Cataracts

What is Cataracts?

A cataract is the fogging that occurs in the normally clear eye lens, a membrane that sits on top of your eye. Having a cataract is a bit like looking through a foggy window or taking a picture with a messy camera. This limits your ability to see details, especially at night, and can make it more difficult to read, use a computer, or drive. Cataracts may also cause sensitivity to light and glare, dulled vision, and/or ghost images. Cataracts take time to develop and their effects will not kick in early on, but they will eventually interfere with your eyesight.      

   Eating a healthier diet, being in a stronger light, or using glasses can help you with cataracts in the beginning. But if they start getting in the way of daily activities, it is time to look into cataract surgery. Do not worry, cataract surgery is a safe and effective procedure. If you do not have surgery, your vision will get worse over time.

   Cataracts develop with ageing as the proteins in your eye lens break down and clump up, and the fog that you see is the clumps of proteins. Over time these clumps get bigger and more severe. You are more likely to develop cataracts sooner if you have the following risk factors:    

• Past eye inflammation or injury    
• Diabetes    
• Steroid use (topical or systemic    
• Excessive alcohol consumption    
• Family history of early cataracts    
• Smoking    
• Too much sunlight exposure

Cataract Symptoms

• Foggy, blurred, and/or dimmed vision  
• Vision is tinted slightly yellow    
• Impaired night vision    
• Sensitivity to light and glare    
• Needing brighter light for reading and other activities    
• Seeing “halos” around lights    
• Frequently changing eyeglass or contact lens prescriptions    
• Double vision in one eye  

Types of Cataracts

• Cataracts you are born with or develop early on (congenital cataracts). Some babies are born with these cataracts or develop them in childhood. These cataracts are often genetic or from an infection or trauma inside the womb. These cataracts might also be due to certain conditions. Sometimes, congenital cataracts might not affect a person’s eyesight, but they should be removed soon after discovery if they do.  
• Cataracts that begin on the edges of the eye lens (cortical cataracts). Cortical cataracts begin as white, opaque, wedge-shaped streaks on the edge of the lens. As they slowly progress, the streaks make their way to the center of the lens and degrade vision.  
• Cataracts that begin in the center of the eye lens (nuclear cataracts). These cataracts may temporarily improve close-up vision, but with time, they yellow further and fog your eyesight. If the cataract continues, it might even begin browning. The cataract will keep yellowing or browning and can make it hard to distinguish colors.  
• Cataracts that affect the back of the eye lens (posterior subcapsular cataracts). Posterior subcapsular cataracts start as small, opaque areas that form near the back of the lens, in the path of light. They often interfere with your reading vision, limit your vision in bright light, and cause glare or halos around lights at night.     

Tests

To determine if you have a cataract, your doctor will review your medical history and symptoms, and perform an eye exam. Your doctor may perform various tests, including:

• Visual acuity test: A visual acuity test uses an eye chart to measure your visual acuity. Each eye is tested one at a time. Using a chart or a viewing device with progressively smaller letters, your eye doctor determines if your vision shows signs of impairment.  
• Visual acuity test: A visual acuity test uses an eye chart to measure your visual acuity. Each eye is tested one at a time. Using a chart or a viewing device with progressively smaller letters, your eye doctor determines if your vision shows signs of impairment. This allows your doctor to detect any small abnormalities.  
• Retinal exam: To prepare for a retinal exam, your eye doctor dilates your pupils using eye drops. This makes it easier to examine the back of your eyes (retina). Your eye doctor can examine your lens by using a slit lamp.  

Treatment

Cataract surgery involves removing the natural lens and replacing it with an artificial lens. The artificial lens, called an intraocular lens or IOL, works the same way a natural lens works and remains a permanent part of your eye. Some eye problems prohibit the use of an IOL. In these situations, eyeglasses or contact lenses are used to correct vision. During cataract surgery, surgeons use a local anesthetic to numb the area around the eye, but the patient stays awake during the procedure, which normally lasts about an hour or less.      

Lens options

Accommodating Intraocular Lenses – An “accommodating” intraocular lens provides good distance vision and usable intermediate distance vision. In most cases, the patient can see the large text without reading glasses but need them for small text.

Monofocal Intraocular Lens

The Monofocal lens is the standard IOL and is designed to correct a patient’s distance vision. With this lens, you can see well from a distance, but your close-up vision remains impaired. This means that you will need glasses to read or do other similar activities.  

Multifocal IOL

Multifocal lenses are lenses that provide the patient with distance, intermediate, and/or reading vision. This lens may not be the best option, as some patients are bothered by unusual distance or reading vision. Some other common side effects include impaired vision in bright light and halos around light at night.  

Toric IOL

These lenses help people with astigmatism see at distance or near rather than other IOLs would.