in vision, sudden eye pain, or a sudden headache, you should contact your doctor immediately.

What causes cataracts?

Generally, cataracts are believed to be an age-related disorder. Some research suggests that other conditions can put you at greater risk for developing cataracts. Conditions thought to be linked to cataract development include:

  • Smoking.
  • Diabetes.
  • Exposure to ultraviolet rays from the sun (not regularly wearing sunglasses).
  • Obesity.
  • High blood pressure (hypertension).
  • Hormone replacement therapy.
  • Some cholesterol medications (statins).
  • Eye inflammation (injury).
  • Family history of cataracts.
  • Extreme far-sightedness.
  • Previous eye surgery.

How are cataracts diagnosed?

An eye care professional will be able to diagnose your cataracts by performing a retinal exam.

During a retinal 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).

Once your eyes are dilated, 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.

Can cataracts be prevented or avoided?

There are currently no studies that prove you can prevent age-related cataracts from forming. It also has not been proven that you can slow the progression of cataracts.

Doctors do recommend some strategies they believe are beneficial for overall eye health.

  • Wear sunglasses. Ultraviolet rays have long been associated as a contributing factor for developing cataracts. Minimize your exposure by protecting your eyes with good sunglasses and even a wide-brimmed hat when you’re outdoors.
  • Stop smoking. Many doctors believe cataracts are more prevalent among people who smoke.
  • See your eye doctor regularly. This is the best way to guard your eye health. Your eye doctor will be able to recommend how often you need to see him or her.
  • Take care of your health—especially if you have a chronic condition like diabetes or high blood pressure.
  • Add fruits and vegetables to your diet. Research hasn’t proven that a diet rich in fruits and vegetables can prevent cataracts. However, there is evidence to suggest that antioxidants (like those found in fruits and vegetables) can reduce your risk for developing cataracts.

Cataract treatment

The most common and effective treatment for cataracts is surgery. Your doctor may not recommend surgery until your cataract causes enough vision loss to impact your daily life. For example, if you are unable to read, drive, or watch TV because of them, you probably qualify for surgery.

If your cataract is not significant enough for surgery, you doctor will likely try to improve your vision by changing your prescription for glasses or contacts. This can help improve your vision until your cataract worsens to the point that you need surgery.

Cataract surgery is one of the most common surgeries in the United States, according to the NEI. It is also one of the safest. To surgically remove a cataract, your surgeon will remove your clouded natural lens and replace it with a clear, permanent, artificial lens.

If you have cataracts on both eyes that require surgery, your surgeon will operate on them separately. The time between surgeries is usually about four weeks or until the first eye has healed. Most people who have cataract surgery can expect to regain near-perfect vision (20/20 to 20/40).

Living with cataracts

When cataracts begin to develop, you may not even realize it. This is because they tend to start small. As they grow, you’ll become aware of them only when they begin to interfere with your vision.

Cataracts don’t develop at the same rate in each eye. Also, they don’t spread from eye to eye. It could be years between when you notice a cataract and when you need surgery for it.

Questions to ask your doctor

  • Am I at high risk for developing cataracts?
  • How long should I wait before having a cataract removed?
  • Will I recover all my lost vision after cataract surgery?
  • What are the risks of cataract surgery?
  • What type of artificial lens should I choose?
  • Does wearing contact lenses affect my risk for developing cataracts?