Cataracts Demystified: Everything You Need to Know

Shilpi Jain
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Dr. Kaushal

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cataracts

Aging brings a lot of health issues with itself; one of the common disorders is Cataracts.

It is also the most common cause of age-related blindness. 

According to the Lancet, the prevalence of Cataracts increases with age from just 3.9% at 45-55 years to 95.6% at 80 years. 

While this eye disorder is associated with the natural aging process, various causes and risk factors contribute to its development. 

This article aims to provide a comprehensive discussion of Cataracts, covering their symptoms, causes, types, diagnosis, treatment options, and prevention.  

What is Cataract

Cataracts are the clouding of the eye’s lens, which may lead to gradual loss of vision.  

The clear and transparent eye lens loses its transparency with the development of Cataracts. 

It can cause diminished visual acuity, blurred vision, and challenges in performing routine tasks.

Cataracts are usually associated with aging, but smoking, Diabetes, and Hypertension can also increase the risk. 

Treatment options for cataracts include surgery, a safe and effective procedure to remove the lens opacification. 

Cataract symptoms

Photophobia SymptomsSource: klebercordeiro_from_Getty_Images
Photophobia (Light Sensitivity)

The Cataract symptoms might not be visible at first but get severe as the disorder worsens. 

Several causes of Cataracts lead to protein breakdown in the eye lens.  

The symptoms occur due to protein clumps that prevent the retina from sending a clear image to the brain. 

The most common symptoms of Cataracts include, 

  • Cloudy vision
  • Faded colors
  • Yellowing vision 
  • Photophobia
  • Halo around lights
  • Double vision
  • Losing vision

What causes Cataracts

Aging is the most common cause of Cataracts due to the gradual changes in the eye. 

Several factors can cause protein breakdown in the lens.

It accumulates as lumps causing a yellowish or brownish tint in the vision, which affects the lens’s transparency. 

Following are the possible underlying factors that cause protein breakdown, which might lead to Cataract.

Diuretics

Studies have shown that potassium-sparing diuretics have a higher risk of developing Cataracts. 

Diuretics can absorb excess amounts of UV rays which can affect the retina leading to protein breakdown, causing lens opacity. 

Oxidative stress

The overproduction of these oxidants (inflammatory molecules) in the body can lead to oxidative stress, resulting in Cataracts. 

It decreases protein solubility in the lens, causing opacity and obstruction in vision. 

Diabetes

Diabetic person consulting a doctorSource: pixelshot
Diabetic person consulting a doctor

Diabetes Mellitus patients are often at risk of developing Cataracts.

It is probably due to the swelling in the eye’s lens due to high amounts of sugar in the fluid. 

Steroid overuse

Prolonged use of steroids has been linked to Cataract development in people over 60. 

The steroid-induced Cataract is caused when they bind to lens proteins leading to protein damage in the eye lens. 

Smoking

Smoking can increase the free radicals in the eyes, which can damage the proteins leading to their breakdown. 

Fact:
According to a 2019 study, the prevalence of Cataracts among smokers was 52.60%, and men who used tobacco in any form had a higher prevalence of Cataracts (67.57%). Tobacco smoking was strongly associated with a higher prevalence of nuclear and Cortical Cataracts.

UV rays

Ultraviolet radiation can damage the lens protein by causing oxidative reactions in the lens. 

This may lead to the accumulation of protein clumps leading to opacification of the lens. 

Who is at risk of developing Cataracts

Several factors can increase an individual’s risk of developing Cataracts. 

The primary risk factor is age, as Cataracts are more prevalent among older individuals. 

Other risk factors include:

  • Family history Cataracts may increase the likelihood of developing them
  • Heavy alcohol consumption can also increase the risk of Cataracts by building calcium clumps in the lens
  • Conditions such as obesity and Hypertension can elevate the chances of Cataracts
  • Physical injury to the eye can lead to the formation of Cataracts

Types of Cataracts

Based on the symptoms, causes, and location in the lens, Cataracts can be of several types. 

Some common types of Cataracts include:

Age-related Cataracts

This is the most common type and occurs due to natural aging. 

It typically develops slowly over time, leading to a gradual clouding of the lens.

Congenital Cataracts

These Cataracts are present at birth or develop during early childhood. 

Genetic factors, infections during pregnancy, or metabolic disorders may cause them.

Traumatic Cataracts

These Cataracts result from an eye injury or trauma. 

Blunt force or penetrating injuries to the eye can disrupt the lens fibers and lead to clouding.

Radiation Cataracts

Exposure to ionizing radiation, such as in certain Cancer treatments or occupational settings, can cause Cataracts to develop. 

These Cataracts may also appear years after the radiation exposure.

Cortical Cataracts

Cortical Cataracts begin as white, wedge-shaped opacities on the outer edges of the lens.

They gradually extend toward the center, resembling the spokes of a wheel.

Nuclear Cataracts

Nuclear Cataracts form in the central or nuclear region of the lens. 

They typically start as a yellowing or browning discoloration and can progress to cause significant vision impairment.

Posterior subcapsular cataract

In the Posterior Subcapsular Cataract, a small cloudy or opaque area appears on the back of the lens.

This Cataract’s symptoms develop rapidly, and one can notice it within some months.

Secondary Cataracts

Secondary Cataracts develop as a secondary complication of other eye conditions or systemic diseases. 

They may also appear after a successful Cataract surgery. 

Diagnosis

Cataract diagnosis involves a comprehensive eye examination performed by an expert such as an ophthalmologist or optometrist. 

They may review your medical history, including any symptoms, and may perform the following tests to diagnose the type of Cataract, 

Visual acuity test

This test measures how well you can see at various distances using an eye chart to assess the clarity of your vision.

Slit-lamp examination

Slit Lamp ExamSource: microgen_from_Getty_Images
Slit lamp exam

A slit lamp allows the eye care professional to examine the structures of your eyes to detect any abnormalities or signs of Cataract formation.

Dilated eye examination

The eye care professional may dilate your pupils using eye drops to examine the back of your eye, including the lens, to identify the presence and severity of Cataracts.

Visual tests

Additional visual tests may be conducted to evaluate the impact of Cataracts on your vision, such as glare and contrast sensitivity and color perception tests.

Warning
If you fall in the group of individuals at risk of developing Cataracts, go for regular eye exams. Early diagnosis and intervention can help preserve and improve your vision.

Treatments

The primary treatment for Cataracts is surgical intervention. 

Cataract surgery is a safe and effective procedure involving removing and replacing the cloudy lens with an Artificial Intraocular Lens (IOL). 

It is usually an outpatient procedure and is generally well-tolerated. 

There are mainly three types of Cataract surgery performed to treat the condition,

Phacoemulsification

This is the most common technique used for Cataract surgery. 

It involves making a small incision in the cornea, through which a tiny probe is inserted to break up the cloudy lens using ultrasound waves. 

The lens fragments are then removed, and an IOL is inserted.

Extracapsular Cataract extraction (ECCE)

This technique is typically used for advanced or complicated Cataracts. 

A larger incision is made to remove the lens in one piece, leaving the rear portion of the lens capsule intact to support the IOL.

Femtosecond laser-assisted Cataract surgery

This advanced technique utilizes a laser to perform precise incisions and fragment the lens, enhancing the accuracy and safety of the procedure.

Patients may experience some mild discomfort following surgery, but these symptoms typically resolve quickly.

Side Effects of Cataract Surgery

Nuclear CataractSource: Nipitphand_from_Getty_Images
Cataract Surgery

Cataract surgery is a highly safe and effective procedure, but it can have potential side effects.

Here are some of the potential side effects of Cataract surgery:

  • Infection in the eye may cause increased redness, pain, swelling, or discharge from the eye
  • Some individuals may experience mild to moderate inflammation in the eye following Cataract surgery
  • Swelling of the cornea can occur, leading to temporary blurry vision, but it usually resolves on its own
  • Cataract surgery can increase the risk of developing or exacerbating Glaucoma
  • Retinal detachment can also occur after a Cataract surgery 

Most individuals who undergo Cataract surgery experience improved vision without significant complications.

But, it is best to consult a doctor if you are experiencing any persistent side effects. 

Prevention

It is impossible to prevent Cataracts entirely, but certain lifestyle choices and measures can help reduce the risk of developing Cataracts or delay their onset. 

Here are some preventive strategies that may be beneficial:

  • Protect your eyes from UV radiation
  • Quit smoking and limit alcohol consumption
  • Eat a balanced and nutritious diet 
  • Keeping these conditions under control can help reduce the risk of Cataract development
  • Use proper eye protection to prevent eye injury 
  • Routine eye examinations allow for early detection and monitoring of any changes in your eye health, including the development of Cataracts
  • Limit prolonged use of Corticosteroids

Other than the preventive measures, regular eye examinations and staying connected with your doctor are important to monitor your eye health.  

Conclusion

Cataracts have a significant impact on the quality of life for individuals, particularly as they age. 

It can result in blurred vision, difficulty performing daily tasks, and a significant vision reduction. 

However, with advancements in medical technology and surgical techniques, Cataract treatment has become highly successful. 

Regular eye exams and appropriate medical care can reduce the risk of complete vision loss.  

Additionally, preventive measures such as avoiding UV radiation and managing underlying health conditions can delay the onset of Cataracts. 

Hence, timely diagnosis and treatment can help you reduce the risk of complete vision loss due to Cataracts. 

Frequently Asked Questions

How do you get Cataracts?

Cataracts develop when the proteins in the eye lens break and clump together, causing clouding and decreased transparency. This can be due to aging, long-term exposure to sunlight, certain medical conditions like diabetes, or eye injuries. 

When should Cataracts be removed?

Cataracts should be removed when they significantly affect a person’s quality of life or impair vision to the point where it impacts their ability to perform tasks such as reading or driving. The decision is made in consultation with an Ophthalmologist.

How do you know if you have Cataracts?

Common signs and symptoms of Cataracts include blurred or cloudy vision, increased sensitivity to light and glare, and frequent changes in eyeglass prescription. An eye examination by an Ophthalmologist can confirm the presence of Cataracts.

Is cataract surgery painful?

Cataract surgery is not usually painful as it is performed under local anesthesia, numbing the eye. Patients may feel pressure or a slight sensation during the procedure, but discomfort is minimal. Postoperative pain is rare and can be managed with medication if necessary.

Citations:
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