Cataracts

A cataract is a clouding of the eye's natural lens, which sits behind the iris and pupil. Cataracts are the leading cause of vision loss worldwide but are highly treatable with surgery that restores clear vision.

What Cataracts Feel Like

Common symptoms include:

• Blurry or hazy vision—like looking through a foggy window
• Increased sensitivity to light and glare
• Halos around lights, especially at night
• Difficulty with night driving
• Faded or yellowed colors
• Frequent eyeglass prescription changes
• Double vision in one eye (less common)
• Need for brighter light when reading

Types of Cataracts

Nuclear Cataracts

• Most common type
• Forms in the center (nucleus) of the lens
• Causes gradual yellowing and hardening
• May temporarily improve near vision ("second sight")

Cortical Cataracts

• Forms in the outer edge (cortex) of the lens
• Wedge-shaped opacities that extend inward
• Often causes glare and light sensitivity

Posterior Subcapsular Cataracts

• Forms at the back of the lens
• Develops more quickly than other types
• Particularly affects reading vision and causes glare
• More common with steroid use and diabetes

Congenital Cataracts

• Present at birth or develops in childhood
• May be inherited or due to infection during pregnancy
• Requires early treatment to prevent amblyopia

What Causes Cataracts

Age (Most Common)

• Natural aging process of the lens
• Proteins denature and aggregate over time
• Nearly universal by age 75-80

Risk Factors

• Diabetes—accelerates cataract formation
• Smoking—doubles or triples risk
• Excessive alcohol use
• Prolonged sun exposure without protection
• Previous eye injury or surgery
• Long-term corticosteroid use
• Radiation exposure
• Family history

When to Seek Care

How Cataracts Are Diagnosed

Comprehensive Eye Exam

• Visual acuity test—reading letters on a chart
• Slit-lamp examination—magnified view of lens structures
• Dilated eye exam—detailed view of lens and retina
• Glare testing—measures vision under bright conditions
• Contrast sensitivity—ability to distinguish shades

Measurements for Surgery

If surgery is planned:

• Biometry—measures eye length and lens power
• Corneal topography—maps cornea shape
• OCT imaging—checks retinal health

Treatment Options

Watchful Waiting

For early cataracts:

• Update eyeglass prescription
• Use brighter lighting
• Anti-glare coatings on glasses
• Magnifying aids for reading
• Surgery when vision significantly impacts quality of life

Cataract Surgery

Indications:

• Vision problems interfering with daily activities
• Cannot achieve satisfactory vision with glasses
• Cataract prevents treatment of other eye conditions

The procedure:

• Outpatient surgery (20-30 minutes)
• Local anesthesia (no general anesthesia needed)
• Cloudy lens removed via small incision
• Clear artificial lens (IOL) implanted
• Usually no stitches required

Success rate:

• 95%+ of patients achieve improved vision
• One of the most successful surgeries performed

Recovery After Surgery

First Week

• Use prescribed eye drops
• Wear protective shield at night
• Avoid rubbing the eye
• No heavy lifting or strenuous activity
• Vision often noticeably clearer within days

First Month

• Gradual vision improvement
• Some fluctuation in vision is normal
• Most restrictions lifted after 2-4 weeks
• New glasses prescription after vision stabilizes

Prevention

While cataracts cannot be completely prevented:

• Wear sunglasses with UV protection
• Quit smoking
• Control diabetes and other health conditions
• Limit alcohol consumption
• Eat a healthy diet rich in antioxidants
• Regular eye exams for early detection

Frequently Asked Questions

Will my cataract come back after surgery?

The cataract itself cannot return because the natural lens is removed. However, some patients develop posterior capsule opacification ("secondary cataract") where the membrane behind the IOL becomes cloudy. This is easily treated with a quick laser procedure.

How do I know when it's time for surgery?

Surgery is typically recommended when cataracts interfere with activities important to you—driving, reading, hobbies, or work. There's no benefit to waiting until cataracts are "ripe."

Can I have both eyes done at the same time?

Usually, one eye is done at a time, with the second eye treated 1-4 weeks later. This allows the first eye to heal and ensures good vision in at least one eye during recovery.

Will I still need glasses after surgery?

It depends on the type of intraocular lens (IOL) implanted. Standard IOLs typically require reading glasses. Premium IOLs (multifocal or accommodating) may reduce or eliminate the need for glasses.

Are there drops or medications to treat cataracts?

Currently, no eye drops or medications can reverse or cure cataracts. Some research is ongoing, but surgery remains the only effective treatment.

Can cataracts cause blindness?

Untreated cataracts can eventually cause severe vision loss, but this is reversible with surgery. Cataract-related blindness is a significant problem in developing countries with limited access to surgery.

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