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Facts about cataracts

Created date

July 23rd, 2018
a doctor shines a line into a patient's eyes

Although smoking, diabetes, alcohol use, and prolonged exposure to the sun can put you at risk for developing a cataract, simple wear and tear over the years is often the cause.

If you are over age 80 and haven’t had a cataract, you are an exception to the rule. Cataracts, or clouding of the lens in the eye, occur in more than half of Americans by the time they have reached their 80th birthday, according to the National Eye Institute (NEI). Cataracts can affect one or both eyes. 

The lens in your eye is made up of water and protein. If the protein starts clumping together, clouding occurs and prevents light from moving through the lens. Vision becomes blurry, night vision decreased, and you may experience sensitivity to glare. You might notice that images look brownish, colors are faded, or it may be hard to distinguish blues or purples.

Researchers do not know the exact causes of cataracts, but according to the NEI, certain factors, including smoking, diabetes, alcohol use, and prolonged exposure to sunlight, put you at high risk. Some cataracts form after eye surgery, radiation, traumatic eye injury, or steroid use.

But even in people without these risk factors, simple wear and tear may be the cause. “For most people, the development of cataracts is due to age,” says Joann Kang, M.D., an ophthalmologist in the department of ophthalmology and visual sciences at Montefiore Health System and assistant professor of ophthalmology, Albert Einstein College of Medicine, Bronx, N.Y.

When to consider surgery

In the initial stages, cataracts can be treated with new or glare-reducing glasses, brighter lighting, or use of magnifying glasses. “Cataract surgery is indicated when a decrease in your vision interferes with everyday activities,” Kang says. “You may also need the procedure if the cataract prevents the examination or treatment of other eye conditions, such as age-related macular degeneration or diabetes-related damage.”

Cataract surgery takes about an hour and is one of the most common, safe, and effective surgeries, and the recovery period is comparatively easy. “The most common aftereffects of cataract surgery are mild discomfort, foreign body sensation, and light sensitivity,” Kang says. “These symptoms resolve usually in the first few days of surgery, and it is also helpful to wear dark sunglasses. Your eye doctor will direct you on the proper use of postoperative medications.”

On rare occasions, people can experience more significant problems, such as double vision or increased eye pressure, but one very serious complication is called retinal detachment. This is a medical emergency because it can result in permanent loss of vision if not treated right away. Symptoms include a sudden increase in specks across your vision (floaters) or flashes. Because there is no pain associated with a detached retina, some people may not think symptoms are important, but you must be seen right away.

If you are unsure about surgery, the NEI reports that delaying the procedure does not make it more complicated or risky, but the deficits in your vision could put you at risk for injuries or falls. Regardless, talk to your doctor about all the risks and benefits so you can make an informed decision, because all surgeries have some level of risk, especially for infection or bleeding.

Scientists are always looking for ways to make surgical procedures easier and safer, and cataract surgery is no exception. “Over the past few years, there have been many technological advances,” Kang says. “The main advance is with the use of femtosecond laser to create precise corneal incisions, treat corneal astigmatism, and to reduce the amount of energy used to remove the cataract. At this time, however, there is insufficient evidence to show that femtosecond laser-assisted cataract surgery has better outcomes than traditional surgery.”

Prevention

If you haven’t developed cataracts, you may be able to prevent or delay them. “You may reduce your risk of the development of, or worsening of, cataracts by wearing proper sunglasses that reduce your exposure to ultraviolet radiation,” Kang says. “If you smoke, talk to your doctor about how you can stop as soon as possible.”

NEI researchers also have found that certain dietary habits are associated with a reduced risk, especially a high intake of antioxidant-rich green leafy vegetables and colorful fruits.

Early treatment of any medical condition is always ideal, and cataracts can be detected—even before they cause symptoms—by a comprehensive eye exam. Seniors should see an ophthalmologist every year or two depending on their visual needs and health.


Cataract surgery postoperative care

1. Use prescribed eyedrops exactly as directed.

2. Keep eyeglasses or eye shields on.

3. Do not rub or press on the eyes.

4. Avoid bending from the waist to pick up anything from the floor.

5. Take it easy and do not lift anything heavy.

6. Monitor carefully for signs of infection such as increased drainage or discomfort.

7. Do not drive until your doctor says it is safe.

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