Cataracts

Understanding Cataracts: What Are They and How Do They Form?

A cataract is a cloudy section of the eye’s natural lens that results in impaired or blurred vision. A person’sability to see things well is connected to the lens’s function, focusing light on the retina at the rear of the eye. But as we age, the proteins inside the lens may clump together, forming a cataract that obstructs light passage and affects general eyesight.

Cataracts develop progressively. At first, only small parts of the lens could become foggy, leading to minimal sight problems. With time, as the cataract progresses to become bigger and denser, it results in more severe vision impairment.

Typically, age is the major risk factor for cataract formation. Nonetheless, factors like smoking, genetics, diabetes, some drugs, and excessive alcohol use could also contribute to cataract development.

Types of cataracts

There are several types of cataracts. Apart from age-related cataracts, others include:

• Pediatric cataracts: This condition develops in infants and children and can be congenital (present at birth) or may form after birth. Typically, pediatric cataracts run in families, though they could also result from eye injury or other eye-related conditions. Immediate treatment in minors with this disorder is necessary to prevent amblyopia (lazy eye).
• Traumatic cataracts: These conditions occur due to eye injuries. Treatment of traumatic cataracts is more complex since the structures surrounding the lens might also require repair.
• Secondary cataracts: Also known as posterior capsular opacification, these cloudy spots develop on the lens capsule (membrane covering the lens). Secondary cataracts are a common complication of cataract surgery, though they are easily correctable.

Types of age-related cataracts

Types of age-related cataracts are named based on their location in the eye lens. Learning the anatomy of the lens generally helps comprehend the different types.

Naturally, the lens is composed of three layers. They include:

• Nucleus: The centre or core of the lens
• Cortex: The layer surrounding the nucleus
• Lens capsule: Thin membrane that covers the cortex. Though it’s not a component of the lens, this lens capsule acts like a tight-fitting skin surrounding and protecting the lens.

Eye care specialists categorize cataracts depending on the area in which they form in the lens. Usually, people develop more than one kind of this condition simultaneously since the foggy patches tend to occur in multiple sections of the lens. These are the three most prevalent types of age-related cataracts:

• Nuclear sclerotic cataract: Forms in the nucleus
• Cortical cataract: Develops in the cortex
• Posterior subcapsular cataract: Occur in the posterior cortex. In this case, posterior implies the back of the lens, a section near the retina, while subcapsular indicates the cataracts that develop at the cortex exterior edge below the lens capsule.

At what age do cataracts normally begin?

Around 40, the proteins in the lens of the eyes begin to break down, but the symptoms typically won’t appear until the age of 60 and above. Sometimes, having health problems such as diabetes can lead to the early onset of the symptoms.

Symptoms of Cataracts

Cataracts can manifest in different symptoms, such as:

• Cloudy, foggy, filmy, or blurry vision
• Changes in color perception. The colors may appear faded or less vivid
• Increased sensitivity to sunlight, bright lamps, or headlights
• Difficulty seeing clearly at night
• Glare, including streaks or halos forming around lights
• Changes in vision prescription as well as worsened near-sightedness
• Double vision
• The need to use a brighter light to read

Are cataracts painful?

In general, cataracts do not usually cause any pain. Nevertheless, increasing eye sensitivity to light can lead to discomfort.

How do cataracts affect vision and day-to-day life?

A person’s everyday life can be greatly affected by cataracts, making simple routine tasks a bit challenging. For example, blurry vision can make it hard to read, and one may need brighter lights or magnifying glasses so as to see clearly. Also, driving can be risky since cataracts impact depth perception, resulting in sensitivity to headlights and streetlight glare.

Facial recognition, on the other hand, can be a problem. This could lead to socialization challenges and loneliness. 

The effect on individual independence and overall life quantity should not be understated. As such, early intervention to avoid more loss of sight is significant.

Causes of Cataracts

Cataracts mostly occur due to aging or eye injuries that may alter the tissue making up the lens. As the fibres and proteins in the lens start breaking down, it makes vision cloudy or hazy.

Furthermore, certain genetic disorders (those passed on from parents) causing other medical conditions can increase the risk of developing cataracts. Different eye problems, previous eye surgery, diseases like diabetes, or prolonged use of steroid drugs can also contribute to cataracts.

How does a cataract form?

With age, the eye lenses become thicker, less clear, and less flexible. Aging and certain health problems can trigger the breakdown and clumping of the fibres and proteins in the lenses, leading to clouding.

In addition, the cloudiness gets worse as the cataract progresses, hence blocking and scattering light as it goes through the lens. This hinders the sharp, clear images from getting to the retina, resulting in blurred vision.

Although cataracts normally occur in both eyes, the effects don’t always happen at the same pace. In some instances, one eye’s condition might be worse than the other, leading to differences in sight.

Risk Factors

These are some of the risk factors associated with cataract formation:

• Aging
• Diabetes
• Excessive exposure to sunlight
• Smoking
• Obesity
• Family history
• Previous eye surgery
• Previous eye injury or inflammation
• Long-term use of corticosteroids
• Excessive alcohol consumption

Diagnosing Cataracts

The eye specialist will first ask about the symptoms and look into your medical history to diagnose cataracts. After that, they will conduct an eye examination to analyze the condition further.

Other diagnostic tests your physician can perform include:

• Vision test: Also known as acuity test, this procedure involves using an eye chart to determine how you can read a letter sequence correctly. The professional will examine each eye separately with a chart or a viewing tool containing letters that get smaller. This will help assess if your vision is 20/20 or if you have an eyesight problem.
• Eye structure exam: This test assists the physician to view the structures at the front of the eye closely. The procedure uses a slit (strong line of light) to illuminate the eye structure to allow a clear view in small sections. This also makes it easy to see the underlying problem.
• Retinal examination: This test is done to look at the retina. Retinal exam preparation involves putting drops in the eyes to open the pupils widely (dilation), making it easy to view the retina. The doctor can then check the lens for cataract signs using an ophthalmoscope or slit lamp.
• Fluid pressure test: Also known as applanation tonometry, this test is used to measure the pressure of the fluid inside the eye.

Treating Cataracts

Usually, a surgical procedure is the only effective option for cataracts when the prescription glasses no longer clear the vision.

When should I consider cataract surgery?

Discuss with your eye specialist to determine if cataract surgery is appropriate for you. In many cases, the surgical procedure may be considered if the condition starts affecting your quality of life, including the capacity to do day-to-day activities like reading or even driving at night.

Generally, there is no urgency to remove the cataracts since they normally don’t cause any damage. However, the condition could worsen rapidly, especially in individuals with other medical conditions like high blood pressure, diabetes, or obesity.

Delaying surgery doesn’t impact the success rate of your vision recovery. Therefore, you should take enough time to look into the advantages and risks associated with cataract surgery.

If you decide to delay the surgery for a while, your eye specialist might suggest regular follow-ups to monitor the cataract progression. The nature of your condition will determine how often you will visit the doctor.

What happens during cataract surgery?

Technically, cataract surgery entails the removal and replacement of the clouded lens with a clear artificial lens (intraocular lens). The artificial intraocular lens (IOL) is placed in the same spot as the natural lens and becomes a permanent part of the eye. When IOL is not applicable, vision can be rectified using contact lenses or eyeglasses after removing the cataract.

Because cataract surgery is outpatient, you won’t have to remain in the hospital after the operation. Medication is usually administered to numb the part around the eye, and you will also be awake during the procedure.

Although cataract surgery is generally a safe procedure, it sometimes poses risks of bleeding and infection. Also, retinal detachment (pulling the retina out of place) is possible during the operation.

Following the operation, healing typically takes a few weeks, and you may experience soreness for some days.

Sometimes, surgery needs to be done on both eyes. In that case, your physician will schedule another appointment to address the second eye as soon as you fully recover from the initial procedure.

What should I expect before, during, and after cataract surgery?

Before the surgery, the eye surgeon will examine the suitable IOL power and prepare you for the operation.

During the surgery, phacoemulsification is done to remove the eye’s cloudy lens. After that, the IOL is placed to restore clear sight.

After the operation, you might experience blurry vision and slight discomfort that will get better in a few days.

The physician may prescribe eye drops and ask you to avoid vigorous activities for post-operative care and recovery. Check-ups during this healing period are also important.

Preventing Cataracts

Even though there are no proven ways of preventing or slowing down the growth of cataracts, these approaches can significantly help lower the risk:

• Regular eye examination: Frequent eye checks can help diagnose cataracts or other eye disorders early. Consult your doctor to determine how frequently you should have an eye test.
• Avoid smoking: Smoking tends to increase the risk of cataracts. Therefore, if you are a smoker, seek assistance on how to quit. Counselling and medications are among the recommended strategies.
• Manage other medical disorders: Appropriately managing diabetes and other health problems can help reduce the possibility of cataracts.
• Healthy diet: Consuming vegetables and fruits provides your body with essential nutrients, vitamins, and antioxidants, which are beneficial for eye health.

While there is no proof that antioxidant supplements can help prevent cataracts, a diet full of minerals and vitamins lowers the risks of the condition. Since vegetables and fruits have numerous health benefits, consuming them gives your body enough nutrients.

• Wear sunglasses: When outside, protect your eyes from exposure to ultraviolet (UV) light by putting on sunglasses that shield ultraviolet B rays. UV light from the sun is a known risk factor for cataracts.
• Limit alcohol consumption: Excessive alcohol drinking can increase the risk of developing cataracts.

Managing Cataracts

Living with cataracts can be generally challenging. However, implementing these coping strategies can assist in managing the symptoms and enhancing overall life quality:

• Using brighter light to read or do close-up chores to improve visibility.
• Using magnifying glasses or large print materials.
• Putting on polarized sunglasses to help minimize glare and enhance visual comfort outdoors.
• Using assistive devices like talking watches, large-button mobile phones, and magnifiers to improve day-to-day activities.
• Seeking emotional assistance and connecting with people with similar conditions by joining support groups or counselling.

Cataracts and Other Eye Problems

Cataracts and other eye conditions can occasionally co-occur, exacerbating the vision impairment further. The common eye problems that can coexist with cataracts are glaucoma, diabetic retinopathy, and age-related macular degeneration (AMD).

Managing more than one eye problem demands a comprehensive strategy, which includes regular eye tests, following the treatment plans, and having open communication with your doctor. In addition, addressing the underlying conditions ensures the best possible visual results and helps maintain general eye health.

Conclusion

Cataracts are common eye problems that greatly affect a person’s sight and quality of life. Maintaining overall eye health, therefore, requires identifying the symptoms, understanding the associated risks, and searching for early intervention through routine checks.