If you’ve ever come across fogged-over car headlights, stared at an impressionist painting such as Van Gogh’s “Starry Night,” or peeked through a cloudy piece of glass, chances are you had to squint or strain your eyes to get a clearer view of what you were looking at. These fuzzy depictions often illustrate the world of people who have cataracts.
Cataracts affect more than 24 million Americans age 40 and older, according to the American Academy of Ophthalmology. And by age 75, half of all Americans have cataracts, according to the National Eye Institute. In honor of Cataract Awareness Month in June, discover how they develop, what the symptoms look like, how they’re treated and how your vision can pay the price if you ignore them.
See the signs
According to the National Eye Institute, a cataract is a clouding of the lens in the eye that impacts a person’s vision. This clouding may become so severe that it leads to blurred sight.
“Overall, most cataracts are due to age-related changes in the lens of the eye that cause it to become cloudy or opaque,” says Dr. Ryan Parker, an optometrist in Ardmore, Oklahoma. “However, other health-related issues like diabetes, trauma and heavy drinking can lead to a higher risk for cataracts.”
Research has shown that a clumping of the protein that’s in the lens also may cause cataracts, according to Dr. Christopher Quinn, president of the American Optometric Association. As people age, he says, some of that protein might clump together and begin to cloud a small area of the lens. This is a cataract. And over time, it could get larger and cloud more of the lens, which makes it more difficult to see.
“Several studies also suggest that there may be an association between cataract formation and low levels of antioxidants, such as vitamin C, vitamin E and carotenoids,” Quinn says.
The NEI says there are several types of cataracts. Most are related to aging, but some might develop after an eye injury (traumatic cataract), as well as surgery for other eye problems such as glaucoma (secondary cataract). Some babies also can be born with cataracts or develop them during childhood, according to the NEI. Lastly, a radiation cataract may happen after exposure to some types of radiation.
The main symptoms include clouded, blurred or dim vision, Parker says. This cloudiness caused by a cataract may affect a small part of the lens, and you might not become aware of any vision loss. But as the cataract gets bigger, it clouds more of the lens and distorts the light that passes through it.
“People with cataracts also experience sensitivity to light and glare with increasing difficulty with vision at night,” he says. “Colors also may not appear as bright as they once did. I tell my patients that if they notice any change in their vision, it is important to make an appointment and have your vision checked as soon as possible.”
Eyes on the prize
In some cases, a change in your eyeglass prescription may improve vision if a cataract is worsening, according to Parker. Another solution is cataract surgery, which is a procedure to remove the lens of the eye and replace it with an artificial lens, he says.
Quinn says as with any other surgery, cataract surgery carries with it similar risks of bleeding and infection. He says it’s important to discuss the risks but also the benefits of surgery with an eye doctor before you make a decision about moving forward with it.
“The risk of a serious complication from cataract surgery is low, generally less than one in 1,000,” Quinn says, adding that it’s one of the safest and most effective surgeries performed.
“Approximately nine in 10 cataract surgery patients report better vision following the surgery.”
Quinn says cataracts are only diagnosed through a comprehensive eye exam, so be sure to visit your eye doctor regularly. The American Optometric Association recommends adults ages 18 to 60 who have no known eye health risks to have an eye exam with an optometrist every two years. People who have known risks should visit every one to two years. For people age 65 and older, the AOA recommends visiting an optometrist annually, unless otherwise recommended.
Ophthalmologist Dr. Ming Wang of the Wang Vision Institute in Nashville, Tennessee, says if cataracts are ignored and subsequently cataract surgery is ignored, the condition can become very severe. They’ll then have a chance to mature, and vision most likely will continue to worsen, Wang says.
People also might become legally blind from untreated cataracts, which can also cause total blindness if left untreated. The longer you wait for surgery, the more rigid and dense the cataract becomes.
“In rare circumstances … it can lead to painful and permanent loss of vision associated with eye inflammation or glaucoma,” Wang says. “For those with severe cataracts, vision activities are often affected significantly and because the onset is gradual, over time they can be somewhat unaware of the severity.
“For instance, I had a patient who came in for their visit one day after cataract surgery and was very upset. Initially, we were concerned she was dissatisfied with surgical outcome. ‘Dr. Wang,’ she remarked, ‘A few months ago I painted my dining room what I thought was a lovely shade of red. Today, I realized it’s purple! None of my family told me! Now I have to repaint.’ She was having significant color variation because of the density of her cataracts.”
Parker says recovery time after cataract surgery is typically minimal. People will need someone to drive them home following the surgery, and they should avoid driving themselves for the rest of the day.
“Patients are also given a pair of sunglasses to protect their eyes from bright light and glare,” Parker says. “In the week following surgery, care must be taken not to bend over or pick up heavy objects to make sure the newly implanted lens remains secure. Eye drops are prescribed after surgery to prevent infection and help the healing process.”
Eye experts urge staying proactive about your eye health. After all, like clockwork everybody gets older, and “everyone will eventually develop cataracts,” Parker says.