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Saai Eye Hospital

Cataract

What is a Cataract?

A cataract is a dense, cloudy area that forms in the lens of the eye. A cataract begins when proteins in the eye form clumps that prevent the lens from sending clear images to the retina. The retina works by converting the light that comes through the lens into signals. It sends the signals to the optic nerve, which carries them to the brain.

It develops slowly and eventually interferes with your vision. You might end up with cataracts in both eyes, but they usually don’t form at the same time. Cataracts are common in older people. It is the most common cause of vision loss in people over age 40 and is also the principal cause of blindness in the world. Types of cataracts include:

A subcapsular cataract occurs at the back of the lens. People with diabetes or those taking high doses of steroid medications have a greater risk of developing a subcapsular cataract.

A nuclear cataract forms deep in the central zone (nucleus) of the lens. Nuclear cataracts usually are associated with ageing.

A cortical cataract is characterized by white, wedge-like opacities that start in the periphery of the lens and work their way to the centre in a spoke-like fashion. This type of cataract occurs in the lens cortex, which is the part of the lens that surrounds the central nucleus



What are the symptoms of Cataract?

At first, a cataract has little effect on your vision. You may notice that your vision is blurred a little, like looking through a cloudy piece of glass or viewing an impressionist painting.

A cataract may make light from the sun or a lamp seem too bright or glaring. Or you may notice when you drive at night that the oncoming headlights cause more glare than before. Colours may not appear as bright as they once did.

The type of cataract you have will affect exactly which symptoms you experience and how soon they will occur. When a nuclear cataract first develops, it can bring about a temporary improvement in your near vision, called "second sight."

Unfortunately, the improved vision is short-lived and will disappear as the cataract worsens. On the other hand, a subcapsular cataract may not produce any symptoms until it's well-developed.

If you think you have a cataract, see an eye doctor for an exam to find out for sure.

Common symptoms of cataracts include:

  • blurry vision
  • trouble seeing at night
  • seeing colours as faded
  • increased sensitivity to glare
  • halos surrounding lights
  • double vision in the affected eye
  • a need for frequent changes in prescription glasses


What Causes a Cataract?

The lens inside the eye works much like a camera lens, focusing light onto the retina for clear vision. It also adjusts the eye's focus, letting us see things clearly both up close and far away.

The lens is mostly made of water and protein. The protein is arranged in a precise way that keeps the lens clear and lets light pass through it.

But as we age, some of the protein may clump together and start to cloud a small area of the lens. This is a cataract, and over time, it may grow larger and cloud more of the lens, making it harder to see.

No one knows for sure why the eye's lens changes as we age, forming cataracts. But researchers worldwide have identified factors that may cause cataracts or are associated with cataract development.

Besides advancing age, cataract risk factors include several underlying causes of cataracts. These include:

  • overproduction of oxidants, which are oxygen molecules that have been chemically altered due to normal daily life
  • smoking
  • ultraviolet radiation
  • the long-term use of steroids and other medications
  • certain diseases, such as diabetes
  • trauma
  • radiation therapy


What are the types of Cataract?

There are different types of cataracts. They’re classified based on where and how they develop in your eye.

  • Nuclear cataracts form in the middle of the lens and cause the nucleus, or the center, to become yellow or brown.
  • Cortical cataracts are wedge-shaped and form around the edges of the nucleus.
  • Posterior capsular cataracts form faster than the other two types and affect the back of the lens.
  • Congenital cataracts, which are present at birth or form during a baby’s first year, are less common than age-related cataracts.
  • Secondary cataracts are caused by disease or medications. Diseases that are linked with the development of cataracts include glaucoma and diabetes. The use of the steroid prednisone and other medications can sometimes lead to cataracts.
  • Traumatic cataracts develop after an injury to the eye, but it can take several years for this to happen.
  • Radiation cataracts can form after a person undergoes radiation treatment for cancer.


What are the Risk Factors of Cataract?

Risk factors associated with cataracts include:

  • older age
  • heavy alcohol use
  • smoking
  • obesity
  • high blood pressure
  • previous eye injuries
  • a family history of cataracts
  • too much sun exposure
  • diabetes
  • exposure to radiation from X-rays and cancer treatments


How the Diagnosing of Cataracts happens?

Your doctor will perform a comprehensive eye exam to check for cataracts and to assess your vision. This will include an eye chart test to check your vision at different distances and tonometry to measure your eye pressure.

The most common tonometry test uses a painless puff of air to flatten your cornea and test your eye pressure. Your doctor will also put drops in your eyes to make your pupils bigger. This makes it easier to check the optic nerve and retina at the back of your eye for damage.

Other tests your doctor might perform include checking your sensitivity to glare and your perception of colours.



What is the treatment for cataract?

If you’re unable or uninterested in surgery, your doctor may be able to help you manage your symptoms. They may suggest stronger eyeglasses, magnifying lenses, or sunglasses with an anti-glare coating.

Surgery

Surgery is recommended when cataracts prevent you from going about your daily activities, such as reading or driving. It’s also performed when cataracts interfere with the treatment of other eye problems.

One surgical method, known as phacoemulsification, involves the use of ultrasound waves to break the lens apart and remove the pieces.

Extracapsular surgery involves removing the cloudy part of the lens through a long incision in the cornea. After surgery, an artificial intraocular lens is placed where the natural lens was.

Surgery to remove a cataract is generally very safe and has a high success rate. Most people can go home the same day as their surgery.



What is the Outlook of a Cataract?

Cataracts can interfere with daily activities and lead to blindness when left untreated. Although some stop growing, they don’t get smaller on their own. The surgical removal of cataracts is a very common procedure and is highly effective.

Prevention of Cataracts:

To reduce your risk of developing cataracts:

  • protect your eyes from UVB rays by wearing sunglasses outside
  • have regular eye exams
  • stop smoking
  • eat fruits and vegetables that contain antioxidants
  • maintain a healthy weight
  • keep diabetes and other medical conditions in check


NEXT STEP

Before you agree to the test or the procedure make sure you know:

  • The name of the test or procedure
  • The reason you are having the test or procedure
  • What results to expect and what they mean
  • The risks and benefits of the test or procedure
  • What the possible side effects or complications are
  • When and where you are to have the test or procedure
  • Who will do the test or procedure and what that person’s qualifications are
  • What would happen if you did not have the test or procedure
  • Any alternative tests or procedures to think about
  • When and how will you get the results
  • Who to call after the test or procedure if you have questions or problems
  • How much will you have to pay for the test or procedure

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