Focus on Cataracts

What are cataracts?

A cataract is a milky patch on the normally clear lens of the eye, formed when the proteins and fibers that make up the lens break down due to advanced age, injury, and genetic or other factors. This white spot reduces the amount of light the eye can absorb, creating blurred vision, sensitivity to light, difficulty seeing at night, and more.

What does vision look like with cataracts?

This overview by the Mayo Clinic provides more information on cataracts, their appearance, potential symptoms, vision changes, and more.

Cataracts are the leading cause of blindness in the world. The Centers for Disease Control and Prevention (CDC) estimates that 20.5 million (17.2%) of people over age 40 in the US have a cataract in one or both eyes. Age-related cataracts are the most common type and progress slowly, often with mild or no early symptoms. Left untreated, cataracts can lead to permanent vision impairment, low vision, and irreversible blindness.

According to the Big Data Report for Adults 65+, produced by VisionServe Alliance and The Ohio State University College of Optometry, 7.3% of older Americans report blindness or vision loss.

What causes cataracts?

There are three main types: nuclear sclerotic (at the center of the eye), cortical (affecting peripheral vision), and posterior subcapsular cataracts (PSC, in the back of the lens). Cataracts are considered a normal part of aging—geriatric cataracts are the most common—but they also occur in three to four out of every 10,000 infants born in the US each year. Causes of infant cataracts include genetic and chromosomal factors (including Down Syndrome) and maternal illnesses such as rubella and chicken pox. Additional risk factors for adult-onset cataracts include:

Exposure to intense heat and UV rays from the sun
Conditions including diabetes and eczema
Smoking
Heavy alcohol use
Eye injury and some eye surgeries
Family history of cataracts
Long-term use of corticosteroids and other medications

Symptoms for cataracts

Age-related cataracts develop over many years and may initially present no symptoms. As the disease progresses, it causes the following changes in vision:

Clouded or blurred vision, fading or yellowing of colors
Trouble seeing at night or in low light
Sensitivity to light and glare
Halos around lights
Frequent changes in eyeglass/contact lens prescription
Double vision in one eye

What are the first signs of cataracts?

Initial symptoms often include clouded, blurred, or dim vision, difficulty seeing at night, and sensitivity to light. These are typical first signs of cataracts and should prompt an appointment for a comprehensive eye examination with dilation. As with any eye disease, early detection can improve therapeutic outcomes, so everyone over 40 should schedule regular eye exams.

How do you test for cataracts?

A comprehensive eye examination with dilation can detect cataracts at all four stages: early, immature, mature, and hypermature. Because the lens sits behind the iris (the colored part of the eye), it can only be seen fully through a dilated pupil. After you provide a brief medical history, including any vision changes, your optometrist or ophthalmologist may conduct the following tests to diagnose cataracts and other eye diseases:

The visual acuity test, or letter chart, examines how well you see at various distances.
The slit-lamp exam looks at the cornea, iris (the “aperture” that controls how much light gets in), and lens (located at the back of the eye) through a powerful lighted microscope that illuminates these as well as the retina (light-sensitive tissue that receives images through the lens) and optic nerve at the back of the eye. An ophthalmoscope—a precision instrument resembling a flashlight—may also be used to examine the back of the eye.
Dilation occurs when your eye doctor administers special drops that temporarily expand (dilate) the pupils, allowing for a better look at the back of the eye.
Tonometry tests the pressure inside the eye.

The American Academy of Ophthalmology provides recommendations for comprehensive eye exams, with adults 65+ having their eyes checked every year or two, and more frequent exams suggested for those diagnosed with, or at greater risk, of eye disease. Check with your eye doctor on the ideal schedule for your eye exams to protect your eyes!

What is the best treatment for cataracts?

How do you test for cataracts?

The visual acuity test, or letter chart, examines how well you see at various distances.
The slit-lamp exam looks at the cornea, iris (the “aperture” that controls how much light gets in), and lens (located at the back of the eye) through a powerful lighted microscope that illuminates these as well as the retina (light-sensitive tissue that receives images through the lens) and optic nerve at the back of the eye. An ophthalmoscope—a precision instrument resembling a flashlight—may also be used to examine the back of the eye.
Dilation occurs when your eye doctor administers special drops that temporarily expand (dilate) the pupils, allowing for a better look at the back of the eye.
Tonometry tests the pressure inside the eye.

What is the best treatment for cataracts?

Cataract surgery is often conducted to help restore vision by removing and replacing the damaged organic lens with a synthetic lens. The three main types of cataract surgery are:

Phacoemulsification, the least invasive cataract surgery, uses sound waves to break up the cataract, which is suctioned out and replaced with a synthetic intraocular lens (IOL)
Femtosecond islaser-assisted cataract surgery (FLACS) that removes the damaged lens with a bladeless incision.
Extracapsular cataract extraction (ECCE) is often recommended for more advanced cataracts and uses a larger incision and stitches, requiring a longer recovery time.

Vision often improves within a few days of surgery, with healing completed and vision stabilized within 4-6 weeks. Post-surgery care is vital, following the doctor’s orders. See this information from the American Academy of Ophthalmology regarding cataract surgery, including post-surgical follow-up. insights.

Glaucoma vs Cataracts

Glaucoma and cataracts are serious eye conditions that can lead to vision loss and blindness if left untreated. They affect different parts of the eye—pressure inside the eye that damages the optic nerve for glaucoma and degeneration of the lens, resulting in cloudy vision and restricted light absorption in the case of cataracts. Each disease has its typical symptoms and requires different treatment. Both glaucoma and cataracts have a hereditary component: your risk of glaucoma and cataracts increases if someone in your family has had them.

Taking supplements—vitamins A, C, E, lutein, zeaxanthin, and omega-3 fatty acids— and maintaining a diet rich in fatty fish, whole grains, fruits, and vegetables are simple ways to support healthy eyes. Smoking and heavy alcohol use both increase the risk of eye disease.

Early detection with a comprehensive eye exam is key. So please schedule regular eye exams to protect your vision.

Vision Rehabilitation Week is June 9-15!

Join us to celebrate and commemorate Vision Rehabilitation Week from June 9-15. It’s the perfect opportunity to spread the word about Vision Rehabilitation training and programs to anyone you know, work with, or support who lives with blindness and low vision. Learn more about Vision Rehabilitation Week and download content and graphics to share with family and friends on social media.