By age 80, more than half of all Americans will have had a cataract, yet many people still do not know what they are or what causes them. Cataracts are common among those over age 50 and are characterized by clouding of the eye’s lens. This results in blurry vision. Surgery is a reliable and frequently performed cure for cataracts.
What are Cataracts?
Cataracts are degenerative changes in the structure of the eye that form when protein in the lens begins to clump together, clouding a small area of the eye. This cloud will continue to grow and interfere with vision. They can occur in one or both eyes. While the most common cause of cataracts is age, they can also be caused by eye trauma, certain medications, and various environmental and lifestyle factors. Additionally, some cataracts are congenital.
Advancing age is the reason most cataracts form, although causes of cataracts may include everything from environmental factors to medications used on a daily basis. If your medical history or lifestyle increases your risk of developing cataracts, it is important to have the health of your eyes monitored regularly by a qualified ophthalmologist.
- Age: Age is the main reason cataracts form. The eye disease appears in over 22 million Americans over the age of 40. According to the American Academy of Ophthalmology, over 50% of Americans over the age of 80 have cataracts. In fact, if we live long enough, nearly all of us will eventually develop cataracts. Because the lens of the eye cannot shed old cells naturally, protein that accumulates on the lens gradually builds up over time, progressively obscuring vision by preventing light from reaching the retina.
- Ultraviolet Radiation (UVA or UVB): According to the U.S. Environmental Protection Agency, long-term exposure to ultraviolet radiation, especially UVB rays, can cause changes in pigment that lead to the formation of cataracts. This is especially common in tropical climates, where sun exposure occurs year-round. To protect the eyes from sun damage, it is important to wear sunglasses with a high level of UVA/UVB protection.
- Medications: Certain medications are well-known causes of cataracts, and can both lead to cataract formation as well as accelerate their development. Steroid medications are most heavily associated with cataract formation, and may be prescribed as pills, injections, or eye drops. If you are taking steroid medications to manage a long-term condition, it is important to have your ocular health managed by a qualified ophthalmologist, and note any visual changes. The medications that can cause cataracts include:
- Eye drops containing steroids
- Glaucoma medications
- Certain antipsychotics and antidepressants
- Certain medications for autoimmune conditions
- Medication to control heart arrhythmia
- Diabetes: High levels of blood sugar cause the lens of the eye to swell with excess fluid, making the eyes of patients with diabetes more susceptible to cataracts and glaucoma. People who have diabetes are more likely to develop cataracts at a younger age, and experience rapid cataract progression. Careful monitoring of blood sugar levels helps to minimize the risk of developing cataracts.
- Weight: Studies show individuals who are overweight are more likely to develop cataracts, while the risk of cataract development doubles for individuals who are clinically obese. Of all the cataract types, weight is most commonly linked to the development of posterior subcapsular cataracts.
- Injury, Inflammation or Trauma to the Eye: Injury or trauma to the eye increases a patient's risk of developing cataracts. Individuals who have experienced inflammation in the eye, either post-operatively or as the result of another eye disease, are also more likely to eventually develop cataracts. For instance, iritis is an ocular condition that causes chronic inflammation inside the eye, and is commonly linked to early and rapid cataract formation.
- Smoking: Lifestyle habits such as smoking or consuming alcohol are often considered causes of cataracts. Men who smoke a pack of cigarettes per day double their risk of developing cataracts, while female heavy smokers increase their risk by 50%. Some doctors attribute the connection to the high level of free radicals present in the bodies of smokers, placing them at particular risk of developing nuclear cataracts.
- Alcohol: Alcohol is responsible for a slight increase in the likelihood that individuals will develop cataracts, and the level of risk directly correlates to the amount of alcohol consumed. For both eye and overall health, it is recommended that drinking be limited to moderate amounts.
Symptoms and Diagnosis of Cataracts
Protein clumps that cloud the eye reduce the sharpness of vision in several ways. An individual with cataracts may experience blurry vision or be unable to see bright colors at their true intensity. Lights may seem excessively bright, and halos may appear around them. Double vision is another symptom that indicates a cataract has formed.
Cataracts can be detected with a full optical examination. Since early cataract diagnosis and monitoring can protect your vision, regular exams are advisable. Catching cataracts early helps patients more easily find a cure. Learn more about cataract symptoms and diagnosis.
At first, a cataract only affects a small portion of the eye’s lens. Over time, the cataract grows, often so gradually that the patient does not notice it. When the entire lens has become clouded, ophthalmologists refer to the cataract as a “ripe” or “mature” cataract. At this stage, cataracts can cause severe vision problems. Learn about the progression of cataracts.
Types of Cataracts
There are three cataract types, each defined by their location on the lens.
- Nuclear cataracts are found in the center, or nucleus of the lens.
- Cortical cataracts begin at the outer rim of the lens, which is known as the cortex, and work toward the center.
- Subcapsular cataracts affect the back of the lens in the capsule, or the membrane that envelops the lens.
Because each of these cataract types affects vision in a distinct manner, it is possible for a patient to have more than one type of cataract at the same time. While age is the most common risk factor for cataracts, some cataract types may also be attributed to:
- Eye trauma
- Certain prescription drugs or steroids
An experienced ophthalmologist can diagnose each of the different cataract types and discuss treatment options. In the majority of cases, patients choose to undergo cataract surgery in order to reduce symptoms such as cloudy vision.
Nuclear cataracts, which form in the lens' nucleus, are the most common type of cataracts. Because opacity develops in the center of the lens, known as the central nucleus, nuclear cataracts interfere with a person's ability to see objects in the distance. Usually the result of advancing age, nuclear cataracts can take years to develop and often give the nucleus a yellow tint.
Cortical cataracts begin at the outer rim of the lens and gradually work toward the central core of the lens. This type of cataract resembles spokes of a wheel that extend from the outside of the lens to the center. Patients with cortical cataracts often notice problems with glare, or a "halo" effect around lights, and experience a disruption of both near and distance vision.
Of all cataract types, subcapsular cataracts progress the most rapidly. While nuclear cataracts take years to develop, subcapsular cataracts reach an advanced stage of progression within a matter of months. Posterior subcapsular cataracts affect the back of the lens, causing glare and blurriness. This type of cataract is usually seen in patients who suffer from diabetes, extreme nearsightedness or retinitus pigmentosa, or who take steroid medication.
Congenital cataracts refer to cataracts that are present from birth, or are developed in early childhood, and may include nuclear, cortical or subcapsular cataracts.Congenital cataracts may be linked to an infection contracted by the mother during pregnancy, or to a genetic condition such as Fabry's disease, Alport syndrome, or galactosemia. Because clear vision is essential to the development of the child's eyes and brain, it is important to diagnose congenital cataracts as early as possible.
The only cure for cataracts is surgery. Cataract surgery is indispensable in providing patients with freedom from clouded, blurred, or dimmed vision. There are many types of cataract eye surgery that may be used to best treat a patient’s condition. A skilled ophthalmologist will discuss your cataract treatment to help decide which option is best for you.
Recovery after Cataract Surgery
After cataract surgery, patients generally feel mild discomfort. Usually, though, over-the-counter pain relievers are sufficient for numbing any pain or itching you might feel. Cataract surgery patients sometimes experience temporary fluid discharge and sensitivity to light following their operation. Learn how to facilitate the cataract surgery recovery process.
Cataract Surgery Cost
The cost of cataract surgery can vary based on a number of factors. For example, the type of replacement lens used and the type of cataract will influence the final cost of treatment. Learn more about cataract surgery cost.
Find a Cataract Surgeon in Your Area
DocShop connects you with reputable doctors in your area so you can learn more about the practice than simply where it’s located. With DocShop, patients can explore an extensive network of healthcare providers and learn about a doctor’s area of expertise, practice philosophy, and much more. If you feel it is time to speak with an eye care professional about what cure or treatments are available for cataracts, DocShop puts you a few simple clicks away. Find a cataract surgeon in your area today.