Cataracts

A cataract is a common eye condition and the leading cause of vision loss or blindness worldwide. The good news is that treatment is quick, painless and can restore your vision.

To understand more about cataracts, we share important aspects of the condition, so you know what to look for and do about it.

What are cataracts?

Imagine trying to see through a foggy window. That is what having a cataract can be like. 

A cataract is a cloudy area that forms in the lens of your eye. It can occur in one or both eyes. 

The cloudiness or blurriness in vision is caused by a breakdown of proteins in the lens of the eye. These proteins begin to group together as they break down, forming a cloudy, foggy area and making it harder for light to pass through. Over time, cataracts can lead to total vision loss or blindness.

What are the types of cataracts?

The type of cataracts you have is based on where and how they develop in the eye. 

The most common types of cataracts are:

• Nuclear sclerotic cataracts: This type forms in the center (nucleus) of the lens of your eye. It’s like having a foggy spot in the middle of a camera lens. 
• Cortical cataracts: This type starts at the edges of the lens of the eye and works its way toward the center. It’s like a fog that creeps in from the sides of a camera lens. This type looks like a spoke wheel or star pattern.
• Posterior subcapsular cataracts (PSC): This type forms on the back side of the lens, opposite your pupil (the black dot in the middle of your eye). It’s like having a haze at the rear end of a camera lens. PSCs usually develop faster than nuclear and cortical cataracts.

Less common cataracts include:

• Traumatic cataracts: A serious injury or trauma to the eye can lead to cloudiness.
• Radiation cataracts: Some types of radiation, like those used in cancer treatments, can cause cataracts.
• Pediatric cataracts (congenital cataracts): Some children are born with or develop cataracts later in childhood.
• Secondary cataracts: This can develop after cataract surgery. Sometimes, after removing the original cataract, scar tissue may form behind the artificial lens and lead to vision problems. Another procedure may be needed, usually a non-invasive procedure using a laser.

Am I at risk for cataracts?

Cataracts are very common. More than half of all Americans over the age of 80 have cataracts or have had surgery to remove them. 

Most cataracts are age-related, but there are also other reasons you can get cataracts. You may be at higher risk if you:

• Smoke
• Drink too much alcohol
• Have certain medical conditions like diabetes
• Have a family history of cataracts
• Had an eye surgery or injury
• Had radiation treatment on your upper body
• Spent a lot of time out in the sun without proper eye protection
• Long-term use of some medications like corticosteroids
• Have certain eye diseases like retina pigmentosa (RP) or uveitis

What are the symptoms of cataracts?

Cataracts can happen in one or both eyes. Most cataracts form slowly, but the symptoms usually get worse as they grow and affect a larger portion of your lens.   

Symptoms may include:

• Blurry or cloudy vision
• Trouble seeing well at night
• Colors seem faded or less bright
• Increased sensitivity to light
• Seeing halo around lights
• Double vision
• Needing a brighter light for reading
• Frequent changes in your glasses prescription

How are cataracts diagnosed?

Cataracts are diagnosed during regular eye exams with an eye care specialist (ophthalmologist or optometrist). Your eye care specialist will use several tests to look at your vision and the health of your eyes. 

These tests may include the following:   

• Eye dilation: Eye drops are placed in each of your eyes to widen (dilate) your pupils. This allows the eye doctor to see the back of your eye, including the retina and optic nerve. Pupil dilation is not painful, but it can make your vision blurry and your eyes more sensitive to light for a few hours.
• Visual acuity: This test examines how well you can see at different distances. You will be asked to read letters or numbers from an eye chart 20 feet away.
• Slit-lamp exam: The eye care specialist will use a light and microscope to look inside your eye and check for any problems.

If your eye doctor suspects you have cataracts, they may order additional tests. These tests may include an imaging test called an optical coherence tomography or an ultrasound to scan the eye.

Treatment for cataracts

Surgery is the only way to remove a cataract and restore clear vision. However, you may not need surgery right away. 

Early care of cataracts

In the early stages, you can make small changes to manage cataracts. This may include using brighter lights at home and work, wearing magnifying lenses for reading and getting a new prescription for eyeglasses or contacts. 

Surgery

As the cataract worsens and gets in the way of your daily life, surgery can replace the cloudy lens with a clear, artificial one called an intraocular lens (IOL). Cataract surgery is one of the safest and most commonly performed surgeries in the United States. It is usually performed on one eye at a time to minimize the risk of possible complications. 

Many types of IOLs are available, including monofocal, extended depth of focus and multifocal lenses. The type you receive will depend on your eye condition and needs.

Cataract surgery has come a long way, and several surgical techniques are available today. Here are the main types:

• Phacoemulsification (Phaco): This is the most common type of cataract surgery. The surgeon makes a small cut and uses high-frequency ultrasound waves to break up the cloudy lens, which is suctioned out. 
• Extracapsular cataract extraction (ECCE): This older technique involves a larger incision to remove the cloudy lens in one piece. ECCE is used if an ultrasound is unable or unlikely to break down the cataract. It usually has a longer recovery time.
• Femtosecond laser-assisted cataract surgery (FLACS): A laser is used to perform some surgery steps, like creating a tiny cut and softening the lens, before using ultrasound to remove it. FLACS is a newer technique that is still evolving but becoming more popular.

After cataract surgery, your vision will be blurry for a little while. You’ll need an eye shield and sunglasses to protect your eye while it heals. The good news is that your eyes should heal within a few days or weeks.

Your surgeon should be able to identify which type of cataract surgery is right for you and help you choose the best course of action. The proper treatment for one person may not be the right choice for you. A good surgeon will explain your options and help you take the right action.

What is the outlook for people with cataracts?

After surgery, most people see much better. It’s a common and safe procedure, often leading to improved vision and a better quality of life. Most people experience a quick recovery, returning to normal activities within a week.

While every person’s experience may vary, cataract surgery is a well-established solution for restoring clear vision. Regular follow-up appointments with an eye care provider are important to address any concerns.

Can I prevent cataracts?

While you cannot prevent cataracts, you can take steps to reduce your risk and promote overall eye health. Here are some tips:

• Quit smoking
• Protect your eyes from UV rays
• Eat a balanced diet
• Drink plenty of water
• Manage chronic diseases like diabetes
• Get regular eye exams
• Protect your eyes from injury
• Exercise regularly

We’re here to help

If cataracts are starting to impact your quality of life, then it’s time to remove them. Speak with an eye care specialist or a Banner Health expert to discuss which surgery is right for you.