Cataracts

What is a Cataract

A cataract is a cloudy area in the lens of your eye. Cataracts are very common as you get older. In fact, more than half of all Americans age 80 or older either have cataracts or have had surgery to get rid of cataracts. At first, you may not notice that you have a cataract. But over time, cataracts can make your vision blurry, hazy, or less colorful. You may have trouble reading or doing other everyday activities.

Most cataracts are age-related — they happen because of normal changes in your eyes as you get older. But you can get cataracts for other reasons — after an eye injury or after surgery for another eye problem (like glaucoma). No matter what type of cataract you have, the treatment is always cataract surgery.

There are five main types of cataracts

Age-related cataract

As you age, a cataract can develop because of natural changes in the lens of your eye. This is called an age-related cataract, and it’s the most common type of cataract. Age-related cataracts may be more likely to form if you: smoke,  drink too much alcohol, have a family history of cataract, have diabetes, have had certain eye surgeries, like glaucoma surgery or take steroids (medicines used to treat a variety of health problems, like arthritis or allergies) for a long time.

Traumatic cataract

Serious eye injuries can damage your lens and cause a cataract. The cataract could form quickly after the injury — or it could form many years later.

Radiation cataract

Certain types of radiation can cause cataracts. This includes ultraviolet (UV) rays from the sun and radiation treatment for cancer.

Pediatric cataract

Children can get cataracts, too. They can be born with cataracts (congenital cataracts), or develop them later on. Cataracts in children are rare, and they’re usually genetic — they run in families. They can also happen because of serious complications during pregnancy or because of illnesses during childhood, like uveitis or tumors in the eye. Children can also get cataracts for the same reasons as adults — eye injuries, radiation, or steroid medications. When pediatric cataracts are large enough to cause vision problems, they need immediate treatment. It’s important to treat these cataracts early on so your child doesn’t develop other vision problems, like amblyopia (lazy eye). Other pediatric cataracts are so small that they won’t hurt your child’s vision. Your child’s doctor can monitor these smaller cataracts to make sure they don’t cause vision problems.

Secondary cataract

posterior capsule opacification - After cataract surgery, some people may develop a condition called secondary cataract that makes their vision cloudy again. This condition is also called after-cataract or posterior capsule opacification. Secondary cataract is common, but it’s easy to fix with a laser treatment in your eye doctor’s office. During cataract surgery, your doctor removes the lens from your eye and replaces it with a clear artificial lens. But over time, the thin membrane that holds your new lens in place can grow scar tissue and make your vision cloudy again.

Secondary cataracts aren’t actually cataracts, because they’re caused by cloudiness on the outside of your lens, not the inside — but the vision problems they cause are very similar. Up to half of all people who have had cataract surgery will develop a secondary cataract. Treatment for secondary cataract is quick and painless. Your doctor will use a laser to make an opening in the membrane behind the artificial lens in your eye — this is called YAG laser capsulotomy. Most people will notice their vision is back to normal a few days after the procedure.

Symptoms of Cataracts

You can get cataracts in one eye or both eyes — but they can’t spread from one eye to the other. You might not have any symptoms at first, but as cataracts grow, they can cause changes in your vision. For example, you may notice that your vision is cloudy or blurry, colors look faded,  you can’t see well at night. Lamps, sunlight, or headlights seem too bright. You see a halo around lights. You see double (this sometimes goes away as the cataract gets bigger). You have to change the prescription for your glasses often. These symptoms can be a sign of other eye problems, too. Be sure to talk to your eye doctor if you have any of these symptoms.

Cataract Risk

Over time, cataracts can lead to vision loss. Your risk for cataracts goes up as you get older. You’re also at higher risk if you: have certain health problems, like diabetes, have a family history of cataracts, have had an eye injury, eye surgery, or radiation treatment on your upper body, have spent a lot of time in the sun or take steroid medications.

Preventing Cataracts

Some steps you can take to prevent cataracts is to always wear sunglasses and a hat with a brim to block the sun. Stop smoking. Eat healthy. Eat plenty of fruits and vegetables — especially dark, leafy greens like spinach, kale, and collard greens. If you’re age 60 or older, get a dilated eye exam at least once every 2 years.

Evaluating Cataracts

An optometrist or ophthalmologist can check for cataracts as part of a comprehensive eye exam that includes a dilated pupil. The exam is simple and painless — your doctor will give you some eye drops to dilate (widen) your pupil and then check your eyes for cataracts and other eye problems.

Managing Cataracts

Early on, you may be able to make small changes to manage your cataracts. You can do things like: Use brighter lights at home or work, wear anti-glare sunglasses, use magnifying lenses for reading and other activities,  get new glasses or contact lenses. A new prescription for eyeglasses or contact lenses can help you see better during the early stages of cataracts.  As cataracts get denser, your vision will decrease and changes in your eyeglass prescription will no longer be helpful.

Cortical and nuclear sclerotic cataract