Cataract Awareness: A Guide

A cataract is the clouding of the part of your eye called the crystalline lens. Your vision becomes blurred because the cataract is like frosted glass, interfering with your sight.

If your optometrist has told you that you have a cataract, don’t be alarmed. Many people over 60 have cataracts and the vast majority can be treated successfully.

In this guide, we’re going to cover all things cataracts from causes and symptoms to diagnosis and treatment options.

 

How Cataracts Form

As you get older, the lenses in your eyes become less clear and thicker. Aging and some medical conditions can cause proteins and fibres within the lenses to break down and clump together. This is what causes the clouding in the lens.

As the cataract develops, the clouding becomes worse. A cataract scatters and blocks the light as it passes through the lens. This prevents a sharply defined image from reaching your retina. As a result, your vision becomes blurred.

You can develop a cataract in just one eye or both of them.

 

Causes of Cataracts

The main cause of cataracts is age and the changes which usually happen naturally as you get older. Certain factors make you more likely to get cataracts, these include:

• Diabetes
• An injury to your eye
• Bad inflammation of your eye
• Exposure to UV light in sunlight over a long time
• Taking medicines called corticosteroids in high doses or for a long time
• Smoking
• Drinking too much alcohol
• Female gender
• Severe dermatitis
• High blood pressure
• A family history of cataracts

 

Symptoms of Cataracts

The symptoms of cataracts include:

• Clouded, blurred, or dim vision
• Trouble seeing at night
• Sensitivity to light and glare
• Need for brighter light for reading and other activities
• Seeing ‘halos’ around lights
• Frequent changes in glasses or contact lens prescriptions
• Fading or yellowing of colours
• Double vision in one eye

At first, the cloudiness in your vision caused by a cataract may affect only a small part of the eye’s lens. You may not notice any vision loss. As the cataract develops, it clouds more of your lens. More clouding reduces the light passing through the lens.

 

Types of Cataracts

There are different types of cataracts that can affect adults. These form in different parts of the lens in your eye.

• Nuclear Cataracts: Are cataracts affecting the centre of the lens. A nuclear cataract may at first cause objects far away to be blurry but objects up close to look clear. A nuclear cataract might even improve your reading vision for a short time, but with time the lens slowly turns more yellow or brown and makes your vision worse. It may become difficult to tell colours apart.

• Cortical Cataracts: Are cataracts that affect the edges of the lens. A cortical cataract begins as white, wedge-shaped spots or streaks on the outer edge of the lens cortex. As the cataract slowly grows, the streaks spread to the centre and affect light passing through the lens.

• Posterior Subcapsular Cataracts: Are cataracts that affect the back of the lens. A posterior subcapsular cataract starts as a small spot that usually forms near the back of the lens, right in the path of light. A posterior subcapsular cataract often affects your reading vision. It also may reduce your vision in bright light and cause glare or halos around lights at night. These types of cataracts tend to grow faster than others.

• Congenital Cataracts: Are cataracts you’re born with. Some people are born with cataracts or develop them during childhood. These cataracts may be passed down from parents. They may also be associated with infections or trauma whilst in the womb.

Diagnosing Cataracts

If you think you have symptoms of cataracts, get your eyes tested by your optometrist. They will look into your eyes using a special instrument called an ophthalmoscope.

If you have a cataract, your optometrist will be able to see that the lens of your eye is cloudy. Your lens may look a different colour when they shine a bright light into your eye – it may be a yellow-brown colour or look grey or white.

Your optometrist may also carry out a slit-lamp exam. A slit-lamp exam allows your optometrist to see the structures at the front of your eye up close. It’s called a slit lamp because it uses an intense line of light (a slit) to light up the structures in your eye. The slit allows your optometrist to view these structures in small sections.

 

Cataract Treatment

When your prescription glasses can no longer sharpen your vision, the only effective treatment for cataracts is surgery.

Before you have cataract surgery, you’ll have an appointment with a specialist who will examine and measure your eye.

You’ll have cataract surgery in a hospital and it typically takes about 15-20 minutes.

It’s usually done under a local anaesthetic. This means you’ll be awake, but you should not feel any discomfort. The local anaesthetic may be given as eye drops, an injection, or both.

Cataract surgery involves removing the clouded lens and replacing it with a clear artificial lens. The artificial lens, called an intraocular lens, is put in the same place as your natural lens. It remains a permanent part of your eye.

During the surgery, you may see movement and changes of light and shade, but you are unlikely to see any details of what’s happening.

Usually you will not need stitches after cataract surgery and your eye will heal by itself. Your eye will be covered with a dressing to keep it clean. You should be able to go home on the same day, but do NOT drive yourself home.

You’ll be given eye drops to help your eye heal and prevent infection. You’ll usually need to take these eye drops for about 4 weeks.

 

Cataracts in Children

Whilst cataracts most commonly affect older adults; some babies are born with cataracts. Children can also develop them at a young age, these are known as childhood cataracts.

Childhood cataracts are often referred to as:

• Congenital Cataracts: Cataracts present when a baby is born or shortly afterwards.
• Developmental, Infantile, or Juvenile Cataracts: Cataracts diagnosed in older babies or children.

Cataracts in babies and children are rare. In the UK, around 3 to 4 in every 10,000 babies are born with cataracts.

As well as poor vision, cataracts can also cause ‘wobbling eyes’ and a squint, where the eyes point in different directions.

There are many reasons why a child may be born with cataracts or develop them while they’re still young. But in many cases it is not possible to determine the exact cause. Possible causes include:

• A genetic fault inherited from the child’s parents that causes the lens to develop abnormally
• Certain genetic conditions such as Down’s Syndrome
• Certain infections picked up by the mother during pregnancy, including Rubella and Chicken Pox
• An injury to the eye after birth

Children may undergo surgery to remove the affected lens if the cataracts are affecting their vision.

 

Cataracts and Driving

If you are a driver, you must reach the visual standard required by the Drivers and Vehicle Licensing Authority (DVLA), and it may be necessary to have the cataract removed in order to keep your licence. Ask your optometrist for more details.

 

If you’re worried about your eyesight or vision health, visit your local Opticare Opticians branch and speak to one of our expert optometrists today.