Cataract: Causes, Symptoms & Treatment
Understanding Cataract
Are you experiencing frequent changes in your eye prescription, blurred vision, or difficulty seeing at night? These could be early signs of cataracts, a common age-related condition where the eye’s natural lens becomes cloudy over time. The cataract can occur in one or both eyes. This usually develops slowly throughout life and is commonly seen in older people. Most people start getting cataracts after 40 years of age, but symptoms are typically seen after 50 years. There are different types of Cataract, some of which are:
Nuclear cataract- A type of cataract that affects the centre of the lens. It leads to yellowing or browning of the lens making it difficult to distinguish between various shades of color.
Cortical cataract- A type of cataract that affects the edges of the lens. It leads to interference with light passing through the centre of the lens.
Posterior subcapsular cataract- A type of cataract that affects the back of the lens. It leads to interference with the reading vision and causes the formation of glare or halos at night.
Congenital cataract- A type of cataract that is present by birth due to genetics or trauma.
Causes and Risk Factors of Cataract
Several causes contribute to the development of cataract. Some of the causes are listed below:
- Age is the primary reason for the development of cataract. As people age, the protein fibres in the lens break down and clump together, leading to the degradation of natural lens tissues over time. This causes the accumulation of oxidative damage in the lens proteins, leading to clouding of the lens.
- A family history of cataract, inherited metabolic disorders that affect the clarity of the lens, or certain genetic disorders such as Down’s syndrome are also known to cause the development of cataract in individuals.
Apart from the above-mentioned causes, there are several factors that elevate the risk of developing cataract. These include:
- Individuals with health conditions such as diabetes, hypertension, or obesity are at a greater risk of developing cataract.
- Individuals with previous injuries, inflammation, or infections of the eyes are at a greater risk of developing cataract over time.
- Certain environmental factors such as excessive exposure to UV radiation from sunlight or exposure to ionising radiation from radiation therapy increase the risk of developing cataract.
- Lifestyle factors such as consumption of alcohol or excessive smoking increase oxidative stress, leading to free radical damage, thereby elevating the risk of developing cataract.
- In the case of congenital cataract, risk factors include intrauterine infections, maternal malnutrition during pregnancy, or genetic mutations that affect the development of the lens.
- Prolonged use of gadgets and exposure to digital screens is also a contributing factor.
Signs and Symptoms of Cataract
There are several signs and symptoms of cataract. These include:
- Cloudy vision
- Blurring of vision
- Increased sensitivity to light, especially at night
- Requirement of brighter light when reading or writing
- Seeing halos around lights
- Increased difficulty seeing in low light
- Issues of double vision
- Frequent changes in prescription lenses
- Significant impairment in vision
- Milky or yellowish pupil
- Worsening of symptoms is indicated by issues with recognizing faces, problems with driving at night, trouble reading small print, and increased strain in the eyes
Diagnosis of Cataract
Here is a list of different diagnostic tests used for assessing eye health and diagnosing cataract in individuals:
- Usually, doctors start by obtaining a detailed history of visual symptoms, eye conditions, systemic diseases, along with reviewing medications and lifestyle factors of the individual.
- Following that, visual acuity testing or a standard eye chart examination is used by doctors to assess the current corrective lenses and differentiate between refractive errors and cataracts.
- Doctors also use slit lamp biomicroscopy to examine the structures of the eyes via a specialised microscope and evaluate the lens for opacity and density of cloudiness.
- Retinal exams are used by doctors to examine retinal health and determine if cataract removal would help improve vision.
- Contrast sensitivity testing is a specialised test used to measure an individual’s ability to distinguish between light and dark and detect the presence of any functional vision loss.
- Several other tests are also used by doctors to measure intraocular pressure, evaluate macular health, and rule out other potential eye diseases.
Treatment Options for Cataract
Various surgical and non-surgical treatment options are available for cataracts, which are based on the type and severity of the condition. These include:
- Non-surgical management of cataracts includes opting for visual aids such as polarised sunglasses, anti-glare glasses, or updated glasses or contact lens prescriptions.
- Phacoemulsification is a commonly used surgical procedure in which a small incision is made to break the cloudy lens. The incision is typically between 2 to 3 mm, and the fragments of the lens are removed by suction.
- For individuals with extremely dense cataracts, extracapsular cataract extraction surgery is used, which involves an even larger incision to remove the lens in a single piece.
- An artificial lens is implanted after removing the cataract-affected lens. These include monofocal IOLs to help provide clear vision at one distance (usually far); multifocal IOLs to assist in vision for multiple distances; toric IOLs to help correct astigmatism in addition to replacing the lens; and accommodative IOLs to move or change shape inside the eye to allow focus at different distances.
Prevention of Cataract
There are several preventive measures that can help delay the onset and progression of cataracts. These include:
- It is recommended to wear sunglasses with 100% protection from UV radiation.
- It is also recommended to wear protective eyewear during high-risk activities, sports, or when in environments with chemical exposure.
- Doctors usually recommend consuming a diet rich in sources of vitamin C (such as citrus fruits or bell peppers), vitamin E (such as nuts and vegetable oil), and omega-3 fatty acids (obtained from fatty fish and flaxseeds).
- It is highly recommended to limit the consumption of alcohol and quit smoking, as both elevate oxidative damage.
- Individuals with chronic lifestyle diseases such as obesity or hypertension are required to manage these conditions with proper medication and lifestyle changes.
- Apart from all preventive measures, early detection is the key. That is why it is recommended to schedule regular eye exams annually after the age of 60 years.
Frequently Asked Questions (FAQs)
How do I know if I have a cataract?
Cataracts usually develop at a later stage of life, and common signs include the presence of blurry or cloudy vision, difficulty seeing at night, frequent changes in prescription eyeglasses or contact lenses, and the appearance of halos around lights.
Can cataracts be prevented?
It may not be possible to completely prevent cataracts; however, with different measures, their onset can be delayed.
Do cataracts cause blindness?
If not detected early and not treated at the proper time, cataracts can cause significant loss of vision, leading to blindness. That is why early detection and surgical treatment are absolutely essential to treat cataracts.
Is cataract surgery safe?
Yes, cataract surgeries are one of the routine procedures in the healthcare industry and are regarded as some of the safest procedures with a high success rate.
Will I need glasses after cataract surgery?
Post-surgery, the majority of people can see adequately well without glasses or contact lenses. It is possible for some people to require glasses for reading or writing.
