Everything You Need To Know About Cataract

What are Cataracts?

Cataracts develop when the natural lens ages and starts giving you hazy vision, extra sensitivity to light, reduced perception of colors, and struggling with foggy vision at night. According to the World Health Organization, almost 17% of people all across the globe have cataracts that give them hazy vision. However, the prevalence can significantly vary for different regions and countries.

This is an age-related eye condition but may also develop due to an injury, long-term medication use, or underlying health conditions like diabetes. As the cataract advances, it hampers daily routines such as reading, driving, or recognizing faces. If not treated in time, cataracts can eventually cause significant vision loss or even blindness.

Fortunately, cataracts can be easily treated with a safe and effective surgery that restores clear vision. Early diagnosis makes treatment easier and better surgical outcomes. 

How do cataracts form?

A cataract forms over the eye lens, which is responsible for focusing the light that enters the eye. The lens is present behind the colored part of the eye, i.e., the iris. It produces a clear and sharp image of the retina. Due to reasons like aging, trauma, radiation exposure, etc., the mechanism of the lens may get disturbed. It will lead to the accumulation of clumps of lens protein. With increased protein deposition, it forms a cloudy layer over the lens, which obstructs the transmission of light to the retina.

So, this condition of cloudy eyesight is called a cataract which keeps progressing with time, making the lens denser, thicker, with opaque. As a result, you get a hazy vision that doesn’t get better.

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Causes of Cataract

• Aging gradually gives you cloudy vision

• Eye trauma can haunt your sight years later.

• Radiation exposure silently clouds your lens over time.

• Genetics may make you more prone to cataract formation despite your efforts.

• Smoking and alcohol rob also affect vision clarity.

• Vitamin C deficiency weakens your eyes and gives hazy vision.

• Diabetes and other conditions can also be major causes of cataract formation.

• Birth defects are yet another common cause of cataracts

• Corticosteroid overuse may lead to cloudy eyesight
  

Symptoms of cataract

• Blurry or cloudy vision, as if you are looking through a hazy window
• Nighttime becomes difficult due to cloudy vision in low light
• Seeing double images in one eye makes it a frustrating and confusing condition
• Bright lights or sunlight cause painful glare and treatment
• Even with glasses, it is difficult to read because of hazy vision
• Seeing lights halos or glowing rings, especially when you’re driving during the night
• Your eye power (refractive error) keeps changing, but there is no improvement in cloudy vision

Faded color perception makes everything appear with a yellowish tint or dull

Types of Cataracts

The different types of age-related cataracts that commonly develop in the eyes include:

Nuclear Cataracts

It is a type of cataract that starts developing at the center of the lens, i.e., the nucleus. It gradually progresses and results in yellow or brown cataracts. If you have a nuclear cataract in one or both eyes, you will at first have nearsightedness, i.e., your nearby vision will improve temporarily.

Cortical Cataracts

A cortical cataract starts as a whitish streak that appears on the outer edge of the cortex lens. This type of cataract also progresses slowly and extends to the center over time, interfering with the light that passes through the center of the lens.

Posterior Subcapsular Cataracts

A posterior subcapsular cataract appears at the back of the lens as a small opaque area in the direct path of the light. It affects the reading vision, reduces the vision in bright light, and causes glares. It progresses quicker than other types of cataracts.

Congenital Cataracts

It is a type of cataract that people are born with or develop during childhood due to trauma, genetics, or intrauterine infection. They usually don’t affect vision. However, if your vision gets affected, you must get them removed as soon as possible.

There are other less common types of cataracts as well including:

• Secondary cataracts are caused by medications or some other diseases, such as glaucoma or diabetes.
• Traumatic cataracts that develop after an injury may take years to develop.
• Radiation cataracts form when a person undergoes radiation treatment for cancer.

Cataract Diagnosis

Tests

• Visual Acuity & Refraction Test

Both these tests are done to examine the sharpness or clarity of your vision. One eye is tested at a time to look for signs of impairment.

• Slit-lamp Examination 

In this exam, a microscope is used to emit an intense line of light (slit) that illuminates the cornea, iris, lens, and the space in between. It allows the eye doctor to see the structures of the eye under magnification and detect abnormalities, including early-stage cataracts.

• Retinal Examination 

To perform a retinal exam, the eye doctor will first dilate your pupils and examine the back of the retina. This helps the doctor to identify whether the light rays are able to reach the retina or not. Generally, an ophthalmoscope is used to detect eye problems like cataracts at the early stage.

Self Diagnosis

To diagnose a cataract yourself, you can try using various self-tests available on the web. These tests take only a few minutes and you’ll be able to confirm whether you have a cataract eye or not.

Besides that, you can also experience your eye lens becoming opaque and the vision declining over time. If you are aware of the symptoms of cataracts, this will also help to recognize that cataracts may be developing in one or both eyes.

Diagnosis by Doctor

If you suspect that you have a cataract, you should see an ophthalmologist. He/she will perform a comprehensive eye exam and suggest some tests.

At first, the doctor will perform a physical exam by dilating your pupil to see the internal components of the eye. If cataracts have advanced to the chronic stage, the doctor will be able to see them clearly during the physical exam. If not, then diagnostic tests will be recommended that includes:

• Visual acuity and refraction test
• Retinal Examination
• Slit-lamp examination
• Applanation tonometry, if needed

Stages of Cataracts

Cataracts usually progress gradually and take years to mature. Over time, the cataract will cover more area of your natural lens as it becomes severe. The severity of cataracts are:

• Early Cataracts- It is the initial stage of cataracts at which the lens is almost clear but its ability to change focus is compromised. Due to this, symptoms like blurry vision, glare from lights, and increasing eye strain start to appear.
• Immature Cataracts- At this stage, the protein starts to accumulate on the lens, giving cloudy vision and slightly opaque lens. Along with vision problems, other symptoms like light sensitivity also appear. You may need eyeglasses or anti-glare lenses to see nearby.
• Mature Cataracts- In this stage, the cataract starts to mature, and the opacity of the lens further increases. The lens appears milky white or amber in color and the vision is also considerably affected.
• Hypermature Cataracts- It is the most serious stage of cataracts when the lens is significantly damaged. If doctors don’t remove it within the right time, a hyper mature cataract can cause inflammation in the eye or increase the eye pressure that can cause glaucoma.

Cataract Risks & Complications If Left Untreated

The effects of cataracts are determined by how fast it is advancing. In the beginning, cataracts will negatively impact your daily life as you won’t be able to read, work, drive, or follow any of your hobbies due to reduced vision.

Eventually, if cataracts are left untreated, they will cause total blindness that will be irreversible.

Cataract Prevention

Various studies have been done to find out if it is possible to prevent cataracts from developing or even slow their progression. 

Though there are no sure shot ways to completely prevent cataracts in human eyes, doctors recommend the following to slow down cataract formation:

• Have regular eye examinations that help you detect early stage cataracts.

• Either completely quit or cut back on smoking as much as possible. Take help in the process if needed (medication or counselling).
• Take care of health conditions like diabetes that add to the risk of developing cataracts.
• Make sure that your diet has fresh fruits and vegetables with antioxidants and is rich in fiber, vitamins, and minerals.
• Avoid UV light exposure and wear sunglasses as much as possible

• Alcohol can also increase the risk of cataracts