Everything You Need To Know About Cataracts

Cataracts are a common visual impairment that is often associated with ageing. They can obscure the passage of light to your retina, resulting in reduced visual clarity or altogether compromised vision. In this article we will be exploring everything about the condition, its causes, contributing risk factors, and treatments available.

What is a cataract?

In the simplest terms, a cataract Is a cloudy area that can form in the eye’s lens. This can prevent light from passing through the eye and reaching the retina. The retina is a structure in the eye that converts stimulation from light into signals that are then sent to the brain via the optic nerve.

As such, if something interferes with the amount of light that reaches the retina, it can lead to a reduced sensitivity to visual stimuli. Cataracts can form in both of your eyes, but it is unusual for them to develop simultaneously. They are one of the leading causes of visual impairment in older people.

How do cataracts form?

Cataracts begin to form when proteins in the eye begin to clump together in a cloudy mass that prevents light from passing through the lens effectively. This is due to a natural occurrence where the proteins in the eyes normally start to break down at around age 40. The clump can become worse over time, gradually becoming more noticeable.

Types of cataracts

There are many types of cataracts that patients need to be aware of. They can be caused by a number of factors, both internally and externally. The main types of cataracts are:

• Nuclear cataracts (Cataracts forming the center of the lens)
• Posterior subcapsular cataracts (cataracts forming at the back of the lens)
• Cortical cataracts (cataracts forming at the edges of the lens)
• Congenital cataracts (cataracts you’re born with)

Various types of cataracts are classified on where and how they form in your eye. For example, nuclear cataracts form in the middle of the lens, whereas cortical cataracts develop around the edge of the nucleus. You may also develop posterior subcapsular cataracts at the back of the lens. This type of cataract creates a ‘halo effect’, which makes it difficult for the patient to read.

They may also develop as a result of certain life events. For example, they can be congenital and be present from birth or form within the first year of a baby’s life. Otherwise, they could be secondary cataracts caused by another ailment or a side effect of certain medication.

You might also develop cataracts from a traumatic event like a head injury. Cataracts caused by penetrating or blunt trauma can start to develop days or even years after the injury. So it’s important to go for regular checkups with your ophthalmologist to ensure you aren’t developing cataracts.

What causes cataracts?

As discussed above, cataracts can develop for various reasons. These include the natural process of ageing, traumatic life events, or comorbidities. While some of these, like an injury to the eye, are unpredictable, several risk factors can increase an individual’s likelihood of developing cataracts. Some of these are:

• Old age
• Drinking alcohol frequently and excessively
• Smoking
• Being overweight or obese
• Having high blood pressure
• Family history of cataracts
• High exposure to the sun or UV radiation
• Diabetes
• Exposure to radiation such as X-rays or cancer treatments

Are cataracts hereditary?

There is a strong genetic link to cataract development. We are all at risk of developing the condition as we age, but you might be more likely to develop the ailment if there is a history of cataracts in your family. Some forms of cataracts, like congenital cataracts or other types associated with systemic diseases, are also strongly linked to genetic factors.

Symptoms of cataracts

The symptoms of cataracts often develop gradually over time, so it can be difficult to notice them before they begin to significantly impact your vision. However, there are some common signs that you might need to visit an ophthalmologist to diagnose the presence of cataracts. These include:

• Blurred eyesight
• Difficulties seeing at night
• Differences in how you perceive colours
• Sensitivity to glare
• Halos around lights
• Double vision
• Frequently changing your glasses prescription

If you are experiencing any of these symptoms, please book a consultation today with one of our experienced ophthalmologists to see how we can help.

Glaucoma and cataracts

Glaucoma is a common condition that is caused by damage to the optic nerve. It is usually caused by a build-up of fluid in the front of the eye, leading to increased pressure within the organ.

While glaucoma doesn’t cause cataracts, it can make them worse in certain situations. For example, glaucoma surgeries like a trabeculectomy or drainage devices like shunts or tubes can accelerate the formation of cataracts. Additionally, there are some common risk factors shared by glaucoma and cataracts. For example, they can both stem from topical steroids used for treating inflammation.

Diabetes and cataracts

Diabetes is one of the key factors that play a role in an individual’s likelihood of developing cataracts. While the interaction between diabetes and cataract formation is not yet fully understood, it is clear that those living with diabetes have a much greater risk of visual impairment. Damage to the eyes is thought to be related to blood sugar levels, so by controlling these effectively, you can reduce the risk of diabetes-related cataracts.

For more information, please visit our diabetes and eye health page.

Cataracts and driving

Unfortunately, due to certain symptoms of cataracts like blurred vision and increased difficulty with vision at night, the disease can compromise your ability to drive. However, this will likely depend on the severity of the condition.

You are not legally required to inform the DVLA of your cataracts as long as you still meet the vision standards for driving. So, as long as you can still read a car number plate from 20 metres away and you have a visual acuity of at least 0.5 on the Snellen scale, you should be okay to drive.

If you are a bus, coach, or lorry driver, there are some slightly different standards. You still need to meet the government’s visual standards for driving, but you also need to show that you do not have an increased sensitivity to glare due to cataracts.

Cataracts treatment

If they are not treated, cataracts can significantly interfere with daily activities and even result in complete blindness. While they might stop growing, they do not get better without medical intervention, so it is essential to find a treatment that works for you.

While a common choice is to undergo surgery to remove cataracts, some people do not wish to have surgery on their eyes unless it is absolutely essential. As such, a doctor might prescribe methods of managing the symptoms. You might be prescribed stronger glasses or anti-glare sunglasses if the condition is mild.

Cataracts surgery

Doctors will often recommend surgery if your cataracts are preventing you from carrying out day-to-day activities. For example, if you have trouble reading or driving, a doctor might suggest surgery to remove cataracts.

The most common cataract treatment is called phacoemulsification cataract surgery. This technique involves a tiny device that vibrates at ultrasonic speed to fracture the lens into small particles. The tiny particles are then removed by a small vacuum through a tiny slit no larger than 2.40 mm.

There are various other surgical techniques to remove cataracts, and these are typically very safe. Overall, fewer than 1% of people will experience complications from cataract surgery.

How to prevent cataracts

While your risk of developing cataracts increases as you age, there are some steps that you can take to reduce the chances of cataract formation. A good way to do this is to protect your eyes from UV radiation when you’re outside by wearing sunglasses as the sun can cause cataracts. Additionally, consider lifestyle changes like:

• Quitting smoking
• Eating fruits and vegetables high in antioxidants
• Maintaining a healthy weight.
• Stay on top of your blood sugar levels if you have diabetes

Finally, one of the best ways to prevent cataracts and manage their formation as you age is to have regular eye examinations. Therefore, consider scheduling routine appointments with Eye Clinic London to stay on top of your ocular health and identify any issues as and when they occur. Taking a proactive approach to your vision is one of the best ways to preserve your eyesight as you age, so regular check-ups are essential.

To find out more or to schedule an eye examination, please book a consultation with one of our experienced practitioners.