June 5, 2013

Cataracts are a very common eye condition which can reduce vision and quality of life with their progression. Responsible for up to 51% of the world’s blindness, cataracts often develop slowly over the course of years. Thankfully, in the United States we have lower rates of vision complications due to cataracts (when compared to more prevalently affected areas like Africa, Indonesia, the Middle East, India, and Burma) because of our medical advances and availability of care.


Cataracts are a clouding of the natural intraocular lens of the eye; this clouding can lead to visual distortions and decreased quality of life, especially if left untreated. Cataracts reduce vision by lens opacification, meaning that the lens can become so dense that it limits the eye’s ability to pass light through to the retina, where the majority of our vision occurs. The term cataract is derived from the latin cataracta, meaning waterfall; comparing the cloudiness of a cataract-affected lens to the frothy white waters produced by Niagara Falls is an apt comparison.


Age-related cataracts are a natural progression, but certain lifestyle factors can expedite the rate of progression and increase the significance of cataract severity. Smoking, steroid use, and exposure to UV-B light can increase how quickly cataracts are developed. Cataracts can also be related to trauma or can be congenital. Age-related cataracts often begin much earlier than we would like to think; approximately 42% of people in the US between the ages of 52-64 have some semblance of cataract. This percentage increases with age; 91% of US adults between the ages of 75-85 will have developed cataracts.


The most common symptoms of cataracts include blurred vision, distorted vision, decreased color perception, glare, halos around lights, and decreased visual acuity in poor lighting conditions. Because age-related cataracts develop over many years, patients may not notice the severity of their condition because their vision has been slowly decreasing over time. This is one reason why it is integral to have routine eye examinations with your eye care provider. Cataracts, especially advanced cataracts, can increase your risk for injuries at home, while driving, and at work; when your vision is decreased, your ability to react quickly and appropriately for certain situations may also be decreased.


Depending on your degree of cataract severity, your eye care specialist may recommend monitoring your eyes for progression or cataract surgery. Surgery in the United States is most commonly done through a procedure called phacoemulsification; this procedure uses ultrasonic waves to break up the cloudy lens before it is removed through a small incision in the eye. The cloudy lens is replaced with a clear, plastic lens which can often provide significant vision improvements, even without glasses! There are many types of lenses used for cataract surgery, but the most common lens is a monofocal intraocular lens, which corrects for one range of vision, usually distance vision. Post-operatively, patients will need to use eye drops, an eye shield for sleeping for a period of time, and will need to limit their exertive activities and avoid exposure to dusty, dirty environments.