A cataract is a clouding, opacification, yellowing, or accumulation of fluid in the lens of the eye that results in a loss of vision that interferes with your lifestyle. Most cataracts are related to aging, and by the time you reach the age of 70 it is almost universal to have some early signs of cataracts.
Age related cataract may occur in one eye first but with time will usually be present in both.
The lens is a clear part of the eye that helps to focus light, or an image, on the retina. The retina is the light-sensitive tissue at the back of the eye that is lined with the photoreceptor cells registering light.
A healthy lens is transparent and passes most of the light to the retina, filtering out some UV. The retinal photoreceptor cells change light into nerve signals that are sent to the brain area in the back of the head.
When the lens becomes cloudy from a cataract, the image you see will be blurred.
Most cataracts are related to aging, but some are have other causes such as trauma, eye diseases,and developmental abnormalities. Eye surgery for glaucoma and other conditions can lead to cataract formation. Certain health conditions like diabetes can also cause cataracts, occasionally very rapidly and in some instances reversible. Prescription steroid medications used long term can result in cataract development. Traumatic cataracts result after serious eye injuries but usually will not progress over time like age related cataracts. Infants occasionally are born with cataracts or develop them in early childhood, often in both eyes. These cataracts may be so small that they do not affect vision. While technically a cataract, I feel opacities need to cause lifestyle interruptions before they should be labeled as a cataract. If they do, the lenses may need to be removed. Radiation exposure can result in cataracts if the dose is high enough or accumulates over repeated exposure.
The lens lies behind the iris and the pupil, the black opening you see in the eyes. The lens adjusts the eye’s focus like the zoom on a camera, allowing us to see things clearly both up close and far away. The lens is made of mostly water with small amounts of protein and other substances. The protein is arranged in precise layers that keep the lens clear and lets light pass through it. When this pattern is disrupted vision becomes hazy and blurry.
There are steps you can take to reduce your risk of developing cataracts. Smoking is a major risk factor for cataract development as well as most causes of blindness. Reducing your UV sun exposure by wearing quality sunglases that meet A.N.S.I. standards is helpful. Sunwear that wraps and blocks sun exposure from the side is even more helpful.
Although research studies have given mixed results, time will probably bear out a protective effect of antioxidants on the lens tissue. Supplementation with vitamin C, lutein, zeaxanthin, and vitamin E likely will be shown to reduce cataract development. Eating foods that are complex carbohydrates such as whole grains and less refined foods with a lower glycemic index are associated with a decreased risk of cataract formation. Leafy green leafy vegetables, fruit, and other foods with antioxidants are always the best source of supplements.
Annual comprehensive dilated eye health exams are vital to monitor for cataracts and allow your optometrist to check for signs of macular degeneration, glaucoma, and other eye diseases. Early treatment and detection of eye disease may save your sight and life!
The most common symptoms of a cataract are:
- Cloudy or blurry vision.
- Colors seem faded.
- Glare. Headlights, lamps, or sunlight may appear too bright. A halo may appear around lights.
- Poor night vision.
- Frequent prescription changes in your eyeglasses or contact lenses as your eyes become more nearsighted.
Cataracts do not require surgery until they interfere with your lifestyle. In rare cases, the lens can rupture causing serious problems. This is almost unheard of today as eye doctors are widely accessible in all areas of the United States. A new eyeglasses prescription, brighter lighting, anti-glare sunglasses, or magnifying lenses can all be used to help in the interim period. Cataract surgery has a success rate over 95% today and replaces the lens with an artificial implant. Frequently your prescription for distance will be significantly reduced after surgery. Many patients find they have only occasional need for glasses for distance. Some lens implants available today provide some reading capacity also. Most of the time delaying cataract surgery will not cause long-term damage to your eye so you should not feel a need to rush into surgery.
Cataract removal may become essential when other eye diseases in the eye such as macular degeneration or diabetic related complications need to be visualized well to be followed. Even if your eye doctor tells you you have a cataract, your cataract may never develop to the point where surgery is required.
If you have cataracts in both eyes, the surgery may be necessary on one eye only for good vision. If surgery is required on both eyes it will be done at separate times several months apart. This is a much safer approach should complications occur, and allows for refinement of procedure if the first outcome is slightly off.
As with any surgery, cataract surgery does have some risks. Infection inside the eye is the most serious, but rare complication. Lenses may be displaced, cause damage to other tissues in the eye, and the retina tissue in the back of the eye may have swelling or detachments. Some prescription medications predispose you to problems during surgery so be sure to discuss all of your prescriptions with your eye doctor well in advance of eye surgery. Flomax, a prescription used to treat benign prostatic hyperplasia (BPH) has been associated with Intraoperative Floppy Iris Syndrome (IFIS). IFIS can cause problems during cataract surgery so you should be sure to inform your eye doctor if you are any prostate medications. Before cataract surgery, your doctor may ask you to temporarily stop taking certain medications that increase the risk of bleeding during surgery. Over the counter drugs like aspirin and advil may fall in this category. After surgery, you must keep your eye clean, wash your hands before touching your eye, and use the prescribed medications to help minimize the risk of infection. Serious infection can result in loss of vision.
Cataract surgery slightly increases your risk of retinal detachment. Other eye disorders, such as high myopia (nearsightedness), can further increase your risk of retinal detachment after cataract surgery. One sign of a retinal detachment is a sudden increase in flashes or floaters. Floaters are little “cobwebs” or specks that seem to float about in your field of vision. If you notice a sudden increase in floaters or flashes, call your optometrist immediately. A retinal detachment is a medical emergency. If necessary, go to an emergency service or hospital. Early treatment for retinal detachment often can prevent permanent loss of vision.
For a few days after surgery, your eye doctor may ask you to use several eyedrops to help healing and decrease the risk of infection. You will need to wear an eye shield or eyeglasses to help protect your eye. Avoid rubbing or pressing on your eye. Sun glasses will be needed to protect your eyes from the bright glare we have in Fort Collins and Northern Colorado.
When you are home, try not to bend from the waist to pick up objects on the floor. Do not lift any heavy objects. You can walk, climb stairs, and do light household chores.
In most cases, healing will be complete within eight weeks. Your doctor will schedule exams to check on your progress.
Problems after surgery are rare, but they can occur. These problems can include infection, bleeding, inflammation (pain, redness, swelling), loss of vision, double vision, and high or low eye pressure. With prompt medical attention, these problems can usually be treated successfully.
Months or years after cataract surgery cell growth can occur on the artificial lens obscuring vision. This is frequently referred to as after cataracts. A simple, brief laser procedure done in the office quickly resolves this problem.
Cataracts surgery is one of the most successful procedures done today. While you don’t want to rush into any surgery you can rest assured knowing if your vision does become problematic you have a good treatment option available. Medicare will cover cataract surgery when your eyesight has degraded to a designated level. Many types of vision insurance, including Vision Service Plan, provide coverage of cataract surgery under some of their policies. You will need to check with your provider to find out what is covered under your plan. Some types of lens implants are usually excluded.
